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Clinical Scenario: Exercise-associated muscle cramps (EAMC) are sudden, painful, and involuntary contractions of skeletal muscles during or after physical activity. The best treatment for EAMC is gentle static stretching until abatement. Stretching is theorized to relieve EAMC by normalizing alpha motor neuron control, specifically by increasing Golgi tendon organ activity, and physically separating contractile proteins. However, it is unclear if stretching or flexibility training prevents EAMC via the same mechanisms. Despite this, many clinicians believe prophylactic stretching prevents EAMC occurrence. Clinical Question: Do athletes who experience EAMC during athletic activities perform less prophylactic stretching or flexibility training than athletes who do not develop EAMC during competitions? Summary of Key Findings: In 3 cohort studies and 1 case-control study, greater preevent muscle flexibility, stretching, or flexibility training (ie, duration, frequency) was not predictive of who developed EAMC during competition. In one study, athletes who developed EAMC actually stretched more often and 9 times longer (9.8 [23.8] min/wk) than noncrampers (1.1 [2.5] min/wk). Clinical Bottom Line: There is minimal evidence that the frequency or duration of prophylactic stretching or flexibility training predicts which athletes developed EAMC during competition. To more effectively prevent EAMC, clinicians should identify athletes' unique intrinsic and extrinsic risk factors and target those risk factors with interventions. Strength of Recommendation: Minimal evidence from 3 prospective cohort studies and 1 case-control study (mostly level 3 studies) that suggests prophylactic stretching or flexibility training can predict which athletes develop EAMC during athletic competitions. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revija Šport is the property of Sport: Revija Za Teoreticna in Praticna Vprasanja Sporta and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Since scoliosis is a three-dimensional deformity, it causes some movement limitations in the spine and related joints. However, functional limitations associated with scoliosis-related hip joint involvement are the subject of research. Aims: This study aims to investigate the physical characteristics and functional limitations associated with idiopathic scoliosis (IS), focusing on hip joint. Methods: Demographic characteristics, scoliosis-specific assessments and hip joint active range of motion (RoM), lumbar mobility (Modified Schober test), lumbopelvic stability (Single leg squat test-SLS), hip joint position sense, lower extremity balance (Y-balance test) and lower extremity functionality (Lower extremity functional scale-LEFS) were evaluated. Results: The study included 120 individuals, with 86 in the scoliosis group (mean age: 15.7 ± 3.4 years) and 34 in the control group (mean age: 16.1 ± 4.8 years). The scoliosis group exhibited limited RoM of the hip joint in flexion, extension, right abduction, adduction, internal rotation, and left external rotation compared to controls (p < 0.001). Lumbar mobility was decreased (p < 0.001). In the joint position sense test, the mean difference for right flexion was and for left flexion. Bilateral decreased SLS test performances (p < 0.001) and Y-balance test performance (p < 0.05) in individuals with IS. LEFS scores were statistically different but not clinically different between groups (p < 0.05). Conclusion: Individuals with IS show decreased hip mobility, lumbopelvic stability, hip joint position sense, and balance compared to healthy peers; however, these limitations do not have a clinical impact on daily living activities. [ABSTRACT FROM AUTHOR]

Objectives: The study was conducted to investigate the effect of Yoga-based exercise program on pain, range of motion (ROM), quality of sleep, depression and quality of life in female patients with myofacial pain of temporomandibular disorders (TMD). Materials and methods: 39 Female patients with myofacial pain of TMD were included in the study. Yoga based exercise program was performed to the first group and second group was control group. Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), neck and jaw ROM, Pittsburg Sleep Quality Index (PUQI), Beck Depression Inventory (BDI) and Short Form 36 (SF36) were evaluated. Evaluations were repeated before treatment and 6 weeks later. Results: From the measurements, a decrease in Temporomandibular Joint (TMJ) (p = 0.005) and neck pain (p = 0.031) was found to be significant in favor of Yoga Group. It was also observed that the increase in ROM in the neck right lateral flexion (p = 0.001) in favor of Yoga Group. The sleep quality did not change. In yoga group, a decrease in depression level (p = 0,023) and increase Quality of life in parameters of physical function (p = 0.023), vital capacity (p = 0.026), emotional health (p = 0.002), mental health (p = 0.080) were found as significant, statistically. Conclusions: It was concluded that yoga-based exercise program can be used as an alternative program in patients with myofacial pain of TMD. Further study on myofascial pain of TMD is recommended. Clinical relevance: Yoga-based exercise program can be used in patients with myofascial pain due to TMD. [ABSTRACT FROM AUTHOR]

Objective To develop a CT-based scoring system for assessment of hip arthropathy in AS. Methods All AS patients were prospectively recruited, consented and underwent whole-body stereoradiographs and pelvis CT, which were assessed by two independent radiologists. Stereoradiographs were assessed according to Kellgreen-Lawrence and BASRI-h. For the Hip arthropathy CT score in AS (HACTSAS), joints were divided into 7 segments and scored for joint space, osteophytes, subchondral cysts/erosions. Patients were clinically assessed for range of motion (ROM), pain and clinical scores (BASMI, BASFI, ASQol, BASDAI and ASDAS). Radiological scores correlations with clinical parameters were compared. ROM sensitivity and specificity for hip arthropathy (BASRI-h ≥ 2) were calculated. Results Sample included 112 patients, with 36/112 females and 76/112 males. Average age was 51.0 ± 11.2 years and mean duration of AS was 20.9 ± 9.6 years. Intraclass correlation coefficients (ICC) for HACTSAS, Kellgreen-Lawrence and BASRI-h were 0.89, 0.89 and 0.82, respectively. HACTSAS showed moderate absolute correlation with ROM (ρ =  −0.41) and BASMI (ρ =  0.45), and weak with pain (ρ  =   0.18) and BASFI (ρ  = 0.25). BASRI-h and Kellgreen-Lawrence exhibited moderate correlation with ROM (ρ =  −0.44 and ρ =  −0.40, respectively), weak with pain (ρ =  −0.27and ρ =  −0.23, respectively) and BASFI (ρ =  −0.16 and ρ =  −0.18, respectively), but only weak with BASMI (ρ =  −0.34 and ρ =  −0.36, respectively). Internal rotation <15°, abduction <31° and intermalleolar distance <75cm were, respectively, 73%, 70% and 73% sensitivity and 81%, 65% and 68% specific for hip arthropathy. Conclusion HACTSAS exhibited higher correlation with BASMI and BASFI when compared with BASRI-h, but less correlation with pain and ROM. Internal rotation was the best clinical discriminator for hip arthropathy. [ABSTRACT FROM AUTHOR]

Introducation: This study aimed to clarify whether or not the prolonged effect of a 180-s static stretching (SS) exercise could be maintained for a longer period by performing an additional short-term (15-s) SS exercise following a 15-min rest. Methods: The participants were 15 healthy untrained adult males in three conditions: (1) SS condition (180-s SS exercise only); (2) SS + 15 s condition (180-s SS and 15-s SS exercise during the rest period); and (3) noSS + 15-s condition (15-s SS exercise only). The knee flexion range of motion (ROM), pain pressure threshold (PPT), and tissue hardness were measured before (PRE), immediately after (POST), and 15 min and 30 min after the SS exercise. Results and discussion: Significant interaction effects were observed in all variables. Post hoc tests showed that knee flexion ROM showed an immediate significant change (P < 0.05) and also at 15 min and 30 min after the SS exercise in the SS + 15 s condition. Tissue hardness showed an immediate significant decrease (P < 0.05) and also at 15 min, but not at 30 min after the SS exercise in the SS + 15 s condition. The additional short-term (15 s) SS exercise in the rest period may have a potential long-lasting effect on ROM increase and tissue hardness decrease. [ABSTRACT FROM AUTHOR]

Background: We currently lack clear definitions for structural and symptomatic spinal osteoarthritis (OA). To define spinal OA and create diagnostic criteria for this condition, it is necessary to determine the relationship between clinical signs and symptoms of back pain and radiographic features of OA. Notably, recent studies suggest a defining sign of spinal OA could be a limited or painful spinal range of motion (ROM). Therefore, our objective was to assess the association between restricted or painful active spinal ROM, and multilevel structural features of lumbar disc degeneration (LDD) (i.e., disc space narrowing, osteophytes) on radiographs. Methods: We used the baseline data from the'Back Complaints in Older Adults' (BACE) study. The association between a limited or painful active spinal ROM, and multilevel disc space narrowing or osteophytes was assessed using multivariable logistic regression adjusted for age, mean pain intensity in the previous week, sex, BMI, and the Fear Avoidance Belief Questionnaire score. Primary analyses were performed on imputed datasets. Results: We included 675 patients with a mean age of 66.52 years (SD 7.69). Limited latero-flexion (fingertip that at best reached halfway up the upper leg) was associated with increased odds of having multilevel osteophytes (OR 1.85; 95% CI: 1.13 to 3.01). However, a limited or painful ROM in other directions (i.e., rotation, ante-flexion) was not associated with multilevel osteophytes, and a limited or painful active ROM in any direction was found to have no association with multilevel disc space narrowing. Conclusions: Our study indicates that a restricted ROM in latero-flexion could potentially be a defining sign in future definitions of symptomatic spinal OA. However, since our results partially differ from previous studies, further research is needed to explore the association between active ROM and LDD. [ABSTRACT FROM AUTHOR]

Introduction: In the early postoperative period after total knee arthroplasty (TKA), joint range of motion (ROM) limitation and increased stiffness due to pain are commonly observed. Previous studies have reported that a single bout of foam rolling (FR) can acutely increase ROM and pain threshold on the contralateral (non-intervention) side in healthy participants. In this study, we aimed to expand this knowledge for TKA rehabilitation and investigated the acute effects of FR intervention on the non-operative side on ROM, stiffness, and pain of the operative side in postoperative patients within the first week after TKA. Materials and methods: The study employed a randomized crossover design: 20 patients (mean age 75.0 ± 7.8 years) in the first postoperative week after TKA were divided alternately into Roll_Break and Break_Roll groups in the order of prescription. In the Roll_Break group, after the initial evaluation, a 180-s (60-s × three sets) FR intervention using a roller massager by a physiotherapist for the knee extensors was performed on the contralateral side (non-operative side), followed by the measurement. Afterwards, after 180-s of supine at rest, the measurement was performed again (i.e., control phase). In the Break_Roll group, after the initial evaluation, each patient was placed in a seated resting position for 180-s, and then another measurement was performed (i.e., control phase). After this, the FR intervention was performed for 180-s, and then the measurement was performed again. The intensity of the FR intervention was set to the maximum intensity that did not cause pain. We measured pain using the visual analogue scale at rest and during the knee joint ROM measurements, knee joint active movement ROM, knee joint passive ROM, and stiffness during the knee joint active movement. Results: All outcome variables showed significant improvements after the FR intervention (intervention phase) when compared pre- to post-intervention, and significantly favourable effects were found compared to the control condition. Conclusion: The results showed significant improvements in ROM, pain, and stiffness of the operative side after the FR intervention on the non-operative side. For future therapy approaches for TKA patients, FR treatment of the non-operative side should be employed in the first weeks after surgery. [ABSTRACT FROM AUTHOR]

Background: Short term results of the change of center of rotation (COR) after Bryan cervical disc replacement (CDR) have been reported. However, there is a lack of long-term studies focusing on the COR and its influences on facet joint degeneration. Objective: To evaluate the long-term clinical and radiographic results of Bryan CDR, and to explore the influence of deviated COR on facet joint degeneration at index level. Methods: It is a retrospective follow up study conducted in China. Eighty-three consecutive patients who received single-level Bryan CDR were retrospectively reviewed. Clinical evaluation included Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), and Odom's scale. Radiographic evaluation underwent before surgery, at early follow-up (3 months) and last follow-up (10 years). The radiographic parameters included range of motion (ROM), location of COR presented by the coordinates (COR-x, COR-y), and facet joint degeneration score. Correlation analysis was conducted between changes of COR and facet joint degeneration score. Results: Fifty-nine patients were included, with an average age of 44.6 ± 7.4 years. The mean follow-up time was 135.7 ± 12.4 (120–155) months. JOA score, NDI and Odom's scale showed significant improvements at last follow-up. The ROM was well preserved through follow-up. 33 patients (55.9%) showed deterioration of facet joint degeneration at index level. The increment of facet joint degeneration score at index level was strongly correlated with the change of COR-x (r = 0.758, P < 0.001), and weakly correlated with the change of COR-y (r=-0.473, P < 0.001). The deviation of COR was significantly greater in Group Degeneration than that in Group Non-degeneration (14.8 ± 10.5% vs. -2.6 ± 8.1% for COR-x, and − 6.4 ± 7.5% vs. 0.8 ± 8.3% for COR-y). Conclusions: Bryan CDR with minimum of 10-year follow-up achieved favorable clinical outcome and good maintenance of ROM. Deviated COR could be an important risk factor for facet joint degeneration. [ABSTRACT FROM AUTHOR]

Background: Short term results of the change of center of rotation (COR) after Bryan cervical disc replacement (CDR) have been reported. However, there is a lack of long-term studies focusing on the COR and its influences on facet joint degeneration. Objective: To evaluate the long-term clinical and radiographic results of Bryan CDR, and to explore the influence of deviated COR on facet joint degeneration at index level. Methods: It is a retrospective follow up study conducted in China. Eighty-three consecutive patients who received single-level Bryan CDR were retrospectively reviewed. Clinical evaluation included Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), and Odom's scale. Radiographic evaluation underwent before surgery, at early follow-up (3 months) and last follow-up (10 years). The radiographic parameters included range of motion (ROM), location of COR presented by the coordinates (COR-x, COR-y), and facet joint degeneration score. Correlation analysis was conducted between changes of COR and facet joint degeneration score. Results: Fifty-nine patients were included, with an average age of 44.6 ± 7.4 years. The mean follow-up time was 135.7 ± 12.4 (120–155) months. JOA score, NDI and Odom's scale showed significant improvements at last follow-up. The ROM was well preserved through follow-up. 33 patients (55.9%) showed deterioration of facet joint degeneration at index level. The increment of facet joint degeneration score at index level was strongly correlated with the change of COR-x (r = 0.758, P < 0.001), and weakly correlated with the change of COR-y (r=-0.473, P < 0.001). The deviation of COR was significantly greater in Group Degeneration than that in Group Non-degeneration (14.8 ± 10.5% vs. -2.6 ± 8.1% for COR-x, and − 6.4 ± 7.5% vs. 0.8 ± 8.3% for COR-y). Conclusions: Bryan CDR with minimum of 10-year follow-up achieved favorable clinical outcome and good maintenance of ROM. Deviated COR could be an important risk factor for facet joint degeneration. [ABSTRACT FROM AUTHOR]

Background: Restriction of movement at a joint due to disease or dysfunction can alter the range of motion (ROM) at other joints due to joint interactions. In this paper, we quantify the extent to which joint restrictions impact upper limb joint movements by conducting a disability simulation study that used wearable inertial sensors for three-dimensional (3D) motion capture. Methods: We employed the Wearable Inertial Sensors for Exergames (WISE) system for assessing the ROM at the shoulder (flexion–extension, abduction–adduction, and internal–external rotation), elbow (flexion–extension), and forearm (pronation-supination). We recruited 20 healthy individuals to first perform instructed shoulder, elbow, and forearm movements without any external restrictions, and then perform the same movements with restriction braces placed to limit movement at the shoulder, elbow, and forearm, separately, to simulate disability. To quantify the extent to which a restriction at a non-instructed joint affected movement at an instructed joint, we computed average percentage reduction in ROM in the restricted versus unrestricted conditions. Moreover, we performed analysis of variance and post hoc Tukey tests (q statistic) to determine the statistical significance (p < 0.05 denoted using *) of the differences in ROM of an instructed joint in the unrestricted versus restricted conditions. Results: Restricting movement at the shoulder led to a large reduction in the average ROM for elbow flexion–extension (21.93%, q = 9.34*) and restricting elbow movement significantly reduced the average ROM for shoulder flexion–extension (17.77%, q = 8.05*), shoulder abduction–adduction (19.80%, q = 7.60*), and forearm pronation-supination (14.04%, q = 4.96*). Finally, restricting the forearm significantly reduced the average ROM for shoulder internal–external rotation (16.71%, q = 3.81*) and elbow flexion–extension (10.01%, q = 4.27*). Conclusions: Joint interactions across non-instructed joints can reduce the ROM of instructed movements. Assessment of ROM in the real-world using 3D motion capture, for example using the WISE system, can aid in understanding movement limitations, informing interventions, and monitoring progress with rehabilitation. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate whether telerehabilitation is as effective as face-to-face rehabilitation in terms of joint range of motion (ROM), edema, and functionality in patients operated for distal radius fractures (DRFs). Patients and methods: Between May 2022 and May 2023, a total of 54 patients (8 males, 46 females; mean age: 56.8±11.6 years; range, 24 to 77 years) who underwent volar plate due to DRF with direct X-ray and computed tomography (CT) were included in this single-blind, randomized study. The patients were randomly divided into the face-to-face rehabilitation group (FFG) and telerehabilitation group (TRG). The same rehabilitation program was applied as face-to-face and Home-Based Real-Time Video Conferencing (HBRVC) telerehabilitation. Demographic data and participation times in rehabilitation sessions were recorded. A perimeter was measured using the Figure of 8 method. The ROM of the joint was measured by goniometry. Hand grip strength was measured with a hand dynamometer, and pinch grip was measured with a pinch meter. The Patient-Rated Wrist Evaluation (PRWE) and Disabilities of the Arm, Shoulder and Hand Questionnaire (Quick-DASH) were used to assess functionality. Results: In the initial evaluation, no statistically significant difference was found between age, smoking, dominant hand, operated hand, sex, and the number of participants in rehabilitation sessions (p>0.05). Comparing the values at Week 12 and Week 2, the change in pinch meter (p=0.007) and hand grip (p=0.030) values was higher in FFG than TRG. The Quick-DASH change (p<0.001) and PRWE change (p=0.001) values were statistically significantly lower in TRG than in FFG. Conclusion: The HBRVC telerehabilitation program seems to be as effective as face-to-face rehabilitation on joint ROM and edema in patients undergoing volar plate fixation for DRF. However, the telerehabilitation method on functionality and muscle strength is less effective than face-to-face rehabilitation. [ABSTRACT FROM AUTHOR]

Background: The mechanism of ulnar collateral ligament (UCL) injury during pitching is excessive elbow varus torque (EVT). The EVT–ball velocity (T-V) relationship allows concurrent assessment of player performance and UCL injury risk. Modifiable physical capacities may underlie individual variation seen in the T-V relationship. Purpose: To identify physical performance characteristics that impact the T-V relationship during pitching. Study Design: Descriptive laboratory study. Methods: A total of 87 National Collegiate Athletic Association Division I pitchers participated. Pitching collection involved measurement of EVT and ball velocity during 5 maximal effort fastballs thrown to a catcher. Physical measures collected were the following: shoulder and hip passive range of motion (ROM) and strength, shoulder rate of torque development (RTD), grip strength, and lumbopelvic stability. Physical measures were entered into univariate linear mixed models with ball velocity as a covariate to predict EVT. Variable reduction for multivariate models involved selection of physical measures based on random forest–derived variable importance and univariate relationship significance, rendering a 27-variable pool. Multivariate linear mixed models predicting EVT, adjusting for physical measures and other physical characteristics, were then created using backward elimination. Results: In univariate analysis, for every 1 m/s (2.2 mph) increase in ball velocity, the mean EVT increased by 1.51 Nċm (95% CI, 0.66-2.37 Nċm; P =.001). In univariate analysis, hip abduction strength symmetry and bilateral lumbopelvic stability significantly increased EVT, while dominant-shoulder ROM, scaption RTD symmetry, and hip ROM significantly decreased EVT. Variables that increased EVT while controlling for ball velocity in the final model include grip strength symmetry, lead-leg lumbopelvic stability, and bodyweight. Increased dominant-shoulder internal rotation (IR) strength, dominant-shoulder flexion ROM, and scaption strength asymmetry decreased EVT as ball velocity increased. Conclusion: Several modifiable physical measures affected EVT in the univariate analysis. In our final model, when controlling for ball velocity, EVT increased with increased grip strength symmetry, lead-leg lumbopelvic stability, and bodyweight and decreased with increased dominant-shoulder IR strength, dominant-shoulder flexion ROM, and scaption strength asymmetry. Clinical Relevance: Defining the individual and multivariate effects of these physical capacities on EVT contextualizes their role in the T-V relationship and helps identify access points through which coaches and clinicians can optimize a pitcher's T-V relationship. [ABSTRACT FROM AUTHOR]

Acute effects of static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) on local and non-local range of motion (ROM) were assessed in 29 participants. Three evaluations were performed one week apart: week-1 Control session (CS); weeks 2–3 either SS or PNF interventions (randomized). Dominant and non-dominant limbs, local (hamstring extensibility) and non-local ROMs (Shoulder extension-ShE) were collected at baseline (T0), immediately after (T1), and fifteen minutes post-intervention (T2). No differences were found between time-points during the CS. Local-ROM significantly increased (p=0.0002, ES=0.74 and 0.0079, 0.56, for dominant and non-dominant lower limbs, respectively) after both SS and PNF. No interaction between time and treatment was detected for ShE in both limbs. However, post-hoc analysis revealed a significant increase in dominant upper limb ShE between T0 and T1 only after SS (p=0.002; +6.5%). Acute bouts of SS and PNF can increase local-ROM, however, no clear effects were observed for non-local ROM. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis has become the predominant manifestation of arthritic conditions on a worldwide scale and serves as a significant instigator of pain, impairment, and increasing socio-economic strain on a global level. The ongoing discourse on the choice between total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) for patients suffering from anterior medial osteoarthritis continues to ignite scholarly controversy. Our objective was to assess and compare the clinical outcomes of UKA and TKA within the same patient, hereby offering a novel perspective on this topic. Materials and methods: Fifty-seven individuals who underwent TKA on one knee and UKA on the other knee at the Department of Orthopaedics, First Hospital of Hebei Medical University between March 2019 and March 2024 were analysed for this retrospective study. We conducted a comprehensive examination and evaluation of perioperative laboratory assessments, radiological examinations, knee functionality, contentment levels, and postoperative complications within the two groups. Results: Following surgical procedures, levels of hemoglobin, red blood cells, and albumin were found to be elevated in the UKA group when compared to the TKA group (hemoglobin: 121.2 ± 12.54 vs. 110.1 ± 13.21 g/L; red blood cells: 4.0 ± 0.47 vs. 3.6 ± 0.42 *1012/L; albumin: 37.7 ± 5.66 vs. 35.3 ± 5.23 g/L). There is a significant difference in the hip-knee-ankle angles between the postoperative UKA group and the TKA group (5.3 ± 3.46° vs. 4.1 ± 2.86°, p < 0.05). There existed no notable disparity in postoperative visual analog scale, knee society score, and forgotten joint score between the two groups. However, a remarkable variance was observed in postoperative range of motion between the two groups (116.4 ± 5.96° vs. 108.4 ± 5.32°). Conclusion: We found that UKA resulted in less physical strain, less postoperative inflammatory response, improved joint mobility, although with less effective lower limb force line correction compared to TKA. Many patients have shown a preference for UKA and express higher levels of satisfaction with the procedure. [ABSTRACT FROM AUTHOR]

This study investigated the changes in fascicle length (FL), musculotendinous unit (MTU) stiffness, muscle oxygen saturation (SmO2), and muscular performance following a single bout of a combination of static stretching (SS) or dynamic stretching (DS) with foam rolling (FR), SS only, and eccentric exercise (ECC) only in young men with hamstring tightness. Twenty-five men (20.5 ± 1.5 years) participated in a crossover randomized study of the four conditions (DS+FR, SS+FR, SS, and ECC); each session was spaced seven days apart. FL, MTU stiffness during the straight leg raise (SLR), hamstring SmO2, and isometric and eccentric torque were measured before, immediately and 30 min after exercise. Immediately after exercise, the SLR increased significantly by means of 7.4% (d = 1.07), 6% (d = 1.27), 6% (d = 1.10), and 8% (d = 1.04, all p < 0.001) for DS+FR, SS+FR, ECC, and SS, respectively. FL was longer after exercise under all four conditions (p < 0.05). MTU stiffness decreased after ECC (p = 0.038, d = 0.40). SmO2 tended to decrease for ECC (p > 0.05), but it was increased immediately after those three exercises. Hamstring isometric torque was significantly reduced by an average of 6-9%, but eccentric torque changes varied among conditions. In conclusion, substantial and similar immediate increases in hamstring flexibility, coupled with reduced isometric torque following various exercises, were accompanied by condition-specific alterations in fascicle length, MTU stiffness, or SmO2. These findings provide practical insights for acutely enhancing range of motion in individuals with tight hamstrings. [ABSTRACT FROM AUTHOR]

Context: Somatic tinnitus is the conscious perception of auditory sensation in the absence of an external stimulus, characterized by buzzing, ringing, hissing, or whistling noises which can affect the quality of life. It may be caused by cervical and temporomandibular joint (TMJ) dysfunction. To date, there is no comprehensive physiotherapy protocol to manage somatic tinnitus with cervical and TMJ dysfunction. However, there is little evidence about individual physiotherapy approaches and no comprehensive integrated protocol exists for managing tinnitus holistically. Aims: This study aimed to develop and assess the feasibility of an integrated SPARKS physiotherapy protocol for individuals suffering from somatic tinnitus. Settings and Design: This feasibility study involved 22 participants clinically diagnosed with somatic tinnitus and were randomly assigned to either a control group or an experimental group. Materials and Methods: The integrated protocol was developed to manage somatic tinnitus using manual therapy, exercises, and virtual reality. The outcomes were assessed on days 1 and 28 using a tinnitus handicap inventory (THI), sleep disorder questionnaire (SDQ), and neck Bournemouth questionnaire (NBQ) to evaluate tinnitus symptoms, sleep quality, pain reduction, and neck disability. Results: Analysis demonstrated significant improvement in all three outcomes in the experimental group (P < 0.05). Between-group analysis of THI (P = 0.0001), SDQ (P = 0.0108), and NBQ (P = 0.0001) indicates a statistically superior improvement in the experimental group, in comparison to the control group (P > 0.05). Conclusions: This novel SPARKS physiotherapy protocol for somatic tinnitus has demonstrated superior effectiveness in managing tinnitus compared to traditional medical treatments and it shows a promising and safe multimodal approach. [ABSTRACT FROM AUTHOR]

Introduction: Mechanical Low Back Pain (MLBP) is a prevalent condition that significantly impacts individuals' quality of life and healthcare systems worldwide. The management of MLBP has explored various manual therapy techniques, including Maitland mobilisation; however, the immediate effects and comparative efficacy of these techniques remain subjects of ongoing investigation. Aim: To evaluate the immediate effects of Maitland mobilisation compared to other manual therapy techniques on flexion and extension Range of Motion (ROM) in patients with MLBP. Materials and Methods: The present systematic review involved a comprehensive search of electronic databases, including PubMed, Cochrane Library, and Google Scholar, from January 2017 to March 2024. The search utilised the keywords "Randomised Controlled Trials (RCTs)", "Maitland mobilisation", and "mechanical low back pain". Studies comparing the immediate effects of Maitland mobilisation with other manual therapy techniques on flexion and extension ROM in patients with MLBP were included. Data extraction and quality assessment were performed using established protocols. Results: Nine studies met the inclusion criteria and were included in the review. The findings revealed that Maitland mobilisation demonstrated significant immediate effects on both flexion and extension ROM in patients with MLBP. Improvements were particularly noted in lumbar flexion following Maitland mobilisation, while lumbar extension showed greater enhancement after specific techniques such as Posteroanterior (PA) mobilisation. Additionally, combination therapies, such as core stability exercises coupled with Maitland manual therapy, showed promising results in reducing disability associated with MLBP. Conclusion: This review investigated the immediate effects of Maitland mobilisation on ROM in MLBP. While some studies indicated improvements in ROM, the evidence for its effectiveness compared to other interventions and its longterm impact on pain and function remains unclear. Future welldesigned studies are needed to definitively assess the role of Maitland mobilisation in the management of MLBP. [ABSTRACT FROM AUTHOR]

Purpose: Improvements in breast cancer management continue to increase survival and life expectancy after treatment. Yet the adverse effects of treatment may persist long term, threatening physical, psychological, and social wellbeing, leading to impaired quality of life (QOL). Upper-body morbidity (UBM) such as pain, lymphoedema, restricted shoulder range of motion (ROM), and impaired function are widely reported after breast cancer treatment, but evidence demonstrating its impact on QOL is inconsistent. Therefore, the aim of the study was to conduct a systematic review and meta-analysis evaluating the effect of UBM on QOL following primary breast cancer treatment. Methods: The study was prospectively registered on PROSPERO (CRD42020203445). CINAHL, Embase, Emcare, PsycInfo, PubMed/Medline, and SPORTDiscus databases were searched for studies reporting QOL in individuals with and without UBM following primary breast cancer treatment. Primary analysis determined the standardised mean difference (SMD) in physical, psychological, and social wellbeing scores between UBM + /UBM − groups. Secondary analyses identified differences in QOL scores between groups, according to questionnaire. Results: Fifty-eight studies were included, with 39 conducive to meta-analysis. Types of UBM included pain, lymphoedema, restricted shoulder ROM, impaired upper-body function, and upper-body symptoms. UBM + groups reported poorer physical (SMD = − 0.99; 95%CI = − 1.26, − 0.71; p < 0.00001), psychological (SMD = − 0.43; 95%CI = − 0.60, − 0.27; p < 0.00001), and social wellbeing (SMD = − 0.62; 95%CI = − 0.83, − 0.40; p < 0.00001) than UBM − groups. Secondary analyses according to questionnaire showed that UBM + groups rated their QOL poorer or at equal to, UBM − groups across all domains. Conclusions: Findings demonstrate the significant, negative impact of UBM on QOL, pervading physical, psychological, and social domains. Implications for Cancer Survivors: Efforts to assess and minimise the multidimensional impact of UBM are warranted to mitigate impaired QOL after breast cancer. [ABSTRACT FROM AUTHOR]

Background/Aims: The increasing cost and incidence of non-specific chronic low back pain means that many physiotherapists are reconsidering the management of this condition. The primary aim of this study was to examine spinal mobility, aerobic capacity and functional movement screen in patients with non-specific chronic low back pain. The secondary aim was to determine the factors affecting the disability level. Methods: Participants aged between 18–65 years old diagnosed with non-specific chronic low back pain for >3 months were recruited as a study group, while those without low back pain in the last 3 months were the control group. Outcome measures included the Functional Movement Screen for functional movement, the 2-Minute Step Test for aerobic capacity, the Spinal Mouse for spinal mobility and Oswestry Disability Index for disability level. Results: A total of 60 participants, 30 people with non-specific chronic low back pain (42.7 ± 10.6 years) and 30 people without low back pain (42.0 ± 7.3 years), were included in this study. There were statistically significant differences in the total sagittal plane angle (P<0.001), total frontal plane angle (P=0.03), 2-Minute Step Test (P<0.001) and Functional Movement Screen (P<0.001) scores between groups. Pain and aerobic capacity explained 42.4% of the variance as determinants of disability in the study group. Conclusions: In people with non-specific chronic low back pain, sagittal and frontal plane range of motion and aerobic capacity were decreased and their functional movements were impaired. Pain intensity and aerobic capacity affect the disability level of non-specific chronic low back pain. Implications for practice: People with non-specific chronic low back pain have reduced spinal mobility, aerobic capacity and functional movement. These parameters should be included when determining treatment programmes. At the same time, the level of disability can be reduced by decreasing pain intensity and increasing aerobic capacity of people with low back pain. [ABSTRACT FROM AUTHOR]

Due to the simplicity, low cost and benefit of avoiding long-term joint immobilization, extension block pinning could be a suitable option for treating the volar base fractures of the middle phalanges. The aim of the present study was to evaluate the outcomes of using extension block pinning in chronic volar base fractures of the middle phalanges. In total, 26 patients with chronic closed volar base fractures of the middle phalanges were included our study. The mean age was 37 years (SD 11.59), and the mean follow-up time was 35 months (SD 19.41). The mean active range of motion (ROM) after surgery was 93° (SD 12.9). There was a negative correlation between the age and the ROM of the injured proximal interphalangeal joint after surgery. ROM did not correlate with the articular surface involvement or the interval between injury and surgery. We obtained a satisfactory result from extension block pinning for volar base fractures of the proximal interphalangeal joint in patients with chronic injuries. Level of evidence: IV [ABSTRACT FROM AUTHOR]

Background: 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). Methods: 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. Result: 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). Discussion: 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 of evidence: level III, retrospective comparative study treatment study [ABSTRACT FROM AUTHOR]

Background: Mandibular range of motion (MROM) variables are widely used to evaluate oral function. Objective: The aim of this study was to establish the reliability of MROM variables in healthy children. Methods: In this cross‐sectional study, healthy children were examined 2 weeks apart. The following MROM variables were established: active maximum interincisal opening (AMIO), passive maximum interincisal opening (PMIO), protrusion and left and right laterotrusion. The reliability of the MROM measurements was determined by analysing the intra‐class correlation coefficient (ICC), standard error of measurement (SEM), smallest detectable change (SDC) and limits of agreement (LoA). Results: A total of 167 healthy children were examined. The ICC indicated good reliability for AMIO (0.885); excellent reliability for PMIO (0.925); and moderate reliability for protrusion (0.578), laterotrusion left (0.601) and laterotrusion right (0.634). The SDC was 0.9 mm for AMIO, 0.4 mm for PMIO, 2.2 mm for protrusion, 1.6 mm for laterotrusion left and 1.4 mm for laterotrusion right. The LoA was −5.67 to 5.82 for AMIO, −3.90 to 3.57 for PMIO, −3.89 to 3.55 for protrusion, −2.99 to 2.77 for laterotrusion left, and − 2.71 to 2.77 for laterotrusion right. Conclusions: AMIO and PMIO measurements are both highly reliable in healthy children. The low SDC indicate that AMIO and PMIO are promising longitudinal measurements. Protrusion and laterotrusion measurements had moderate reliability. These results support our clinical recommendation to measure AMIO rather than PMIO, as PMIO is more difficult and more time‐consuming to perform than AMIO. [ABSTRACT FROM AUTHOR]

Purpose: Understanding relationships between blood flow and muscle inflexibility in the lower leg can support improved healthcare competency. Sports medicine practitioners might use the reference ranges and knowledge of relationships among these variables to support effective health screenings among their competitive runners. These variables have been linked in other areas of the body where inflexibility in the pectoralis minor and scalene muscles have been associated with diminished blood flow to the upper limb. No studies, however, have examined the relationship between vascular and mobility characteristics in the lower legs of runners. Therefore, the purpose of this study was to examine the relationship between blood flow in the posterior tibial artery and ankle range of motion (ROM) among competitive runners. Methods: Blood flow in the posterior tibial artery and ankle ROM were measured bilaterally on twenty-five, asymptomatic collegiate track athletes (15 males, 10 females, age = 20.0±1.2 years, height = 171.5±10.2 cm, mass = 66.7±13.7 kg) using diagnostic ultrasound and standard goniometry, respectively. Pearson correlation analysis was used to analyze the relationship between blood flow in the posterior tibial artery and ROM of the ankle joint. Results: Findings revealed no significant relationship between blood flow in the dominant leg's posterior tibial artery and dorsiflexion (r=.14, P=.52, CI95% = -0.27 - 0.51) or plantar flexion (r=-.32, P=.12, CI95% = -0.63 - 0.09) and no significant relationship between blood flow in the non-dominant leg's posterior tibial artery and dorsiflexion (r=-.02, P=.93; CI95% = -0.41 - 0.38) or plantar flexion (r=-.02, P=.92; CI95% = -0.41 - 0.38). Conclusion: While muscle inflexibility is associated with compromised blood flow in other body regions, findings of this study demonstrated no relationship between the variables within the lower legs of a sample of competitive runners. Sports medicine practitioners should consider these findings in their efforts to predict, prevent, and manage potential vascular and musculoskeletal adaptations among clients/patients who are competitive runners. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the relationship between patient age, gender, and various complications, such as pain, restricted range of motion (ROM), and hemorrhage following total knee arthroplasty. Materials and Methods: This cross-sectional study included 62 patients (Mean±SD age= 65.9±7.38 years; female participants=74.2%) who underwent total knee arthroplasty at Atieh Hospital in Tehran, Iran, between 2020 and 2021. Pain levels were assessed using the numerical pain rating score. Meanwhile, knee joint ROM was evaluated using a reliable mobile application. Hemorrhage was measured through knee joint drainage. Statistical analyses were performed to analyze the data. Results: Women reported higher pain levels and more restricted ROM in passive knee extension and active/passive knee flexion compared to men (P<0.05). However, no significant differences were observed between genders in active knee extension and hemorrhage. A significant inverse correlation was found between pain and ROM in passive knee extension (rho=-0.41, P≤0.001), as well as in active (rho=-0.5, P≤0.001) and passive knee flexion (rho= -0.59, P≤0.001). However, no significant relationship was observed between pain and active knee extension or hemorrhage. Age showed no statistically significant correlation with the other variables. Conclusion: This study highlights the association between higher pain levels and greater ROM restrictions in passive knee extension and active/passive knee flexion following total knee arthroplasty; however, patient age and gender were not found to be associated with postoperative hemorrhage. These findings underscore the importance of closely monitoring pain and ROM, particularly in women undergoing total knee arthroplasty. [ABSTRACT FROM AUTHOR]

Frozen shoulder patients complains of pain, as well as a restriction or complete loss of mobility in all directions. The purpose of this pilot study is to find out the short term effects of virtual reality exergaming in frozen shoulder patients. 30 patients underwent virtual reality exergaming and conventional physiotherapy for 40 minutes. The total duration was 3 session in a week. Measurement were obtained at baseline and after one week of intervention. Pain and range of motion were measured using visual analogue scale and universal goniometer. Four goniometric measurements were taken encompassing shoulder flexion, abduction, internal rotation and external rotation. The subjects improved with pain and range of motion after 3 session using virtual reality exergaming and conventional Physiotherapy. In conclusion, the result suggest further investigation is needed using virtual reality exergaming for the longer period as an effective treatment for frozen shoulder. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether postoperative neck pain in the first 4 weeks following multi-level posterior cervical fusion (PCF) with orthosis is equivalent to multi-level PCF without orthosis. Methods: Patients were randomly assigned in a 1:1 ratio to postoperative orthosis (CO) for 6 weeks or no orthosis (NO). Randomization was stratified by indication (traumatic vs. degenerative), and preoperative opioid use. A model of longitudinal regression for repeated measures was used. The two-sided 95% confidence interval (CI) was used to test equivalence. If the CI lay between the pre-determined margin of equivalence (−2.0 to + 2.0 pain score) the two groups were considered equivalent. A multiple imputation procedure was used to replace missing data. Results: Thirty-one patients were enrolled in each group. At baseline, the CO group had more neck pain (5.3 vs. 3.2, p = 0.013). The Four week post-operative neck pain intensity score was 4.6 ± 0.3 for the CO group vs. 4.9 ± 0.3 for the NO group. The 95% confidence interval (−1.2 to 0.6) was within the pre-determined equivalence margin. Neck Disability Index, quality-of-life scores, and arm pain were similar. Eleven patients in the CO group and 12 patients in the NO group had an adverse event. The CO group had reduced range of motion at 6 weeks. Conclusion: Pain scores over the first 4 weeks after surgery were equivalent for patients undergoing multi-level PCF treated with or without a cervical orthosis. Our findings do not support the routine use of a postoperative cervical orthosis for postoperative pain control. Clinical Trials Registration Number NCT04308122, April 22, 2020. [ABSTRACT FROM AUTHOR]

Context: Hip muscle imbalance, especially between gluteal muscles and tensor fasciae latae (TFL), is one of the risk factors for developing low back pain which should be considered in rehabilitation programs. This study compared the effect of exercises with gluteal-to-TFL muscle activation index above and below 50 on pain intensity, disability, and lower limbs' range of motion (ROM) in patients with nonspecific chronic low back pain. Design: A semiexperimental intervention study with a pretest and posttest. Methods: A total of 45 patients with nonspecific chronic low back pain were randomly divided into 2 experimental groups of gluteal-to-TFL muscle activation index above 50 (n = 15), below 50 (n = 15), and a control group (n = 15). Pain intensity (visual analog scale), disability (Roland–Morris Disability Questionnaire), and lower limbs' ROM including hip extension, hip abduction, hip external rotation, and knee extension (goniometer) were assessed at pretest and after 8 weeks of intervention. Results: Within-group comparison showed significant improvement of pain, disability, and ROMs in both experimental groups. No significant changes were observed in the control group. In between-group analysis, significant differences were observed in group of gluteal-to-TFL muscle activation index above 50 for only pain (P =.03) and disability (P =.01). For ROMs, although clinical improvement of lower limbs' ROMs was higher in group of gluteal-to-TFL muscle activation index above 50, no statistically significant differences were found between 2 experimental groups. Both experimental groups were superior to the control group for all outcomes. Conclusions: Findings indicate the statistically and clinically superior effectiveness of exercises with a gluteal-to-TFL muscle activation index above 50 in the reduction of pain and disability. Based on the clinical significance of exercises with a gluteal-to-TFL muscle activation index above 50 for improving ROMs, utilizing specific exercises that more activated gluteal muscle compared to TFL is recommended for patient with restricted lower limbs' ROMs. [ABSTRACT FROM AUTHOR]

Inertial sensors may help clinicians to assess patients' movement and potentially support clinical decision making. Our aim was to determine whether shoulder range of motion during movement tasks measured using inertial sensors is capable of accurately discriminating between patients with different shoulder problems. Inertial sensors were used to measure 3-dimensional shoulder motion during 6 tasks of 37 patients on the waiting list for shoulder surgery. Discriminant function analysis was used to identify whether the range of motion of different tasks could classify patients with different shoulder problems. The discriminant function analysis could correctly classify 91.9% of patients into one of the 3 diagnostic groups based. The tasks that associated a patient with a particular diagnostic group were the following: subacromial decompression: abduction, rotator cuff repair of tears ≤5 cm: flexion and rotator cuff repair of tears >5 cm: combing hair, abduction, and horizontal abduction–adduction. The discriminant function analysis showed that range of motion measured by inertial sensors can correctly classify patients and could be used as a screening tool to support surgery planning. [ABSTRACT FROM AUTHOR]

Context: Physical performance tests (PPTs) and mobility tests have been widely used in sports rehabilitation. However, the feasibility of PPTs and mobility tests via telehealth is unknown. Objectives: To verify the feasibility of PPTs and mobility tests to assess athletes via telehealth. Design: This is a feasibility study. Participants: Athletes enrolled in a sports team or club for at least 2 years and with previous enrollment in a competitive league were recruited through advertisements on social media. The athletes included in this study (mean age = 25.9 y, from different sports) performed a battery of PPTs and mobility tests for the lower-extremity or upper-extremity and trunk, according to their sport modality. Main Outcome Measure: The feasibility was assessed with recruitment, success, and dropout rates. In addition, athletes' perceptions of easiness, satisfaction, and safety during the lower-extremity or upper-extremity and trunk PPTs and mobility tests were assessed. Results: Seventy-three athletes were included, between January and April 2021: 41 were allocated to the lower-extremity and 32 to the upper-extremity and trunk PPTs and mobility test, according to their sports modality. The overall dropout rate was 20.55%; >89% of the athletes agreed that the PPTs and mobility tests via telehealth were easy to perform, >78% were satisfied, and >75% felt safe during the assessments. Conclusion: This study indicated that these 2 batteries of performance and mobility tests via telehealth are feasible to assess the lower and upper-extremities, and the trunk of athletes, considering the adherence, athletes' perception of easiness, satisfaction, and safety. [ABSTRACT FROM AUTHOR]

Objective: Using a rat model, we investigated the effect of multidisciplinary rehabilitation, including aerobic training and ointment, on the ROM, vWF, VEGF content, and femoral artery hemodynamics in rats with joint contracture. Methods: A total of 44 Wistar rats were divided into the normal control group (NC, eight rats) and the experimental group (EG). A joint contracture model was established for the rats in the EG group by an external fixator. After fixator removal, 32 rats are further divided into the MC, SC, RE, and SR groups (n = 8). Before and after the 42 day intervention, the ROM, vWF, VEGF, PS, ED, and RI were measured using X-ray imaging, ELISA, and color Doppler ultrasound, respectively. Results: After fixator removal, ROM for EG group was lower than that of the NC group (p <.01). After the intervention, ROM for the SR, RE, and SC groups was improved. The ROM for the SR group reached a similar value for NC group. vWF and VEGF levels in SR group were lower than in the MC, SC, and RE groups (p <.05), and had a similar value to the NC groups. PS value for SR and RE groups was higher than the MC and SC groups. The RI value for SR group was higher than that of NC and MC groups. Conclusion: Multidisciplinary rehabilitation used in this study can treat joint contracture synergistically. It improves the ROM of the joint, reduces the content of vWF and VEGF, and improves the femoral artery hemodynamics. [ABSTRACT FROM AUTHOR]

Développé à la seconde is a classic ballet movement that requires the maintenance of a high hip joint range of motion (ROM) and muscle strength. However, the contribution of these hip joint biomechanical parameters to this movement's esthetic performance is unclear. Therefore, this study evaluated hip joint biomechanical characteristics of 21 experienced ballet dancers (15–29 y old) and verified the relationship between these variables with the développé à la seconde static and dynamic performance. Correlations between age, ballet practice time, gluteus maximus and gluteus medius thicknesses, ROM, and muscle strength with absolute and relative static and dynamic performances were verified. Flexors, extensors, and internal rotators peak strength and external rotation ROM were highly correlated with absolute and relative static performances (0.5–0.7). Flexors and extensors strength and external and internal rotation ROM showed the highest correlations with the développé dynamic performance (0.49–0.67). Flexor strength and flexor and internal rotation ROM predicted 26% to 41% of this movement's static and dynamic performances. Thus, from a biomechanical perspective, clinical assessment of hip strength and ROM may be used to predict the quality of the ballet dancers' performance of the développé à la seconde and guide classical ballet training. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the clinical and radiographic outcomes and to determine the survivorship of a high-flexion design total knee arthroplasty (TKA) prosthesis, the LOSPA knee system, over a follow-up period of 10–12 years. Methods: The study included 386 patients (503 TKAs) who were treated with TKA from 2011 to 2013 (follow-up period 10–12 years).The patients were assessed clinically using range of motion (ROM) of the knee, the Knee Society scoring system (KSS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). For radiographic analysis, the positions of femoral and tibial implants as α, β, γ, and δ angles, hip knee ankle (HKA) angle, and radiolucent lines were used. Kaplan–Meier survival analysis was performed. Results: Mean ROM improved significantly from the preoperative baseline of 117.3° to 126.5° at the final follow-up (p < 0.001). The mean KSS and WOMAC scores also both showed significant improvement after surgery (all p < 0.001). A non-progressive radiolucent line less than 2 mm was observed in 23 cases (4.7%). Nine patients underwent revision surgery on the knee during the follow-up period. Revision surgery was performed on four patients due to aseptic loosening, three patients due to infection, one patient due to ankylosis, and one patient due to instability. When the endpoint of survival was the entire surgical cases, the survival rate was 96.2%. The survival rate, with revision for any reason as the endpoint, was 97.2%, and 97.8% for aseptic causes. Conclusions: The LOSPA knee system, a high-flexion design total knee prosthesis, showed excellent long-term survivorship and improvements in clinical outcomes at 10- to 12-year follow-up. [ABSTRACT FROM AUTHOR]

Background: Stretching exercises are widely used for pain relief and show positive effects on musculoskeletal, nociplastic and neuropathic pain; the magnitude of altered pain sensitivity responses following regular stretching is currently unknown. This study aimed to investigate the effect of six weeks of regular stretching exercise on regional and widespread pain sensitivity and range of motion and the effect of stretching cessation on regional and widespread pain sensitivity and range of motion. Methods: An experimental single-blind longitudinal repeated measures study. Twenty-six healthy adults were recruited. Regional and distant pressure pain thresholds and passive knee extension range of motion were measured at three points: before (baseline) and after six weeks (post-stretch) of daily bilateral hamstring stretching exercises and following four weeks of cessation (post-cessation) from stretching exercises. Results: Participants had a mean ± standard deviation (range) age of 23.8 ± 2.1 (21–30) years. There was a 36.7% increase in regional (p = 0.003), an 18.7% increase in distant pressure pain thresholds (p = 0.042) and a 3.6% increase in range of motion (p = 0.002) between baseline and post-stretch measures. No statistically significant differences were found for regional (p = 1.000) or distant pressure pain thresholds (p = 1.000), or range of motion (p = 1.000) between post-stretch and post-cessation. A 41.2% increase in distant pressure pain thresholds (p = 0.001), a 15.4% increase in regional pressure pain thresholds from baseline to post-cessation (p = 0.127) and a 3.6% increase in passive knee extension range of motion (p = 0.005) were found from baseline to post-cessation. Conclusions: Six weeks of regular stretching exercises significantly decreased regional and widespread pain sensitivity. Moreover, the results showed that the hypoalgesic effect of stretching on regional and widespread pain sensitivity persisted following four weeks of cessation. The results further support the rationale of adding stretching exercises to rehabilitation efforts for patients experiencing nociceptive, nociplastic, and neuropathic pain. However, further research is needed to investigate how the long-term effects of stretching exercises compare with no treatment in clinical populations. Trial registration: The trial was registered June 1st, 2021 at ClinicalTrials.gov (Trial registration number NCT04919681). [ABSTRACT FROM AUTHOR]

Background: Neck pain (NP) is a prevalent musculoskeletal disorder, especially among individuals with sedentary occupations. The interplay between cervical and thoracic spine mobility is hypothesized to contribute significantly to NP severity, yet this relationship requires further exploration. Methods: This cross-sectional study involved 179 young white-collar workers with NP lasting for at least six weeks. Participants were stratified into mild (n = 78) and moderate (n = 101) pain groups based on their scores on the Northwick Park Neck Pain Questionnaire (NPQ). Cervical and thoracic range of motion (ROM) in the sagittal plane was measured using inclinometers. NP severity was further assessed using the NPQ and the Neck Disability Index (NDI). Correlation, regression, and mediation analyses were conducted to investigate the relationship between cervical and thoracic ROM and NP severity. Results: Thoracic ROM was higher in the mild pain group (median: 47.35, IQR: 10.13) than in the moderate pain group (median: 42.10, IQR: 13.60; p < 0.001). The NDI had a negative correlation with thoracic ROM (r = −0.65; p < 0.05) and a positive correlation with cervical ROM (r = 0.84; p < 0.01). Additionally, thoracic ROM mediated the effect of cervical ROM on NP, particularly influencing NDI scores (p < 0.01). Conclusions: This study found a significant association between reduced thoracic ROM and increased NP severity, highlighting the role of thoracic spine mobility in NP among young white-collar workers. Targeted interventions for thoracic dysfunction may reduce compensatory cervical strain and improve NP management, suggesting that thoracic spine assessments should be integrated into routine clinical evaluations. [ABSTRACT FROM AUTHOR]

This study aimed to test the validity and reliability of the KFORCE Sens® (electrogoniometer) in carpal tunnel syndrome (CTS) patients. Thirtyone volunteers (aged 32-60 years) diagnosed with unilateral CTS were included in this study. Each of the two raters evaluated the participants' wrist range of motion (ROMs) (flexion, extension, radial deviation, and ulnar deviation) twice, for a total of four times, using an electrogoniometer. In addition, wrist ROMs were evaluated once with a universal goniometer. According to the study findings, both the inter-rater and test-retest reliability of the electrogoniometer device in all ROMs of the wrist were excellent (ICC>0.80). In addition, the ROM values of the electrogoniometer device and the ROM values of the universal goniometer in the same joint were highly correlated (r>0.80, p<0.05). The electrogoniometer is a valid, reliable, and practical device for evaluating wrist ROMs in patients with CTS. [ABSTRACT FROM AUTHOR]

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), mixed gender, aged (1.4–11.8) years living and working together. Goniometry measured joint PROM, a validated, non-invasive method. Dogs were conscious and placed in standing position. Triplicate measures of joint flexion and extension were taken bilaterally of each dog for afore-mentioned joints. Median values of triplicate measures were computed. Paired t-tests compared laterality of joint PROM, gender, age (< 6 vs. ≥ 6 years) effects. Inferential symmetry indices [SI] were calculated. For all joints, there was no significant difference (p > 0.05) between left and right-side flexion and extension measures nor between genders. Age (< 6 vs. ≥ 6 years) had a significant effect on right hip flexion (p < 0.001); both left and right-side shoulder flexion (p < 0.001); elbow flexion (p = 0.001 and p < 0.001); hip extension (p = 0.02 and p < 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. [ABSTRACT FROM AUTHOR]

Introduction: A variety of techniques for measuring finger range of motion (ROM) are available for hand therapist use, however, there is no clear description of which finger ROM methods are preferred in practice. This study explored the preferred measurement techniques, the factors influencing clinical decision-making, and the clinical reasoning processes employed when faced with practice-based measurement scenarios. Methods: This was a cross-sectional online survey study of hand therapists and American or Canadian Society of Hand Therapists members. Quantitative methods were employed for participant demographics and categorical clinical questions about practice patterns. Qualitative descriptive questions and vignettes were analysed using inductive and deductive content analysis, respectively. Results: Four hundred and eighty-one responses were included, representing hand therapists with a median age of 51 years and median experience of 19 years. Participants preferred measuring individual joints with a goniometer (N = 210, 44%) for perceived utility in informing treatment decisions, reliability, and confidence in measurement skills. Participants also preferred active functional ROM (N = 117, 24%) for being quick, easy, and useful in informing treatment decisions. Participants reported using different methods with time constraints in a busy clinic, taking precautions with pins/wounds, bulky dressings/casts, pain tolerance levels of patients, or with specific pathologies. Participants' responses to the multi-stage vignette identified distinct patterns of clinical reasoning approaches within individual vignettes. Conclusions: Hand therapists use multiple methods to measure finger ROM while preferring to use goniometers to measure individual finger joints. They engage procedural and pragmatic reasoning modified by contextual factors when measuring finger ROM. [ABSTRACT FROM AUTHOR]

Background and Objectives: Total knee arthroplasty (TKA) improves balance performance in patients with osteoarthritis; however, balance deficit and fall incidence after TKA have been reported. This study aimed to determine the effects of combined balance exercises on knee range of motion (ROM), balance, gait, and functional outcomes during the acute phase after TKA. Materials and Methods: A total of 42 participants were randomly assigned to either the combined balance group (n = 21) or the general physical therapy (control) group (n = 21). The combined balance exercise group performed exercise programs for 30 min per session, five times a week for 4 weeks (20 sessions), and the control group completed general physical therapy, which included active simple exercise. Measurements were performed before and after the 4 weeks of training to assess changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee joint ROM, static balance, timed up-and-go (TUG), and 10 m walk test (10 MWT). Results: The combined balance exercise group demonstrated significant improvements post intervention (p < 0.05) for all outcomes. The time × group interaction effect for the WOMAC scores showed statistically significant interaction effects for pain, stiffness, and physical function; the static and dynamic balance values showed statistically significant interaction effects for CEA, PL, AV, and TUG; and gait ability showed a significant interaction effect for the 10 m walk test (p < 0.05). Conclusions: This study confirmed that combined balance training with general physical therapy has a positive effect on ROM, static and dynamic balance, gait, and functional outcomes in the acute phase post TKA and that combined balance exercise can be proposed as a rapid rehabilitation intervention with general physical therapy following TKA. [ABSTRACT FROM AUTHOR]

Purpose: Static stretching (SS) improves flexibility but may impair the accuracy of joint position sense. Therefore, this study aimed to investigate the acute effects and time course of SS on the accuracy of joint position sense, range of motion (ROM), and muscle–tendon unit (MTU) stiffness. Methods: This study randomly assigned 16 healthy, young males to the SS and control conditions. SS intervention in the SS condition was performed on the plantar flexors of the dominant leg for three sets of 60 s. The participants were instructed to sit for 240 s in the control condition. The ankle dorsiflexion (DF) ROM, passive torque at DF ROM, MTU stiffness, and joint position sense on the dominant leg side were measured before (PRE) and immediately (POST) and at 5, 10, and 20 min postintervention. Results: A significant interaction effect was observed in the relative error in the joint position sense, and significant increases were noted in POST compared to PRE in the SS condition. Further, significant interactions were observed in DF ROM, passive torque at DF ROM, and MTU stiffness. The SS condition demonstrated significant increases in DF ROM and passive torque at DF ROM compared to PRE with POST, 5 min, and 10 min, and MTU stiffness significantly decreased in POST compared with PRE. Conclusion: Our results indicated that the accuracy of the joint position sense decreased immediately after SS, but returned to baseline in a very short time. [ABSTRACT FROM AUTHOR]

Purpose: The results of past studies comparing percutaneous techniques with traditional open techniques for hallux valgus are controversial. Therefore, this study aimed to compare the radiologic and clinical outcomes of percutaneous and open distal chevron osteotomies. Methods: Seventy-one patients with mild to severe hallux valgus deformity were randomized to undergo percutaneous distal chevron osteotomy (percutaneous group, n = 36) or open distal chevron osteotomy (open group, n = 35) between October 2019 and September 2020. Radiological and clinical outcomes were assessed preoperatively and postoperatively. Outcome measures included the foot and ankle outcome score, foot functional index, visual analogue scale (VAS) scores for pain, range of motion (ROM) of the first metatarsophalangeal (MTP) joint, hallux valgus angle, intermetatarsal angle, and first metatarsal shortening. Additionally, the first metatarsal declination angle was measured to evaluate sagittal malunion. Results: The mean first metatarsal declination angle decreased significantly at 12 months postoperatively in both groups (p = 0.021 and p < 0.001 in the percutaneous and open groups, respectively), and the decrement was significantly greater in the open group (p = 0.033). The mean VAS score for pain on postoperative day one was 4.2 ± 1.9 and 5.3 ± 1.7 in the percutaneous and open groups, respectively (p = 0.019). The mean ROM of the first MTP joint did not change significantly after surgery, from 72.5 ± 7.5 preoperatively to 71.0 ± 9.5 at 12 months postoperatively in the percutaneous group (p = 0.215); however, it decreased significantly from 70.6 ± 7.3 preoperatively to 63.4 ± 10.4 at 12 months postoperatively in the open group (p < 0.001). There were no significant differences between the groups regarding other clinical outcomes. Conclusion: The percutaneous group showed a lower immediate pain level at postoperative day 1 and better ROM of the first MTP joint at 12 months postoperatively. [ABSTRACT FROM AUTHOR]

Aim: Previous stretching studies mostly investigated effects on the skeletal muscle but comprehensive explorations regarding the role of the connective tissue are scarce. Since the deep fascia has been demonstrated to be sensitive to mechanical tension, it was hypothesized that the fascia would also respond to stretching, contributing to enhanced range of motion (ROM). Methods: Forty (40) recreationally active participants (male: n = 25, female: n = 15) were included in the randomized controlled cross-over trial and allocated to different groups performing 5 min static (STAT) or dynamic (DYN) plantar flexor stretching or control condition (CC) in a random order. Pre- and immediately post-intervention, muscle and fascia stiffness, as well as muscle and fascia thickness were measured using high-resolution ultrasound and strain elastography. ROM was assessed in the ankle joint via the knee to wall test (KtW) and goniometer. Results: STAT reduced both, muscle and fascia stiffness (d = 0.78 and 0.42, p < 0.001, respectively), while DYN did not reduce stiffness compared to the control condition (p = 0.11–0.41). While both conditions showed significant increases in the KtW (d = 0.43–0.46, p = 0.02–0.04), no significant differences to the CC were observed for the isolated ROM testing (p = 0.09 and 0.77). There was a small correlation between fascia stiffness decreases and ROM increases (r = − 0.25, p = 0.006) but no association was found between muscle stiffness decreases and ROM increases (p = 0.13–0.40). Conclusion: Our study is the first to reveal stretch-induced changes in fascia stiffness. Changes of fascia's but not muscle's mechanical properties may contribute to increased ROM following stretching. [ABSTRACT FROM AUTHOR]

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Rhythmic gymnastics is a sport of asymmetry and lateral preferences, so the main objective of this study was to examine and compare hip and shoulder range of motion (ROM) and inter-limb asymmetry in 44 rhythmic gymnasts (RGs) and 51 age-matched non-athletes (NAs), i.e. controls. The baseline characteristics of 95 female participants, divided into two age- group categories (U8: 6-8 years, N=36; U11: 8-11 years, N=59) were established, as well as their hip (right/left hip flexion, right/left hip extension, right/left hip abduction, in °) and shoulder ROM (right/left shoulder flexion, right/left shoulder extension, in °), and asymmetry index (ASI, in %) was calculated. Significant differences between RGs and NAs were established (the exception is hip and shoulder extension in U8s, p>0.05), with greater ROM values recorded in RGs. Significant age differences were recorded among RGs in hip flexion and left hip abduction (p<0.05), in favor of U11s, and within NAs only in the case of right hip flexion (p=0.017), but in favor of U8s. The presence of asymmetries (ASI>15%), as well as its absence, is established in both RGs and NAs, but statistically significant side-to-side differences were recorded in U8 NAs (shoulder flexion, p=0.044) and U11 NAs (shoulder extension, p=0.057). [ABSTRACT FROM AUTHOR]

Biomaterials, such as hydrogels, have an increasingly important role in the development of regenerative approaches for the intervertebral disc. Since animal models usually resist biomaterial injection due to high intradiscal pressure, preclinical testing of the biomechanical performance of biomaterials after implantation remains difficult. Papain reduces the intradiscal pressure, creates cavities within the disc, and allows for biomaterial injections. But papain digestion needs time, and cadaver experiments that are limited to 24 h for measuring range of motion (ROM) cannot not be combined with papain digestion just yet. In this study, we successfully demonstrate a new organ culture approach, facilitating papain digestion to create cavities in the disc and the testing of ROM, neutral zone (NZ), and disc height. Papain treatment increased the ROM by up to 109.5%, extended NZ by up to 210.9%, and decreased disc height by 1.96 ± 0.74 mm. A median volume of 0.73 mL hydrogel could be injected after papain treatment, and histology revealed a strong loss of proteoglycans in the remaining nucleus tissue. Papain has the same biomechanical effects as known from nucleotomies or herniations and thus creates a disc model to study such pathologies in vitro. This new model can now be used to test the performance of biomaterials. [ABSTRACT FROM AUTHOR]