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Background: Breast cancer is one of the most common tumours and one of the leading causes of death among women in all parts of the world. The aim of this study is to investigate the influence of Nordic walking on the functional capacity of women who have undergone surgery for breast cancer. Methods: The study involved a cohort of women who exercised through Nordic walking for 10 weeks (from March to May 2022). The subjects trained with a licenced instructor (INWA method), with two training sessions per week of 70–80 min each. We collected information on pain, arm mobility, hand grip strength, shoulder joint range of motion bilaterally, circumference of both arms, body mass index, physical activity, aerobic capacity, and endurance. Results: There were 14 women, median age 63. BMI was significantly lower (28.9/28.1; p = 0.013) after training and a difference in shoulder range of motion was better (anteflexion right (142.5/170, p = 0.002), retroflexion right (40/60, p = 0.005), abduction right (135/180, p = 0.005), abduction left (135/180, p = 0.005)). There was no difference in right hand strength, while there was a significant difference in left hand strength (19/20, p = 0.007). A correlation was found between BMI and the six-minute walk test (r = −0.70; p = 0.005). Conclusions: Considering the multidimensionality of the disease itself and the results of this study, we believe that Nordic walking is a favourable and good choice of physical activity for breast cancer patients. [ABSTRACT FROM AUTHOR]

Breast cancer is a disease that mainly affects women and can have a negative impact on their quality of life. Mastectomy, as part of the treatment, can lead to limitations in shoulder mobility. In this context, therapeutic exercise is presented as an important intervention to improve joint mobility and quality of life and facilitate the recovery of patients. Therefore, the aim of this systematic review is to describe the effects of therapeutic exercise on shoulder joint mobility in post-mastectomy patients. Following the PRISMA model, we searched databases such as PubMed and Cochrane Library for information from the last 5 years using MeSH terms. We included studies published in English or Spanish; controlled trials and randomized controlled trials (RCTs); Applying inclusion and exclusion criteria, 16 articles investigating shoulder exercise and mobility in post-mastectomy patients were selected. A positive trend was observed in most of the studies analyzed, demonstrating significant benefits of therapeutic exercise in shoulder joint mobility, mainly in flexion, extension and abduction movements. The results indicate that rehabilitation programs, which include various exercise modalities, significantly improve range of motion in patients, regardless of the duration of interventions. [ABSTRACT FROM AUTHOR]

Introduction: The aim of our study is to evaluate the functional and mobility outcomes in patients who have undergone arthroscopic circumferential arthrolysis of the shoulder and to find out if there are differences in the results in relation to the patient's age. Materials and methods: This is a retrospective case series of patients with idiopathic adhesive capsulitis treated by arthroscopic 360º circumferential capsulotomy in lateral position and followed for a minimum of 2 years. Range of motion (ROM), functional outcomes using the Constant Score (CS), health-related quality of life outcomes with the EuroQol Five Dimensions tool (EQ-5D), pain using the Visual Analogue Scale (VAS). Results: A total of 26 shoulders were included, 10 men (41.7%) and 14 women (58.3%), with 2 patients being bilateral. The mean age was 48.64 ± 7.5 years, and the mean follow-up was 50.2 months. Postoperative ROM improved significantly compared to preoperative ROM (p < 0.05). Shoulder forward flexion improved by 38.6° (95%CI 22.3–54.9, p < 0.01), abduction by 35.2° (95%CI 17.6–52.8, p < 0.01) and external rotation by 21.9° (95%CI 12.8–30.9, p < 0.01 p < 0.01). Median internal rotation improved from buttock to T12 (p < 0.01). The mean improvement in CS was 54.3 ± 24.4 points (p < 0.01). The EQ-5D and VAS scores at the end of follow-up were 0.73 ± 0.23 and 2.73 ± 2.55, respectively. There were no statistical differences between young patients and patients aged 50 years or older in ROM or functional results. Conclusions: Patient age did not affect outcomes significantly, with patients older than 50 years showing similar results to younger patients. [ABSTRACT FROM AUTHOR]

The shoulder joint is a highly mobile joint that is prone to injuries. Shoulder impingement is a painful shoulder condition caused by injuries to the structures in the subacromial space. Symptoms include pain, disruptions in daily activities, and a decrease in the range of motion of the joint. The research aims to analyze the effects of the Mulligan Technique and Ultrasound on pain and functional ability in shoulder impingement conditions at EMC Sentul Hospital. The research method used is a quasi-experimental design with pre and post-test control groups. Thirty participants were divided into two groups: an intervention group receiving the Mulligan Technique and Ultrasound (15 participants) and a control group receiving TENS and conventional exercise therapy (15 participants). Each participant underwent six sessions per week, twice a week. Before and after the treatment, each participant's pain level was measured using the Numeric Rating Scale (NRS), and functional ability was assessed using the Shoulder Pain and Disability Index (SPADI). The analysis of the data showed that both treatments in the two groups reduced pain and improved functional ability in shoulder impingement conditions. However, there was a significant difference in the group receiving the Mulligan Technique and Ultrasound, with an average pain reduction from 6.6 NRS to 1.3 NRS and an increase in functional ability from 62.6% to 11.85%. In contrast, the group receiving TENS and conventional exercise therapy showed an average pain reduction from 3.6 NRS to 6.13 NRS and an increase in functional ability from 61.3% to 40.2%. In conclusion, the study suggests that the application of the Mulligan Technique and Ultrasound is more effective in reducing pain and improving functional ability compared to TENS and conventional exercise therapy in shoulder impingement conditions. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of double-row suture bridge fixation and single row fixation under arthroscope in the treatment of full-thickness rotator cuff tear, and to analyze the risk factors of early postoperative retear. Methods: Clinical data of 200patients with full-thickness rotator cuff tear who were admitted to Beibei Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from January 2018 to December 2021 were retrospectively analyzed, and they were divided into group A (n=97, receiving single row fixation) and group B (n=103, receiving double-row suture bridge fixation) according to different surgical programs. Pain, shoulder function, shoulder joint range of motion and the incidence of early postoperative retear were compared in the two groups. Univariate and multivariate Logistic regression were used to analyze the risk factors of early postoperative retear in patients with full-thickness rotator cuff tear. Results: 6 months after operation, the visual pain simulation scale (VAS) score in the group B was lower than that in the group A, while the University of California at Los Angeles (UCLA) score and American shoulder and elbow surgeons (ASES) score were higher than those in the group A (P＜0. 05). 6 months after operation, the angles of anteflexion, abduction and lateral external rotation in the group B were greater than those in the group A (P＜0. 05). The total incidence of early postoperative retear in the group B was lower than that in the group A (P＜0. 05). Early postoperative retear was related to the diabetes history, tear size, smoking history, age, preoperative muscle mass, gender, fat infiltration and corticosteroid injection (P＜0. 05). Multivariate Logistic regression analysis showed that age≥60 years, gender with male, smoking history, diabetes history, tear size of giant type retear, fat infiltration, and corticosteroid injection were the risk factors for occurrence of early postoperative retear (P＜0. 05). Conclusion: The double-row suture bridge fixation under arthroscope in the treatment of full-thickness rotator cuff tear can better relieve pain symptoms, improve joint function and range of motion. In addition, diabetes history, adipose infiltration, smoking history, advanced age, tear size of giant type retear, male, corticosteroid injection are risk factors for early postoperative retear in patients with full-thickness rotator cuff tear. [ABSTRACT FROM AUTHOR]

Objective: Arthroscopic release is effective for patients with shoulder stiffness, but the traditional inside‐out procedure cannot effectively alleviate the mobility of some severe stiff shoulder and even cause itrogenic injuries sometimes. The aim of this study is to evaluate the clinical efficacy and advantages of a modified outside‐in shoulder release approach for severe shoulder stiffness. Methods: Included in this retrospective study were 15 patients (five male and 10 female) with severe shoulder stiffness who underwent modified outside‐in shoulder release surgery at our hospital between June 2019 and March 2021. Of them, 10 patients had a primary frozen shoulder and five had secondary shoulder stiffness, involving the right shoulder in six cases and the left shoulder in nine cases. The mean age of the 15 patients was 56.7 (34–69) years. The patients were instructed to exercise passively from second‐day post‐operation and enhance the rehabilitation exercise gradually. All patients received a range of motion (ROM) examination before and after surgery. The American Shoulder and Elbow Surgeon's Score (ASES), Constant Score (CS), and Visual Analog Scale (VAS) score for pain were recorded. All data were tested by normal distribution first and then by paired T test, otherwise by Wilcoxon rank sum test. Results: The mean follow‐up period was 18.2 (12–33) months. Compared with the preoperative value, the mean ASES score at the final follow‐up improved from 38.4 ± 7.37 to 88.13 ± 6.33 points; the mean CS score from 43.27 ± 6.71 to 78.74 ± 6.93 points; the mean VAS score from 5.07 ± 1.03 to 0.81 ± 0.83 points; forward flexion from 81.93° ± 11.45° to 156.73° ± 9.12°; abduction from 65.93° ± 16.82° to 144.80° ± 8.83°; neutral external rotation from 13.53° ± 10.38° to 51.20° ± 4.77°; internal rotation from the buttock to waist (L3), all showing a significant difference (P < 0.0001). No serious complication was observed in any patient during the postoperative follow‐up periods. Conclusion: The present study has demonstrated that the modified arthroscopic outside‐in shoulder release approach can improve ROM of patients and alleviate pain effectively, proving it to be an appropriate surgical option for the treatment of severe shoulder stiffness. [ABSTRACT FROM AUTHOR]

Aim. The study aimed to the application of the propose kinetic programme that conduce to the complete recovery of the athlete participating in the study. Methods. The study was carried out on a subject - case study - 20-year-old athlete, at Club Sportiv Medgidia (Division A), dominant right arm, position on the field: pivot, has been playing handball for 11 years. Diagnosis - subluxation (partial dislocation) right shoulder. The tests applied to validate the research: 1.VAS scale, an acronym for the Analog-Visual Pain Assessment and Quantification Scale - to assess the pain parameter. 2. Upper limb dysfunction assessed by the DASH questionnaire. 3. Evaluation of muscle strength by manual testing for flexion, extension, abduction, internal rotation and external rotation movements of the shoulder. 4. Evaluation of shoulder joint amplitude for flexion, extension, abduction, internal rotation and external rotation movements. Results. Pain parameter evaluated by the VAS scale was reduced from initial to final testing - from 6 to 1. Upper limb dysfunction assessed by the DASH questionnaire show us a significant improvement from initial score - 38.81% to 1.31% to final score. The statistical analysis on the functional balance of the shoulder, revealed that the values recorded at the final test are significantly better than those from the initial test (p < 0.05). Conclusions. The application of our prevention programme led to the athlete's return to competitive life and managed to combat the athlete's absence from both training and matches. The effectiveness of the programme for the prevention of shoulder injuries in performance in handball players led to an increase in muscle strength, an improvement in ability, mobility and joint stability, thus, we conclude that through the prevention programme we have prepared the athlete for the limiting situations during matches and training. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study is to improve the the scapula-humeral range of motion by obtaining a satisfactory degree of active mobility, in terms of flexion (fl) - extension (e), abduction (abd) - adduction (add) and internal rotation (ir) - external rotation (er). Methods. We included in this study five subjects aged between 49 and 67 who benefited from an individualized recovery program that consists of low-intensity physical exercises. The subjects were evaluated by joint balance for the movements of flexion, extension, abduction, external rotation and internal rotation. Results. The flexion and extension movements increased by 35°, respectively 14.6°. For the abduction movement, the median value increased from 120° to 170°. In the case of internal rotational movement, the average value increased by 45°, from 39° at the initial assessment to 84° at the final assessment. For the external rotation movement, the values obtained at the initial and final evaluations show an increase in the average by 42.5°. The bilateral t-test showed a statistically significant difference between the averages recorded at the two evaluations, p value <0.05. Conclusions. Surgical treatment together with adjuvant treatment used in the neoplasm contributes to decreased mobility of the scapula-humeral joint and the development of lymphedema, which negatively influences the quality of life of patients. Performing low-intensity physical exercises increases the upper limb range of motion after breast cancer surgery. [ABSTRACT FROM AUTHOR]

This study aimed to compare the outcomes of arthroscopic rotator cuff repair (ARCR) surgery between younger and older patients. We performed this systematic review and meta-analysis of cohort studies comparing outcomes between patients older than 65 to 70 years and a younger group following arthroscopic rotator cuff repair surgery. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and other sources for relevant studies up to 13 September 2022, and then assessed the quality of included studies using the Newcastle–Ottawa Scale (NOS). We used random-effects meta-analysis for data synthesis. The primary outcomes were pain and shoulder functions, while secondary outcomes included re-tear rate, shoulder range of motion (ROM), abduction muscle power, quality of life, and complications. Five non-randomized controlled trials, with 671 participants (197 older and 474 younger patients), were included. The quality of the studies was all fairly good, with NOS scores ≥ 7. The results showed no significant differences between the older and younger groups in terms of Constant score improvement, re-tear rate, or other outcomes such as pain level improvement, muscle power, and shoulder ROM. These findings suggest that ARCR surgery in older patients can achieve a non-inferior healing rate and shoulder function compared to younger patients. [ABSTRACT FROM AUTHOR]

Background: Axillary crutches are commonly used in rehabilitation. Inappropriately fit crutches may result in upper limb pain or injury. Objective: To investigate the effects of axillary crutch length on upper limb kinematics to better understand potential injury mechanisms. It was hypothesized that crutches that were longer or shorter than standard‐fit crutches would alter upper limb kinematics. Design: Cross‐sectional. Setting: Gait laboratory. Participants: Fifteen healthy males with no prior crutch experience. Interventions: Participants were fit with axillary crutches using standardized methods, as well as with crutches that were 5 cm longer and 5 cm shorter. Participants performed swing‐through gait (1.20 ± 0.07 ms−1) with all crutch lengths in randomized order. Kinematics were recorded using an optical motion‐tracking system and joint angles for the scapula, shoulder, elbow, and wrist were computed. Main Outcome Measures: The effects of crutch length on joint range of motion (ROM) and joint angles at initial crutch contact were analyzed using multivariate analysis (Hotelling's T2; α =.025) and simultaneous confidence intervals (CI). Results: The long‐standard crutch fit comparison showed effects across all joints (ROM p =.009; initial contact p <.001). Longer crutches resulted in greater scapular upward rotation (mean difference [95% CI] ROM: 1.0 [−0.2 to 2.2]; initial contact: −2.7 [−4.4, −1.1]) and shoulder abduction (ROM: 0.8 [−0.1 to 1.8]; initial contact: −1.9 [−4.1 to 0.3]). Crutch length also had effects across all joints for the short‐standard fit comparison (ROM p =.004; initial contact p =.016). Shorter crutches resulted in greater scapula downward rotation (2.2 [−0.4 to 4.8]) and greater shoulder adduction (2.5 [−0.6 to 5.6]) at initial contact. Shorter crutches also reduced shoulder flexion/extension ROM (−2.5 [−4.4 to −0.6]). Conclusions: Altered crutch length results in scapular and shoulder kinematic deviations that may present risk factors for upper limb injury with crutch‐walking. This may underline the importance of appropriate device fitting to reduce injury risk in crutch users. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Prescrição e Fisiologia do Exercício is the property of Instituto Brasileiro de Pesquisa e Ensino em Fisiologia do Exercicio 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.)

High-intensity laser therapy (HILT) is one of the therapeutic approaches used in the treatment of musculoskeletal disorders (MSD). The main objective of this study was to examine the effectiveness of HILT for reducing pain and improving functionality in people with MSD. Ten databases were systematically searched for randomized trials published up to 28 February 2022. Randomized clinical trials (RCTs) assessing the effectiveness of HILT on MSD were included. The main outcome measures were pain and functionality. In total, 48 RCTs were included in the qualitative synthesis and 44 RCTs in the quantitative analysis. HILT showed a decrease on the pain VAS (mean difference (MD) = −1.3 cm; confidence interval (CI) 95%: −1.6 to −1.0) and an improvement in functionality (standardized mean difference (SMD) = −1.0; CI95%: −1.4 to −0.7), with low and moderate quality of evidence, respectively. A greater effect was observed when compared with control than with other conservative treatments, both on pain (χ2 = 20.6; p < 0.001) and functionality (χ2 = 5.1; p = 0.02). Differences in the effectiveness of HILT were found depending on the location (χ2 = 40.1 p < 0.001), with further improved functionality in MSD of the knee and shoulder. HILT is an effective treatment for improving pain, functionality, range of motion, and quality of life in people with MSD, although these findings must be treated with caution due to the high risk of bias in the studies. Further clinical trials should be well designed to lower the risk of bias. [ABSTRACT FROM AUTHOR]

Background: Little information exists to guide the choice of exercise for regaining shoulder range of motion (ROM). The purpose of this study was to compare the maximal ROM reached, pain and difficulty associated with 4 commonly prescribed exercises. Methods: Forty (9 females) patients with various shoulder disorders and a limited flexion ROM performed 4 exercises for regaining shoulder flexion ROM in a randomized order. Exercises included the self-assisted flexion, forward bow, table slide and rope-and-pulley. Participants were videotaped while performing all exercises and the maximal flexion angle reached during each exercise was recorded using Kinovea motion analysis freeware (Kinovea 0.8.15). Pain intensity and the perceived level of difficulty associated with each exercise were also recorded. Results: The forward bow and table slide generated significantly greater ROM compared with the self-assisted flexion and rope-and-pulley (P ≤ 0.005). The self-assisted flexion was associated with a greater pain intensity compared with the table slide and rope-and-pulley (P = 0.002) and a greater perceived level of difficulty compared with the table slide (P = 0.006). Conclusions: Due to the greater ROM allowed, and similar or even lower level of pain or difficulty, clinicians may wish to initially recommend the forward bow and table slide for regaining shoulder flexion ROM. [ABSTRACT FROM AUTHOR]

Background: Reparation of C5 by proximal selective ipsilateral C7 transfer has been reported for the treatment of neurogenic shoulder abduction limitation as an alternative to the reparation of the suprascapular nerve (SSN) and the axillary nerve (AXN) by distal nerve transfers. However, there is a lack of evidence to support either strategy leading to better outcomes based on long-term follow-up. Objective: The purpose of the study was to investigate the safety and long-term outcomes of the posterior division of ipsilateral C7 (PDIC7) transfer to C5 in treating neurogenic shoulder abduction limitation. Methods: A total of 27 cases with limited shoulder abduction caused by C5 injury (24 cases of trauma, 2 cases of neuritis, and 1 case of iatrogenic injury) underwent PDIC7 transfer to the C5 root. A total of 12 cases (11 cases of trauma and 1 case of neuritis) of C5 injury underwent spinal accessory nerve (SAN) transfer to SSN plus the triceps muscular branch of the radial nerve (TMBRN) transfer to AXN. The patients were followed up for at least 12 months for muscle strength and shoulder abduction range of motion (ROM). Results: In cases that underwent PDIC7 transfer, the average shoulder abduction was 105.9° at the 12-month follow-up. In total, 26 of 27 patients recovered at least M3 (13 reached M4) (Medical Research Council Grading) of the deltoid. In cases that underwent SAN transfer to SSN plus TMBRN to AXN, the average shoulder abduction was 84.6° at the 12-month follow-up. In total, 11 of 12 patients recovered at least M3 (4 reached M4) of the deltoid. Conclusion: Posterior division of ipsilateral C7 transfer is a one-stage, safe, and effective surgical procedure for patients with neurogenic shoulder abduction limitation. [ABSTRACT FROM AUTHOR]

Background: The axillary lymph node dissection (ALND) is essential for staging, prognostic assessment and local control in patients of breast cancer with the clinically evident nodal disease in the axilla. A prospective study conducted by us evaluated the effect of infiltrative anesthesia injected along the nerve bundles exposed during surgery in reducing the restriction of the range of motion of the arm and pain scores following ALND. Further to our pilot study we conducted this nonrandomized comparative trial for evaluation of range of movement, reduction in pain and long-term complications like paresthesia and occurrence of lymphedema post-ALND. Methods: A prospective nonrandomized comparative study was done on 97 patients undergoing ALND, who were distributed into two groups. One who received intraoperative infiltration of local anesthesia along the nerve bundles with postoperative conventional shoulder exercises (II + CSE) and the other group who received postoperative conventional shoulder exercises only (CSE). Mobility in the form of range of movements (flexion, extension and abduction at ipsilateral shoulder), pain parameters, paresthesia and lymphoedema were compared among the two groups. Results: The range of motion measured by the degree of flexion, extension and abduction on Day 0 (postoperative evening) and Days 3, 7 and 28 after surgery were significantly more in II + CSE gp till post-op Day 7. Pain in the arm was assessed by Visual Analog Scale (VAS) on Days 0, 1, 3, 7 and 28 and was significantly lower on Days 0, 1, 3 and 7 in the test group. Incidence of paresthesia was statistically insignificant while lymphedema was significantly less in the intervention group. Conclusion: Our study reinforces that infiltrative anesthesia with local anesthetic along the nerve bundles exposed during ALND is effective in improving the range of motion restriction of the shoulder and pain relief. The incidence of lymphedema was also found to be significantly less in the interventional group. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. 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.)

Purpose: Reverse shoulder prosthesis is a method used after massive rotator cuff tears. It is a surgical method used to improve shoulder functions and to cope with pain. Long-term results of physiotherapy programs applied after surgery are insufficient. The aim of this study is to investigate the long-term results of reverse shoulder prosthesis applied to both shoulders. Methods: A 66-year-old female patient with a rotator cuff tear on both shoulders was included in the study. After surgery, 40 sessions of physiotherapy were applied to the left shoulder and 45 sessions of physiotherapy to the right shoulder, and the right shoulder was followed for 6 years and the left shoulder for 8 years. VAS for pain, goniometer for active range of motion, and constant shoulder score questionnaire for functionality were used in the evaluations. Results: Significant differences were found in the preoperative and postoperative evaluation in terms of pain, activities of daily living and active range of motion of the patient. While the preoperative Constant scores were 32 for the left shoulder and 34 for the right shoulder, the postoperative Constant scores were calculated as 84 for both shoulders. [ABSTRACT FROM AUTHOR]

This study developed a wearable sensor device featuring biomimetic structures inspired by tree frog toe pads to measure shoulder joint movements effectively. A PVA/PAA double-network hydrogel was formulated by mixing PVA and PAA in a 3:7 ratio, resulting in a Young's modulus of 7.2 kPa, closely matching human skin's mechanical properties. To enhance moisture retention, the hydrogel was supplemented with 20 mL glycerin, increasing its weight retention rate to 95 % after 28 days, a 5.6-fold improvement over glycerin-free hydrogels. Additionally, the incorporation of 0.2 wt% cellulose nanocrystals (CNC) increased the cross-linking density, reducing the swelling ratio from 124 % to 106 % and minimizing the impact of swelling cycles on mechanical properties from 22 % to 4 %. Treefrog-inspired microstructures were fabricated on the sensor surface using laser cutting and casting techniques, significantly enhancing adhesion under humid conditions, with normal, lateral, and peel-off adhesion forces improving by 500, 700, and 700 %, respectively. The sensor demonstrated accurate measurement of shoulder joint movements with an error margin of 6.3 % for polar angles (45°-135°) and 7.8 % for azimuth angles (0°-45°). The accompanying smartphone application provided real-time feedback, helping to prevent exercise injuries and improve user awareness and control of shoulder movements, making it suitable for both rehabilitation and athletic training. [Display omitted] • This study introduces a PVA/PAA hydrogel inspired by tree frog toe pads to enhance adhesion in humid environments. • The hydrogel patch mimics human skin's mechanical properties with young's modulus of 7.2 kPa. • Adding cellulose nanocrystals (CNC) enhances both the anti-swelling properties and mechanical strength of the hydrogel. • The smartphone app provides real-time feedback on shoulder joint movements, reducing the risk of exercise injuries. [ABSTRACT FROM AUTHOR]

By establishing a three-dimensional finite element model of ankle injury arising from supination and external rotation, the stress characteristics of the posterior malleolar surface can be obtained, and analysis of the corresponding stress on the lateral ankle can be conducted. Thin-layer computed tomography images of normal ankle joint in the supination and external rotation nonweight-bearing states was selected, to construct a three-dimensional data model of each ankle joint. A load was applied to examine different ankle joint stress values and pressure distributions on the surface of the posterior ankle joint. A 600 N vertical compressive and 10 Nm internal rotation load was applied in Stage III (removing the anterior tibiofibular ligament and the posterior tibiofibular ligament) of SER (supination-external rotation). When the lateral malleolar was intact, the maximum stress (132.7 MPa) was located at the point of attachment of the posterior tibiofibular ligament to the fibula, and the maximum pressure of the posterior malleolar surface was lower than 4.505 MPa. When a lateral malleolar fracture was present, the maximum stress (82.72 MPa) was located on the fibular fracture surface, and the maximum pressure of the posterior malleolar surface was 8.022 MPa. This study shows that reconstruction of the lateral malleolus in supination-external rotation ankle injuries significantly affects the stress distribution at the posterior malleolar joint surface. Through this reconstruction, the pressure distribution of the posterior malleolar joint surface can be significantly reduced. [ABSTRACT FROM AUTHOR]

Rehabilitation robotics aims to facilitate the rehabilitation procedure for patients and physical therapists. This field has a relatively long history dating back to the 1990s; however, their implementation and the standardisation of their application in the medical field does not follow the same pace, mainly due to their complexity of reproduction and the need for their approval by the authorities. This paper aims to describe architecture that can be applied to industrial robots and promote their application in healthcare ecosystems. The control of the robotic arm is performed using the software called SmartHealth, offering a 2 Degree of Autonomy (DOA). Data are gathered through electromyography (EMG) and force sensors at a frequency of 45 Hz. It also proves the capabilities of such small robots in performing such medical procedures. Four exercises focused on shoulder rehabilitation (passive, restricted active-assisted, free active-assisted and Activities of Daily Living (ADL)) were carried out and confirmed the viability of the proposed architecture and the potential of small robots (i.e., the UR3) in rehabilitation procedure accomplishment. This robot can perform the majority of the default exercises in addition to ADLs but, nevertheless, their limits were also uncovered, mainly due to their limited Range of Motion (ROM) and cost. [ABSTRACT FROM AUTHOR]

Shoulder elevation, defined here as arm raising, being essential for activities of daily living, dysfunctions represent a substantial burden in patients' lives. Owing to the complexity of the shoulder joint, the tightly coordinated muscular activity is a fundamental component, and neuromuscular impairments have devastating effects. A single-joint shoulder type version of the Hybrid Assistive Limb (HAL) allowing motion assistance based on the intention of the user via myoelectric activation has recently been developed, and its safety was demonstrated for shoulder rehabilitation. Yet, little is known about the physiological effects of the device. This study aims to monitor the changes in muscle activity and motion during shoulder HAL rehabilitation in several patients suffering from shoulder elevation dysfunction from cervical radicular origin. 8 patients (6 males, 2 females, mean age 62.4 &#177 9.3 years old) with weakness of the deltoid muscle resulting from a damage to the C5 nerve root underwent HAL-assisted rehabilitation. We combined surface electromyography and three-dimensional motion capture to record muscular activity and kinematics. All participants showed functional recovery, with improvements in their Manual Muscle Testing (MMT) scores and range of motion (ROM). During training, HAL decreased the activity of deltoid and trapezius, significantly more for the latter, as well as the coactivation of both muscles. We also report a reduction of the characteristic shrugging compensatory motion which is an obstacle to functional recovery. This reduction was notably demonstrated by a stronger reliance on the deltoid rather than the trapezius, indicating a muscle coordination tending toward a pattern similar to healthy individuals. Altogether, the results of the evaluation of motion and muscular changes hint toward a functional recovery in acute, and chronic shoulder impairments from cervical radicular origin following shoulder HAL rehabilitation training and provide information on the physiological effect of the device. [ABSTRACT FROM AUTHOR]

Background: Arthroscopic Bankart repair (ABR) yields good results in young athletes with anterior shoulder instability. However, the treatment for overhead athletes is challenging because recovery of range of motion is necessary for return to play and repeated shoulder motion may lead to recurrent instability. The aim of this study was to investigate the clinical outcomes and return to sports after ABR on the dominant shoulder in overhead athletes.Methods: This study included 24 competitive level overhead athletes who underwent ABR on their dominant shoulders. The mean age at surgery was 17.6 years, and the mean follow-up was 39.7 months. The range of bilateral shoulder motion, the Rowe score, the Japanese Shoulder Society Shoulder Instability Score (JSS-SIS), and the Japanese Shoulder Society Shoulder Sports Score (JSS-SSS) were evaluated before the surgery and at the final visit. Recurrent instability, the final level of return to sports, and the duration before returning to sports were confirmed, as well as the pre-, intra- and postoperative factors, which prohibited complete return to play.Results: There were no cases of recurrent instability. The Rowe score, JSS-SIS, JSS-SSS, and the range of flexion, abduction, internal rotation significantly improved postoperatively. Fifteen athletes (62.5%) returned to the same or superior levels without any complaint in their shoulders. The mean duration needed for a complete return was 13.3 months. The postoperative external rotation deficit in abduction was larger in the athletes who returned incompletely than those who returned completely, 7.8° and 2.3°, respectively.Conclusions: ABR is a reliable surgery for preventing recurrent instability in overhead athletes, however the rate of a complete return to preinjury level was low and a long duration was needed for complete return to play. The postoperative external rotation may be necessary for a complete return to overhead sports.Level Of Evidence: Level IV: Retrospective Case Series. [ABSTRACT FROM AUTHOR]

Intraarticular (IA) corticosteroid injections have been demonstrated to be an effective management for adhesive capsulitis in both the short- and mid-term. Yet, certain patients fail to improve both subjectively and clinically. This study aims to identify predictive factors for treatment failure of IA injections in management of adhesive capsulitis. A retrospective review found 533 patients undergoing IA corticosteroid or IA NSAID injection for adhesive capsulitis between June 2015 and May 2020 at a single healthcare institution. Patient demographics characteristics, comorbidities, pain scores, and range of motion were compared. Treatment failure was defined as need for subsequent IA injection within 6 months or progression to surgical management within 12 months. 152 patients (28.52%) experienced treatment failure of IA corticosteroid injection. Pre-injection pain scores were greater for those who experienced treatment failure (5.40 vs. 4.21, p < 0.05). Post-injection pain scores were greater for those who experienced treatment failure (3.77 vs. 2.17, p < 0.01). Reduced post-injection external rotation in abduction also predicted treatment failure (56.88° vs. 70.22°, p < 0.01). IA corticosteroid injections are associated with increased rates of failure and progression to surgical management when patients present with increased pain levels as well as with less improvement in pain levels and ROM following injection. [ABSTRACT FROM AUTHOR]

The aim was to compare the morbidity of shoulder function following modified radical neck dissection with and without Pectoralis Major Myocutaneous muscle flap (PMMC) harvest in head and neck cancer patient to determine the effect of PMMC flap harvest on shoulder function and also to determine the effect of physiotherapy. Materials and methods: Prospective study involving two groups study group of 20 patients with MRND, with PMMC flap reconstruction as part of head and neck cancer surgery and control group of 20 patients who had undergone MRND(IJV & SAN sparing) without PMMC flap in same period were included. All patients were assessed at 3rd and 6th month following completion of surgery using subjective (Shoulder Disability Questionnaire) and objective (goniometer and manual muscle testing) parameters. 40 patients were included in the study, 33 (82.5%) male and 7 (17.5%) female with a mean age of 49 years with stage III/IV carcinoma In Group-1 and Group-2 the shoulder disability decreased significantly after physiotherapy intervention and also at 6thmonth postoperatively both groups showed improvements in shoulder range of motion and muscle strength. Harvesting of PMMC flap does not intensify the morbidity of shoulder which is common in RND and during MRND. A regimen of home-based exercises and patient education are effective tools to reduce shoulder disability and improving shoulder function. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical observation of shoulder joint exercise eight type rehabilitation exercise combined with Taijiquan in patients with modified radical mastectomy for breast cancer. Methods: From January 2020 to December 2021, 96patients with modified radical mastectomy for breast cancer were selected and divided into two groups according to the random number table. They were 48 cases in the control group and treated with eight exercises in shoulder joint exercise. 48 cases in the observation group and treated with eight type rehabilitation exercise of shoulder joint exercise combined with Taijiquan exercise. Functional recovery of affected limb, sleep quality, changes of immune function and incidence of lymphedema were compared between the two groups.Results: 12 weeks after intervention, range of motion(ROM) of affected limbs in the two groups were expanded, and the observation group was larger than the control group (P<0.05). 12 weeks after intervention, scores of Pittsburgh Sleep Quality Index(PSQI) items in the two groups decreased, and the observation group was lower than the control group (P<0.05). 12 weeks after intervention, CD3+, CD4+,CD4+/CD8+ increased in the two groups, and the observation group was higher than the control group, while CD8+ decreased in the two groups, and the observation group was lower than the control group(P<0.05). The incidence of lymphedema in observation group was lower than that in control group (P<0.05). Conclusion: Based on the eight types of shoulder joint exercises, combined with Taijiquan exercise, the patients with modified radical mastectomy for breast cancer can effectively improve sleep quality and immune function,promote recovery of limb function, and reduce the incidence of lymphedema, which has good effect. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff retear is a major concern after arthroscopic rotator cuff repair (ARCR); however, the effects of retear remain unclear. Therefore, the purpose of this study was to assess the clinical outcomes of postoperative retear and intact tendons after ARCR.Methods: We searched PubMed, Cochrane Library, Scopus, and PEDro databases for studies performed from January 2000 to June 2020. Clinical outcomes included the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles shoulder (UCLA) score, pain score, range of motion, and muscle strength. Meta-analysis using random-effects models was performed on the pooled results to determine significance.Results: The initial database search yielded 3141 records. After removal of duplicates, 26 of which met the inclusion criteria. Patients in the retear group had significantly lower Constant score [- 8.51 points (95% CI, - 10.29 to - 6.73); P < 0.001], ASES score [- 12.53 points (95% CI, - 16.27 to - 8.79); P < 0.001], UCLA score [- 3.77 points (95% CI, - 4.72 to - 2.82); P < 0.001], and significantly higher pain score [0.56 cm (95% CI, 0.10 to 1.01); P = 0.02] than the intact group. In addition, the retear group had significantly lower flexion [- 10.46° (95% CI, - 19.86 to - 1.07); P = 0.03], abduction [- 14.84° (95% CI, - 28.55 to - 1.14); P = 0.03], and external rotation [- 7.22° (95% CI, - 13.71 to - 0.74); P = 0.03] range of motion, and flexion [- 1.65 kg·f (95% CI, - 2.29 to - 1.01); P < 0.001], abduction [- 1.87 kg·f (95% CI, - 3.02 to - 0.72); P = 0.001], and external rotation [- 1.66 kg·f (95% CI, - 3.25 to - 0.07); P = 0.04] muscle strength.Conclusion: Our results suggest that retear after ARCR leads to poor clinical outcomes after surgery. [ABSTRACT FROM AUTHOR]

Copyright of Studia Universitatis Babes-Bolyai, Educatio Artis Gymnasticae is the property of Babes-Bolyai University, Cluj-Napoca, Romania 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: Burns are mild or severe lesions produced in living tissue, due to the action of different agents. This pathology is considered the third cause of accidental death in the world by the World Health Organization. Among the most disabling sequelae in these patients, pain and range of motion have the greatest impact. A recommended tool to complement the treatment or management of the symptoms associated with burns is virtual reality. Objective: The objective of this study was to analyse the effectiveness of virtual-reality therapy for pain relief and the improvement of the range of joint movement in patients who have suffered burns. Methodology: This study is a systematic review conducted following the PRISMA statements. An electronic literature search was performed in the following databases: PubMed, Cochrane, Dialnet, Scopus and Science Direct. The inclusion criteria were: participants with burns in any part of the body, interventions with virtual reality with or without complementary treatment, studies in both Spanish and English, and outcome measures of pain and range of motion. Results: Finally, 10 studies were included in the review. The sample consisted of one pilot study, three randomized controlled clinical trials, one prospective randomized controlled clinical trial, one control group and treatment group trial, one interventional clinical trial and three comparative studies. The most commonly used assessment tools for pain were the graphic rating scale (GRS) and for range of motion the goniometer. The use of virtual-reality games significantly reduced pain scores during physiotherapy and occupational therapy treatments as well as in nursing care. The range of motion improved significantly during virtual-reality exercises performed during a physiotherapy treatment in 33% of studies included in this review. Conclusion: The results of the studies analysed in this systematic review suggest that the use of virtual reality for the management of pain and range of movement limitations associated with burn injuries could control these symptoms and decrease their negative consequences on the person. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the range of motion (ROM) at the shoulder joint before and after silent manipulation. Methods: This retrospective study included all patients who underwent silent manipulation at our institution between January 2013 and December 2017. In total, 1,665 shoulders in 1,610 patients (519 men, 1,146 women; mean age 55.4 ± 8.8 years) were treated during the study period. The mean symptom duration was 6.6 ± 7.1 months. ROM at the shoulder joint was measured in flexion, abduction, and external rotation before silent manipulation and at 1 week and 1, 2, and 3 months after the procedure. Results: Mean ROM at the shoulder was 98.8° (95% confidence interval [CI] 97.9–99.8) before silent manipulation and 155.5° (154.1–156.8) after 3 months in flexion (p = 0.0000), 75.6° (74.5–76.8) and 152.9° (151.0–154.9), respectively, in abduction (p = 0.0000), and 12.7° (12.0–13.4) and 45.9° (44.4–47.4) in external rotation (p = 0.0000). All ROM values were significantly increased at all time points after the procedure. There were no unanticipated adverse events or serious adverse reactions. Conclusions: This study reports on the efficacy and safety of manipulation using conduction anesthesia for shoulder contractures in a large group of patients. Silent manipulation can increase ROM at the shoulder safely and effectively. [ABSTRACT FROM AUTHOR]

Objective: To assess the factors associated with outcomes of arthroscopic surgical repair of rotator cuff tears (RCTs). Method: This prospective study recruited patients, at least 18 years old, who underwent arthroscopic rotator cuff repair for full‐thickness RCTs at the First People's Hospital of Hangzhou Xiaoshan between July 2019 and October 2020. Patient demographics, lifestyle habits, and medical histories were collected preoperatively; RCT sizes and affected tendons were determined intraoperatively. Outcomes were assessed by shoulder range of motion (ROM) determinations 1.5 and 3 months postoperatively. The factors associated with ROM were determined using a binary logistic regression analysis, and the results were expressed as adjusted relative risks (RRs) and 95% confidence intervals (CIs). Results: A total of 132 patients with RCTs underwent arthroscopic surgery. Five were lost to follow‐up, leaving 127 patients (mean age, 59 years; 58.3% women) who were included in the study analysis. The majority of the patients (54.5%) had RCTs that were classified as large or massive, and approximately 20% had tears involving multiple tendons; 80.3% of the patients had tears involving only a single tendon. Moreover, 29.9% of the patients had hypertension and 11.0% had diabetes. Among the patients, 23.0% were smokers and 34.6% drank alcohol. According to the multivariate analysis, none of the assessed factors were associated with shoulder ROM at the 1.5‐month follow‐up. At the 3‐month follow‐up, RCTs involving a single tendon demonstrated 3‐fold better abduction (RR = 4.00; 95% CI, 1.30–12.33; P = 0.016) and 3.15‐fold better internal rotation (RR = 3.15; 95% CI, 1.19–8.36; P = 0.021) than did RCTs involving multiple tendons. Patients who did not drink alcohol demonstrated 6.08‐fold better anteflexion (RR = 7.08; 95% CI, 2.11–23.73; P = 0.002) and nearly 4‐fold better abduction (RR = 4.97; 95% CI, 1.62–15.23; P = 0.005) than patients who drank alcohol. Conclusion: To improve outcomes, the results indicate that more targeted measures should be directed toward patients with multiple‐tendon RCTs and that preoperative alcohol abstinence education is needed for patients with RCTs. [ABSTRACT FROM AUTHOR]

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.)

In this paper, an autonomous exercise generation system based of fuzzy logic approach is presented. This work attempts to close a gap in the design of a completely autonomous robotic rehabilitation system that can recommend exercises to patients based on their data, such as shoulder range of motion (ROM) and muscle strength, from a pre-set library of exercises. The input parameters are fed into a system that uses Mamdani-style fuzzy logic rules to process them. In medical applications, the rationale behind decision making is a sophisticated process that involves a certain amount of uncertainty and ambiguity. In this instance, a fuzzy-logic-based system emerges as a viable option for dealing with the uncertainty. The system's rules have been reviewed by a therapist to ensure that it adheres to the relevant healthcare standards. Moreover, the system has been tested with a series of test data and the results obtained ensures the proposed idea's feasibility. [ABSTRACT FROM AUTHOR]

Aim: The scapulohumeral periarthritis is a clinical syndrome characterized by shoulder pain and movement mobility limitation, caused by periarticular structures affecting the following: tendons, capsule, ligaments, muscles, synovial bursa. The disorder is favored by the congenital factors (a too narrow space between the rotator muscles tendons and the subacromial bony arch, for exemple) or by the mechanical factors (the excesive professional or sportif use of the articulation). This study had as its purpose to determine in which degree the use of active with resistance Thera-Band exercises increases strength and mobility on the shoulder, compared with the application of the classical strategies in therapy. Methods: The research was conducted at the Balneal and Recovery Sanatorium of Techirghiol in 2020 autumn and included 26 patients (11 men, 25 women, age media 43), all being diagnosed with scapulohumeral periarthritis and equally divided into two groups, control and experimental. Results: All the subjects involved in the research gained mobility and pain intensity decreased, but the experimental group presented a higher score of the final goniometry tests than the control group. Conclusions: Resistance band exercises for periarthritic shoulder optimized the given physical therapy sessions. It represents an effective and simple technique, which provides semnificative improvements in joint range of motion. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rotator cuff tear is the most common cause of shoulder pain. If nonsurgical treatment fails, arthroscopic rotator cuff repair (ARCR) is recommended. Since the standards for rehabilitation after ARCR are not clear, various rehabilitation methods have been suggested. This study intends to investigate the effect on the recovery phase of ARCR patients through a postoperative rehabilitation protocol (PRP) that considers the healing process and rehabilitation trend. Materials and Methods: This single-arm, pragmatic intervention study was conducted on 30 patients, two weeks postoperative day (POD) after ARCR. ARCR patients received intervention for six weeks from POD two-week, and pain intensity and shoulder function were evaluated at two-week intervals until POD 12-week, and range of motion (ROM) was evaluated at POD four-week and eight-week. Results: In this study, all variables improved over time (p < 0.05). As a result of the comparison between time points, a significant improvement was found in shoulder function at POD 6-week. In addition, the effect size had a large effect on ROM (flexion, scaption flexion, abduction, and external rotation) and shoulder function. Conclusions: Management through the PRP based on scientific evidence in the strategy of postoperative rehabilitation of patients with ARCR is effective for pain intensity, ROM, and shoulder function. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study was to identify the effect of Maitland mobilization with hand-eye coordination and hand function exercises in the prognosis of adhesive capsulitis. Methods: This non-randomized control trial was done with 40 patients with adhesive capsulitis referred to the OPD at UCA College of Physiotherapy, Chennai. The study was performed for 8 months duration from August 2018 to March 2019. After providing a sufficient explanation of the procedure, the patients were divided into Group-A and Group-B. Group-A were allocated to Maitland group (n=20) (MG) and Group-B, were assigned to the Maitland, Hand-eye coordination and Hand Function exercises group (n=20) (MHG), respectively. We measured Quality of life using SF36 to know whether these patients had poor QOL compared to normative. Each patient underwent testing before the experiment to evaluate the range of motion of the shoulder (Abduction and External rotation) measured using a 180° goniometer, Functional Disability assessed using SPADI index. Statistical analysis was applied using SPSS version 20.0. Before the study, data normality was tested. A parametric test was used to compare pre-and post-intervention data in each Group-And also compare the MG vs. MHG. An α < 0.05 is the level of significance in all analyses. Results: A total of 40 subjects accounted for the study results. Their quality of life was significantly lower from the normative values. Both groups were homogenous at baseline with no significant difference between the ROM and SPADI scores. Both groups showed a significant improvement in ER, abduction ROM and SPADI scores, however the between group posttest analysis revealed that the Group-B subjects progressed significantly better. Conclusions: The study concluded that the Maitland mobilization and hand-eye coordination and hand function exercises are an effective tool in improving shoulder abduction, external rotation and shoulder functions. [ABSTRACT FROM AUTHOR]

This study analyzes the rehabilitation effects of athletes with anterior cruciate ligament injury of the knee based on multidisciplinary combined nondrug therapy. For this purpose, 70 athletes with anterior cruciate ligament injury of the knee admitted from September 2019 to December 2020, who were randomly selected, were the subjects of the study. According to the random number table method, they were divided into the control group and observation group, with 35 cases in each group. The control group was given conventional conservative treatment such as braces braking, local physiotherapy, and routine rehabilitation exercise after injury. For the observation group, multidisciplinary combined nondrug therapy was implemented on the basis of the control group. After receiving the intervention, the balance function score of the observation group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). After receiving the intervention, the functional recovery scores of the knee joint of the observation group were significantly higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). Before treatment, there was no significant difference in knee flexion extension, internal rotation, and external rotation between the two groups (P > 0.05). After treatment, flexion extension, internal rotation, and external rotation of the knee joint in the observation group were significantly higher than those in the control group (P < 0.05). There was no significant difference in VAS scores between the two groups before treatment (P > 0.05). After treatment, the VAS score of the observation group was significantly lower than that of the control group (P < 0.05). Multidisciplinary combined nondrug therapy has a good therapeutic effect in the treatment of anterior cruciate ligament injury of the knee for athletes. It can be used as a conservative treatment method to improve the score of balance function and recovery of lacquer joint function, enhance the range of motion of the knee joint, and reduce the VAS. [ABSTRACT FROM AUTHOR]

Purpose: Presentation of a physiotherapeutic program after nerve transfers in the shoulder area and follow-up of the effect of its application. Material and methodology: The contingent is 15 men with a mean age of 37.1 years with adult brachial plexus injury and subsequent double nerve transfer in the shoulder area. The physiotherapeutic program before reinnervation, focuses on exercises with activation of the donor nerve. After the reinnervation active exercises are used, both with and without resistance, as well as exercises for distinguishing the old nerve function from the new one. Physiotherapeutic results were reported at the 6th and 12th postoperative months by goniometry and Medical Research Council Scale (MRCS). Results: At the 12th postoperative month average active flexion 97.9°, average abduction 86.4° and average external rotation 32.1° were reported. The results of the MRCS of 12th postoperative month showed an average score of 3.6 for the shoulder abductors, an average of 3.1 for the shoulder flexors and an average of 2.9 for the external rotators. Conclusion: An adequate physiotherapy program after nerve transfers provides the necessary reeducation of the donor's nerve. For a period of 12 postoperative months it is possible to achieve a good active range of motion and satisfactory muscle function in the shoulder area. This creates preconditions for the improvement of the combined movements in the shoulder, which are necessary for several activities of daily living. [ABSTRACT FROM AUTHOR]

Introduction: ACJ separation is a common shoulder injury. A variety of surgical techniques for high-grade ACJ separations have been described. A commonly used technique represents open reduction and fixation by a hook plate. Goal of the present study was to evaluate radiographic and functional outcome in patients with high-grade ACJ separations following surgical treatment with a hook plate before and after surgery as well as after hook plate removal. Materials and methods: Patients undergoing surgery with a hook plate due to traumatic ACJ separation between 2012 and 2014 were included and examined during a follow-up control. Demographic and clinical data as well as radiographs pre- and postoperatively were evaluated. Additionally, range of motion, DASH Score and Constant–Murley Score (CMS) were analysed in a follow-up examination. Wilcoxon signed-rank test and Spearman's rank correlation were used for statistical analysis. Results: 99 patients (88 m/11 w, 44 y) were included in the present study. 69 (64 m/5 w, 49 y) could be examined during long-term follow-up (38 month). After hook plate removal, the CCD increased significantly (13.7 ± 0.9 mm) compared to the hook plate in situ (9.9 ± 0.8 mm, p = 0.000001). 68% of all patients achieved a full range of motion post-operatively. Main limitations of range of motion affected external rotation as well as ante-/retroversion. Mean DASH Score was 5.6 ± 1 points and CMS 90.0 ± 1.4 points. Conclusion: In contrast to a significant higher CCD after hook plate removal, nearly all patients achieved good to excellent functional results for DASH and CMS. This indicates that loss of reduction does not necessarily lead to poor functional outcome after ACJ separation surgery. [ABSTRACT FROM AUTHOR]

Shoulder deformity and inadequate shoulder function in brachial plexus birth palsy (BPBP) occur due to imbalance between the shoulder abductors, external rotators, adductors and internal rotators. This is due to cross innervation of the regenerating axons and subsequent target muscle innervation. These lead to internal rotation deformity along with glenohumeral dysplasia. Conjoint muscle transfer in the form of latissimus dorsi and teres major muscle combined with release and slide of subscapularis muscle improves shoulder functions. This study aims to evaluate the outcomes of shoulder function after a simultaneous conjoint muscle transfer and subscapularis slide in the management of BPBP. 18 children with BPBP, who presented with shoulder deformity and inadequate shoulder functions, underwent conjoint muscle transfer along with subscapularis muscle slide. At 18 months, shoulder functions were assessed preoperatively and postoperatively using Mallet score system and range of motions. Statistical analysis was performed to ascertain if the outcomes were statistically significant. Mean age was 4.64 years with a mean preoperative Mallet score of 10.89 ± 1.60 and mean postoperative Mallet score of 16.22 ± 1.86. At 18 months, mean gain in shoulder abduction at 18 months was 57.22 ± 16.11° with external rotation of 26.66 ± 7.67°. All children showed improvement in shoulder functions. There was no correlation between the clinical outcomes and age of the child. This procedure was effective in improving shoulder functions in a cohort of patients. The long-term effect of this procedure, however, remains to be evaluated by further follow-up and with similar such studies. [ABSTRACT FROM AUTHOR]

Background:Adhesive capsulitis is a common and debilitating medical condition which is treated by various surgical and non-surgical treatments but there is no significant method universally. Physical therapists use various shoulder mobilization techniques to improve the ROM. Radiographic and surgical evidence presents tightened CHL to be a prime contributor to inadequate shoulder external rotation in individuals diagnosed with adhesive capsulitis. Objective: To determine the combined effectiveness of Kaltenborn posterior glide and coracohumeral ligament (CHL) positional stretching on external rotation in patients with adhesive capsulitis. Methods and Measures:A number of 30 subjects, both Male and Female with a primary diagnosis of shoulder adhesive capsulitis by the physician were recruited. 15 subjects each were randomly assigned to Group-A(Experimental) and Group-B(control). All subjects received 6 therapy sessions consisting of moist heat, shoulder pendular and ROM exercises, Kaltenborn posterior glide and Coracohumeral ligament positional stretching in Group-A. Moist heat, shoulder pendular and ROM exercises in Group-B. Pre-test and post-test were carried out for both the groups and analysed using paired and independent t tests in an SPSS software. Results: The experimental group(Group-A) mean VAS score had decreased from 6.27 to 3.73, SPADI mean score decreased from 0.534 to 0.380 and also Goniometer (Shoulder external ROM) showed an improvement from 29.2 to 35.33 but when intergroup analysis was done, it resulted in significance only for SPADI where p < 0.05. Through this measure, we can state that the treatment protocol for group A had a significant improvement in disability but not much on pain and ROM in patients with adhesive capsulitis. Conclusion: All the interventions has brought about some improvement in each group post-treatment based on the mean score but its significance vary. So, this study can be concluded that, the treatment protocol, Kaltenborn posterior glide and CHL positional stretching could bring a significant difference with regard to disabilty but not much of difference in pain and ROM in patients with adhesive capsulitis. [ABSTRACT FROM AUTHOR]

BACKGROUND: In clinic, there are various fixation methods for greater tuberosity avulsion fractures of the humerus. If the fixation of the greater tubercle is unsatisfactory, it will lead to the absorption of the greater tubercle as the mechanical core of the shoulder joint, resulting in serious shoulder joint dysfunction. OBJECTIVE: To explore the curative effect of the treatment of anterior dislocation of shoulder joint with greater tuberosity avulsion fractures of the humerus by double-row suture anchors under shoulder arthroscope. METHODS: A retrospective study was conducted in 20 patients with anterior dislocation of the shoulder and avulsion fracture of the greater tuberosity of the humerus in Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University who underwent arthroscopic double-row suture anchors from January 2016 to October 2018. After operation, systematic shoulder joint function exercise was performed, and joint function evaluation and pain score were regularly followed up. The functional recovery was compared before and after operation. RESULTS AND CONCLUSION: (1) The incisions of all patients healed in stage I, without complications such as infection, loosening of anchor pin, or nerve injury. After one-year follow-up, there was no significant subacromial impact in all patients. (2) At 1, 3, 6 and 12 months postoperatively, the Constant-Murley score and the University of California at Los Angeles shoulder rating scale score were significantly different (P < 0.05); and the score of each time point was better than that of the previous time point (P < 0.05). (3) At 1 month after surgery, the resting and activity visual analogue scale scores were significantly lower than before surgery (P < 0.05); the displacement distance of greater tuberosity fracture was significantly less than that before operation (P < 0.05). (4) One year after operation, the range of motion of shoulder joint such as flexion, abduction, external rotation and adduction recovered well. (5) It is indicated that arthroscopic double-row suture anchors can effectively restore the displacement of the greater tuberosity fractures, and achieve a good fixation of the rotator cuff tendon injury, promote healing, and relieve patients’ pain, which is conductive to early shoulder functional exercise. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Sport Sciences / Magallat ulum Al-Riyadat is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) 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.)