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Background Rotating hinged knee prosthesis is frequently used for certain indications. The indications and results for rotating hinge knee prosthesis in primary and revision arthroplasty are controversial. The aim of this study was to investigate the effects on hip function following rotating hinged knee arthroplasty surgery and to compare outcome of primer and revision rotating hinged knee arthroplasty.Methods 46 patients underwent rotating hinged knee prosthesis by a single surgeon; including 21 primary arthroplasty and 38 revision, 59 knees arthroplasty were included. Hospital for Special Surgery (HSS) knee scores, SF-12 quality of life scale, joint range of motion, VAS score, Harris hip scores (HHS) were evaluated before and after surgery.Results A statistically significant increase was found in both hip joint HHS scores in patients with rotating hinged knee replacement. A statistically significant improvement was found in HSS scores, knee joint VAS in patients with rotating hinged knee replacement (p Conclusion A successful knee arthroplasty surgery in patients with advanced biomechanical problems contributes to the improvement in hip function by improving the biomechanics and functions of the knee joint. It is necessary to evaluate all joints and bone structures in both lower extremities to make better preoperative planning.

Background Step Test (ST) is frequently used to assess dynamic balance and locomotor function in clinical practice. Aims This study aimed to determine the concurrent validity, reliability, and minimal detectable change (MDC) of the ST in patients with total knee arthroplasty (TKA). Methods The study included 56 patients with TKA. The intraclass correlation coefficient (ICC) was used to assess the test-retest reliability of the ST. The correlations of the ST with timed up and go (TUG) and 10-m walk test (10MWT) were assessed for concurrent validity. Results Test-retest (ICC 0.90) reliability of the ST was determined to be excellent. The SEM and MDC95 values of test-retest reliability were 0.76 and 2.11, respectively. A significantly moderate correlation was found between the ST and TUG (p < 0.05, r: - 0.69), and 10MWT (p < 0.05, r: - 0.67). Conclusion The ST is a valid and reliable method in the assessment of dynamic balance ability and locomotor function in patients with TKA. The ST can be used to quantify changes in dynamic balance level and locomotor function in patients with TKA.

The L test is a modified version of the timed up and go test (TUG), extending the walking distance from 6 to 20 meters and also requiring participants to make four turns in both (right/left) direction. It could be a useful measurement method in assessment of functional mobility for patients with Total Knee Arthroplasty (TKA). The aim of the study was to determine reliability, concurrent validity, and minimal detectable change (MDC) of L test in patients with TKA.The study included 43 patients with TKA. The Intraclass Correlation Coefficient (ICC) was used to assess the intra-rater reliability of the L test. The correlations of the L test with TUG were assessed for concurrent validity.Intra-rater (ICC 0.97) reliability of the L test was determined to be excellent. The SEM and MDCThe L test is a valid and reliable method in the assessment of functional mobility in patients with TKA. The L test can be used to quantify changes in functional mobility level in patients with TKA.Implications for rehabilitationThe L test is a reliable and valid measurement tool that can be used to assess functional mobility in patients with TKA.Clinicians and researchers can use a greater change than 2.84 seconds for the L test as a meaningful change in patients with TKA.

Local infiltration analgesia (LIA) is a simple, surgeon-administered technique for the treatment of postoperative pain after total knee arthroplasty (TKA). The aim of the study was to investigate the efficacy of LIA and its effects on functional outcomes in TKA. A total of 135 patients with primary TKA were recruited and randomized either to receive LIA or to receive placebo injection (PI). Pain, active range of motion (ROM), knee function score, functional activities, and hospital length of stay (LOS) were assessed before surgery and from postoperative day (POD) 1 to at discharge. Lower pain scores at rest were recorded on POD1 and POD2 in the LIA group (p = 0.027 and p = 0.020, respectively). Lower pain score on walking was recorded on POD1 in the LIA group (p = 0.002). There was a statistically significant difference in active knee flexion between groups on POD1 (p = 0.038). There was a significant difference in LOS between LIA and PI groups. Shorter stay was seen in LIA group. There were no statistically significant differences between the groups in terms of knee function score and functional outcomes. LIA technique is effective for pain management in the early postoperative period. LIA added benefit for knee function in terms of active knee flexion ROM after TKA. A shorter hospital LOS was observed in LIA group. However, we did not find any differences in groups in terms of functional assessment such as ability to rise from a chair and walking capacity.The level of evidence is randomized controlled trial, level I.

Objective To investigate the effects of kinesio taping and cold therapy on pain, edema, range of motion, muscle strength, functional level and quality of life in patients with total knee arthroplasty. Design Randomised controlled trial. Setting A university hospital. Subjects One-hundred patients were included. Intervention Patients were allocated into three groups; control group, kinesio group and cold therapy group. The control group received a standard rehabilitation program. Kinesio taping group received two fan-shaped kinesio taping bands and cold therapy group received cold packs in addition to the standard rehabilitation program. Main measures The outcome measures were pain, edema, range of motion, muscle strength, functional level and quality of life. Participants were assessed at preoperative, discharge and postoperative third month. Results The groups were similar at preoperative. A significant difference was determined in terms of pain in kinesio taping group compared to the control group at the discharge. Cold therapy was efficient in reducing postoperative swelling but kinesio taping had no significant effects on swelling control. There was no difference between the groups in terms of range of motion, muscle strength, functional level and quality of life. The groups were similar in all parameters at the postoperative third month measurements. Conclusion Fan-shaped kinesio taping is an effective technique in terms of postoperative pain relief. Cold therapy is an effective method in terms of edema control. Kinesio taping and cold therapy has no specific beneficial effect on functional level, muscle strength and quality of life compared to control group.

Background Ankle sprains are one of the most frequent injuries between athletes. After an ankle injury, 72% of patients will experience some degree of functional impairment (proprioception, ankle stability, and balance), which leads to changes in sporting and occupational activities. In the literature, there is no enough information about how bandaging and taping can affect the ankle sprain treatment and rehabilitation process. Method Seventy-four healthy participants, the age range was 18-30 years old participated in this study. The participants were divided into two groups (taping, and bandaging groups). Proprioception and balance have been measured four times (before using tap, 20 min after using tap, 24 h after using tap, and after removing the tap). Results In both groups (bandaging group and taping group), proprioception and balance significantly increased immediately after using tape and bandage, after 24 h of using tape and bandage, and after 48 h using tape and bandage when compared to the baseline measurements. There were no significant differences in proprioception and balance between groups. Conclusion Ankle tape and bandage can significantly improve balance and proprioception in the uninjured ankle during the entire interval of their use.

Background/aim: The 6-minute walk test (6MWT) is the most commonly used and well-established test to measure functional exercise capacity in research and clinical settings. Country-specific reference values are important to interpret the results of 6MWT. However, no reference values have been reported for healthy Turkish children aged between 6 and 12 years old. The aim of this study was to determine normal reference values for the 6MWT test of healthy Turkish children aged between 6 and 12 years old. Materials and methods: Two hundred and sixty-two healthy children aged between 6 and 12 years old were included in this cross-sectional study. Measures included height, weight, body mass index (BMI), leg length, and 6MWT distance (6MWD). Results: The mean 6MWD was 572.58 (SD = 117.72) m. There were significant correlations between 6MWD and age (r = 0.764, P < 0.001), height (r = 0.742, P < 0.001), weight (r = 0.605, P < 0.001), BMI (r = 0.234, P < 0.001), and lower extremity length (r = 0.708, P < 0.001). In the stepwise multiple linear regression model, age and height explained about 60% of the variability of the 6MWT distance for the total sample. Conclusion: Reference values and prediction equation for the 6MWT in healthy Turkish children aged 6?12 years old have been reported for the first time in this study. Researchers and clinicians can use them to interpret the effectiveness of a treatment and/or to compare the results of disabled children with healthy ones.

Purpose: Performance-based outcome measures are becoming increasingly important in health care. The 2-minute walk test (2MWT) and the Timed Up and Go test (TUG) are frequently used in clinical trials as performance-based tests in many diseases including osteoarthritis. The purposes of this study were: (1) to determine test-retest reliability of data for the 2MWT and the TUG; (2) to determine minimal detectable change (MDC) scores for the TUG and 2MWT in patients with total hip arthroplasty (THA). Methods: 37 patients, who had undergone primary THA, were included. Patients twice performed trials for the 2MWT and TUG on the same day. In addition to demographic data of patients, the Harris Hip Score, 2MWT and TUG scores were recorded. Results: The TUG and 2MWT showed excellent test-retest reliability. The Intraclass correlation coefficient ICC (2,1), Standard error of measurement (SEM) and minimal detectable chance at the 95% CI (MDC95) for TUG were 0.96, 0.59 seconds and 1.62 seconds respectively. The ICC (2,1), SEM and MDC95 for 2MWT were 0.96, 6.37 m and 17.56 m respectively. Conclusion: Clinicians and researchers can be confident that greater changes than 1.62 seconds for TUG and 17.56 m for the 2MWT over time represent a real clinical change in rehabilitation process in patients with THA. Both the 2MWT and TUG may assist in early identification of patients who may need additional rehabilitation to reduce the potential for poor outcomes after THA. Therefore, both of these tests can be used in a clinical setting with a small measurement error.

Objective The aim of the study was to determine intrarater and interrater reliabilities for static strength assessment of knee flexors and knee extensors in patients with total knee arthroplasty, during the acute postoperative rehabilitation. Design Forty-five total knee arthroplasty patients were included in the study. Two physical therapists performed strength assessments by using hand-held dynamometry. Patients performed three trials and a 30-sec rest was provided between each trial. After this, a 5-min rest was provided, and then, a second investigator performed the same procedure for interrater reliability. Assessments for intrarater reliability were performed 1 hr later. Results The intrarater reliability of knee extensors and knee flexors strength measurements were 0.96 and 0.94, respectively. The standard error of measurement and minimal detectable change 95% confidence level were 6.17 and 17.01 Nm for knee extensors and were 8.89 and 24.51 Nm for knee flexors, respectively. The interrater reliability of knee flexors and knee extensors strength measurement was 0.96 for both. The standard error of measurement and minimal detectable change values at 95% confidence level were 6.00 and 16.54 Nm for knee extensors and were 6.32 and 17.42 Nm for knee flexors, respectively. Conclusions Hand-held dynamometry is a reliable method to assess static knee strength. Hand-held dynamometry assessment can be implemented during acute postoperative rehabilitation. Our results may assist the clinicians in determining an accurate postoperative rehabilitation program after total knee arthroplasty surgery.

BACKGROUND: Six-minute walk test (6MWT) is the most used test to assess functional capacity. Including arm span in the prediction equations for 6MWT performance might be an alternative for use in traditional reference equations. OBJECTIVE: The aim was to investigate the usability of arm span to predict the 6MWT distance in healthy children. METHODS: 262 healthy children aged between 6 and 12 years old participated in this study. 6MWT was conducted according to the standardized protocol. Height, weight, and arm span were measured before performing the 6MWT. A multiple stepwise linear regression analysis was used to generate the regression model. RESULTS: The 6MWT distance had strong positive correlations with age, arm span, height, and weight (p

Background: Evaluation of range of motion (ROM) is integral to assessment of the musculoskeletal system, is required in health fitness and pathologic conditions, and is used as an objective outcome measure. Several methods are described to check ROM, each with advantages and disadvantages. Hence, this study introduces a new device using a smartphone goniometer to measure ankle joint ROM. Objective: To test the reliability of smartphone goniometry in the ankle joint by comparing it with the universal goniometer (UG) and to assess interrater and intrarater reliability for the smartphone goniometer record (SGR) application. Methods: Fifty-eight healthy volunteers (29 men and 29 women aged 18–30 years) underwent SGR and UG measurement of ankle joint dorsiflexion and plantarflexion. Two examiners measured ankle joint ROM. Descriptive statistics were calculated for descriptive and anthropometric variables, as were intraclass correlation coefficients (ICCs). Results: There were 58 usable data sets. For measuring ankle dorsiflexion ROM, both instruments showed excellent interrater reliability: UG (ICC = 0.87) and SGR (ICC = 0.89). Intrarater reliability was excellent in both instruments in ankle dorsiflexion: UG and SGR (mean ICC = 0.91). For measuring ankle plantarflexion, both instruments showed excellent interrater reliability: UG (ICC = 0.76) and SGR (ICC = 0.82). Intrarater reliability was excellent in both instruments in ankle plantarflexion: UG (mean ICC = 0.85) and SGR (mean ICC = 0.82). Conclusions: Smartphone-based goniometers can be used to assess active ROM of the ankle joint because they can achieve a high degree of intrarater and interrater reliability.

Background:Total knee arthroplasty (TKA) is a very common procedure, particularly implemented for the treatment of knee osteoarthritis (OA). Patient expectations after TKA surgery now include being able to enjoy appropriate recreational activities representing ambulatory activities beyond that of just pain relief and adequate knee motion (1). Since recreational activity comprises of more complex functions and requires longer standing durations, walking for 6-meter in a straight line in the timed up and go test (TUG) does not fully reflect the functional capacity of patients with TKA, and TUG test may be limited to detect the balance and mobility capacity in TKA patients (2, 3). As such, there is a need to determine more effective and functional evaluation tools that better reflect realistic situations in order to assess ambulatory performance level for patients with TKA. However, no studies have been conducted in patients with TKA to examine the applicability of the L-test, which assesses ambulation of individuals and consists of complex mobilization activity.Objectives:The purposes of this study were to determine the test-retest reliability and the minimal detectable change (MDC) of the L-test for TKA patients.Methods:Twenty-four patients with TKA due to knee OA, operated by the same surgeon, were included in this study. Patients performed trials for L-test twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. The tester recorded the performance time while the participant was asked to get up from a chair, walk 3 m in a straight line, turn right, continue walking for 7 m in a straight line, turn left, walk back along the same path and sit down in the chair at their usual walking speed. Prior to the real testing session, the L-test was demonstrated by the tester and all participants were allowed to a practice trial.Results:The L-test showed an excellent test-retest reliability (ICC2,1= 0,98) in this study. Standard error of measurement (SEM) and MDC95for L-test were 1,01 second and 2,8 second, respectively.Conclusion:This study found that the L-test is a reliable test for patients following TKA. Overall, the excellent test-retest reliability of the L-test indicates that it may be an applicable standardized method to assess TKA patients who are able to walk greater distances and have better gait in more functional situations. Clinicians and researchers can be confident that changes in L-test time above 2,8 seconds, represent a “real” clinical change in an individual patient with TKA. We, therefore, recommend the use of L-test as complementary outcome measures for balance and functional evaluation in TKA patients.References:[1]Swinkels, A., & Allain, T. J. (2013). Physical performance tests, self-reported outcomes, and accidental falls before and after total knee arthroplasty: an exploratory study. Physiotherapy theory and practice, 29(6), 432-442.[2]Deathe, A. B., & Miller, W. C. (2005). The L test of functional mobility: measurement properties of a modified version of the timed “up & go” test designed for people with lower-limb amputations. Physical therapy, 85(7), 626-635.[3]Kim, J. S., Chu, D. Y., & Jeon, H. S. (2015). Reliability and validity of the L test in participants with chronic stroke. Physiotherapy, 101(2), 161-165.Disclosure of Interests:None declared

Background:Patients with TKA show impairments in standing balance up to 1 year after surgery. The impaired standing balance in TKA patients was found to be associated with falls risk and decreased functional level. Assessing of standing balance with objective and reliable assessments tools would therefore be extremely useful for determining accurate exercise program, and risks of falling, especially during the rehabilitative period when ambulation is at its most unsteady (1, 2). The stepping maneuver requires adequate strength and motor control to stabilize the body over the stance limb while the other leg is stepping, therefore the Step Test (ST) provides significant information for dynamic standing balance and lower limb motor control (3). The reliability of ST is reported in patient groups such as stroke, however, there is not any study that investigates the reliability of ST in patients with TKA in the current literature.Objectives:The purposes of this study were to determine the test-retest reliability and the minimal detectable change (MDC) of the ST in patients with TKA.Methods:40 patients with TKA due to knee osteoarthritis, operated by the same surgeon, were included in this study. Patients performed trials for ST twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. The ST assesses an individual’s ability to place one foot onto a 7.5-cm-high step and then back down to the floor repeatedly as fast as possible for 15 seconds. The score is the number of steps completed in the 15-second period for each lower extremity. Scores for each lower extremity were recorded separately. Prior to the testing, the ST was demonstrated by the tester and all participants were allowed to a practice trial.Results:The ST showed an excellent test-retest reliability (ICC2,1=0.95) in this study. Standard error of measurement (SEM) and MDC95for ST were 0.37 and 1.02, respectively.Conclusion:This study found that the ST has an excellent test–retest reliability in patients with TKA. It is an effective and reliable tool for measuring dynamic standing balance and participant falls. As a performance-based clinical test, the ST is easy to score, can be applied in a short time as part of the routine medical examination. Therefore, inclusion of ST into a more comprehensive battery of performance-based measures of standing balance and lower limb motor control function in subjects with TKA should be considered.References:[1]Si, H. B., Zeng, Y., Zhong, J., et al. (2017). The effect of primary total knee arthroplasty on the incidence of falls and balance-related functions in patients with osteoarthritis. Scientific reports, 7(1), 1-9.[2]Moutzouri, M., Gleeson, N., Billis, E., et al. (2017). The effect of total knee arthroplasty on patients’ balance and incidence of falls: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 25(11), 3439-3451.[3]Hill, K. D., Bernhardt, J., McGann, A. M., et al. (1996). A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly. Physiotherapy Canada, 48(4), 257-262.Disclosure of Interests:None declared

OBJECTIVE: To investigate the reliability of the 50-Foot Walk Test (50 FWT) and 30-second Chair Stand Test (30 CST) in patients who have undergone total knee arthroplasty (TKA). METHODS: The study was designed as a test-retest research. Thirty-three patients who would undergo bilateral TKA were recruited. The tests 30 CST and 50 FWT were performed twice on the same day with 5-minute intervals, respectively. Between the first and second tests, patients waited for an hour on sitting position in order to prevent fatigue. In addition to these tests, we registered the knee pain experienced by the patients using a 100 mm VAS scale. RESULTS: The 50 FWT and 30 CST showed excellent reliability. ICC for 50 FWT and 30 CST were 0.97 and 0.92, respectively. SRD95 was 1.07 for 50 FWT and 0.96 for 30 CST. CONCLUSIONS: According to results of this study, both 50 FWT and 30 CST have excellent reliability in patients with TKA. These tests are simple, no time consuming and constitute sensitive methods to measure the functional performance in patients with TKA in the clinical settings. Clinicians and researchers may use these tests to quantify even small changes in functional performance for patients with TKA. Level of Evidence III, Diagnostic Study.

To investigate the test-retest reliability of the 4-meter walk test (4 MWT) and 10-meter walk test (10 MWT) in patients undergoing lower extremity surgery during inpatient rehabilitation.In all, 102 patients with total hip arthroplasty (THA), total knee arthroplasty (TKA), lower extremity fracture (LEF) and soft tissue operation were recruited. Patients performed two 4 MWT and two 10 MWT trials on the same day. The same researcher performed all the measurements to avoid inter-rater variability.The 4 MWT and 10 MWT were shown to have excellent test-retest reliability. The ICCs for the 4 MWT and 10 MWT were found as 0.94 and 0.95, respectively. The SEMs for the 4 MWT and 10 MWT were 2.0 and 5.5 seconds, respectively. The smallest real difference at the 95% confidence level (SRD95) was 5.5 seconds for the 4 MWT and 12.2 seconds for 10 MWT and SRD95 percentage was 31.2 for the 4 MWT and 28.5 for the 10 MWT.Both the 4 MWT and the 10 MWT have excellent reliability in patients undergoing lower extremity surgery such as TKA, THA, LEF and soft tissue operation during inpatient rehabilitation. Clinicians and researchers can be confident that changes above the SRD95s for the different patient groups, for both sexes and with regard to weight-bearing status, represent a real clinical change in rehabilitation process. Implications for Rehabilitation The 4 MWT and the 10 MWT are simple methods and were also shown to be reliable measurement methods in many patient groups. This study illustrates that the test-retest reliability of the 4 MWT and 10 MWT are excellent in patients undergoing lower extremity surgery during inpatient rehabilitation (ICC: 0.94 for 4 MWT, ICC: 0.95 for 10 MWT). Clinicians and researchers can be confident that changes above the SRD95s for the different patient groups, for both sexes and with regard to weight-bearing status represent a real clinical change in rehabilitation process.

Aims: The functional reach test (FRT) and lateral reach test (LRT) provide important measures of postural stability. The aims of this study were to (1) establish the normative values for FRT and LRT, and (2) examine the effects of age, gender, and various anthropometric measurements on FRT and LRT. Methods: Two hundred eighty children, aged 6–12 years, completed the study. One hundred fifty-two subjects were females. The mean age was 9.0 ± 2.0 years. Each child performed two trials of FRT and LRT. Results: No significant differences were detected in any age group between males and females. The normal values of FRT ranged between 23.0 and 36.5 cm, and that of LRT between 18.0 and 28.0 cm. Height, length of upper and lower extremity, and arm span had a higher correlation with FRT. Age and weight showed a good correlation with FRT. Age, height, weight, length of upper and lower extremity, and arm span showed good correlation with LRT. Conclusions: These normative data will be useful for clinicians in the assessment of balance of individual children and in the diagnosis of potential balance deficits at an early age in the Turkish population. © 2017 Taylor & Francis Group, LLC.

Background Two-minute walk test (2MWT) and the Timed Up and Go test (TUG) are simple, quick, and can be applied in a short time as part of the routine medical examination. They were shown to be reliable and valid tests in many patient groups. The aims of the present study were: (1) to determine test-retest reliability of data for the TUG and 2MWT and (2) to determine minimal detectable change (MDC) scores for the TUG and 2MWT in patients with TKA. Methods Forty-eight patients with total knee arthroplasty, operated by the same surgeon, were included in this study. Patients performed trials for TUG and 2MWT twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. Results The TUG and 2MWT showed an excellent test-retest reliability in this study. Intraclass correlation coefficient [ICC(2,1)] for TUG and 2MWT were 0.98 and 0.97, respectively. Standard error of measurement and MDC 95 for TUG were 0.82 and 2.27, respectively. Standard error of measurement and MDC 95 for 2MWT were 5.40 and 14.96, respectively. Conclusion The TUG and 2MWT have an excellent test-retest reliability in patients with TKA. Clinicians and researchers can be confident that changes in TUG time above 2.27 seconds and changes in 2MWT distances above 14.96 meters, represent a "real" clinical change in an individual patient with TKA. We, therefore, recommend the use of these 2 tests as complementary outcome measures for functional evaluation in patients TKA.

The purpose was to investigate the test-retest reliability of the 50-Foot Timed Walk (50FWT), and 30-Second Chair Stand Test (30CST) in the patients with total hip arthroplasty (THA). The study was a test-retest study. Thirty-seven patients with THA performed two trials for both the 30CTS and 50FWT on the same day with one hour interval. To assess reliability, the intra-class correlation coefficient [ICC(2,1)], standard error of measurement (SEM), the smallest real difference at the 95% confidence level (SRD95) were calculated. The ICCs for the 50FWT and 30CTS were 0.98 and 0.94, respectively. The SEM and SRD95 for the 50FWT and 30CTS were 0.3 and 0.8 seconds and 0.4 and 1.2 repeats, respectively. The test-retest reliability of the tests was very high. The 50FWT and 30CST are very reliable to measure the functional performance in patients with THA in the clinical settings.

Although a relationship between short pectoralis minor and upper trapezius and scapular dyskinesis has been postulated, no studies have investigated this theory. Understanding the effect of these muscle lengths on observable scapular dyskinesis may aid in determining risks and therefore making treatment decisions. Being aware of the magnitude of this effect would help gauge the significance of risks involved. Our aim was to evaluate the influence of pectoralis minor and upper trapezius lengths on scapular dyskinesis.Cross-sectional study.University research laboratory.Asymptomatic participants (n = 148; 296 arms) were evaluated.Scapular Dyskinesis Test (SDT) was used to identify scapular dyskinesis, Pectoralis Minor Index (PMI) and Upper Trapezius Length Testing were used to determine muscle length.SDT+ arms had shorter pectoralis minor resting length (PMI: 7.49 ± 0.38) (p 0.001) and greater incidence of short upper trapezius (ISUT) (66.7%) (p 0.001) compared to SDT- arms (PMI:8.58 ± 0.75, ISUT:22.5%). With each decrease in PMI, the likelihood of having scapular dyskinesis increased 96% (p 0.001). Arms with short upper trapezius were 2.049 times more likely to exhibit scapular dyskinesis than those with normal length (p = 0.042).Having a shorter pectoralis minor and upper trapezius length substantially increased the likelihood of having visually observable scapular dyskinesis.

Purpose Stair climbing is one of the important functional activities of daily living to maintain mobility and independence. Walking and stair climbing have been identified by clinicians and patients as critical functional activities before and after total hip arthroplasty (THA). Testing the ability to manage steps has been commonly used in clinical and research settings because it is an inexpensive and simple way to measure functional status after THA. The frequent use of this test supports studies seeking evidence to validate stair test (ST) as a measure of physical performance in subjects with THA. The aim of this study is to determine the test-retest reliability of the 9-step ST in patients with THA. Methods Patients performed twice trials for the ST on the same day with one hour interval. To assess test-retest reliability, the intra-class correlation coefficient – ICC (2,1), standard error of measurement (SEM), minimal detectable change at the 90% confidence level (MDC90) were calculated. Results A total of 37 patients with THA participated in this study. The ST showed very high reliability (ICC = 0.98 (95% CI, 0.96 to 0.99)). The SEM was 0.3 seconds and the MDC90 was 0.7 seconds. Conclusions Test-retest reliability of the ST was very high for the patients with THA, and the SEM and MDC90 were adequate for clinical use. The ST is less time consuming and has very high reliability to measure the functional level after THA in the clinical setting.

Background Total knee arthroplasty (TKA) is a common surgical procedure in patients with end-stage osteoarthritis to reduce pain and improve locomotor function. However, TKA may result in severe postoperative pain, usually requiring hospitalization from 5 to 10 days to provide effective analgesia (1). Local infiltration analgesia (LIA) is a simple technique for the treatment of postoperative pain after TKA. However, the specific efficacy of LIA has been confounded by frequent limitations in study design (2). Objectives To investigate the efficacy of LIA in patients with TKA. Methods The study was designed as a randomized double blind placebo control trial. A total of 63 patients with primary total knee arthroplasty were randomized either to receive a periarticular local infiltration analgesia or to receive placebo injection (63 patients: 57 knee in LIA group, 44 knee in placebo group). Pain intensity, active range of motion, knee function score [Hospital for Special Surgery (HSS) score] and length of hospital stay (LOS) were evaluated. Functional activities were evaluated using the Iowa Level of Assistance Scale, and walking speed was evaluated using the Iowa Ambulation Velocity Scale. The dates of ability to perform straight leg raise actively and to reach 70° of knee flexion were recorded. Patients and investigator were blinded the groups. Results There were no significant differences between the groups for demographic characteristic. Lower pain scores were recorded on postoperative day 1 and postoperative day 2 after the operation in Group LIA (p p =0.034) and ability to perform straight leg raise actively in favour of Group LIA ( p =0.034). There was no significant difference between the groups in the HSS score, Iowa Level of Assistance Scale, Iowa Ambulation Velocity Scale and LOS. Conclusions Andersen and Kehlet reported that LIA significantly reduced pain intensity, specifically during standing and walking up to 48 h after operation. Our results suggest that LIA significantly reduced pain intensity in early postoperative day. This results are corroborate with Andersen and Kehlet9s study (2). We also have found a better recovery of knee flexion immediately after operation. Possible mechanisms of better recovery of knee flexion could be lower pain scores. Patients with lower pain scores can also perform earlier straight leg raise. However, LIA technique did not provide additional impact on LOS because LOS depends on many other factors. In conclusion, LIA significantly reduced pain intensity, improve recovery of active range of motion but did not provide additional impact on LOS compared with placebo injection in patients with TKA. References Kerr, DR, & Kohan, L. (2008). Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthopaedica, 79(2), 174–183. Andersen, LO, & Kehlet, H. (2014). Analgesic efficacy of local infiltration analgesia in hip and knee arthroplasty: a systematic review. British journal of anaesthesia, aeu155. Disclosure of Interest None declared

Objectives: Alterations of the normal position or any abnormal motion of the scapula during active motions of shoulder is termed Scapular Dyskinesis (SD). SD is quite common in overhead athletes with or without shoulder pain. In addition to overhead athletes, SD has also been identified in healthy, asymptomatic individuals. Although there are several proposed methods to identify SD, there are two common methods used in clinical practice; as Lateral Scapular Slide Test (LSST) and Scapular Dyskinesis Test (SDT). SDT was developed as a dynamic functional test after the development of LSST which is a static measurement. SDT has also relatively higher reliability than LSST. In the 2013 consensus statement from ‘scapular summit’, SDT was recommended as a simple and reliable method for scapular assessment because of being a dynamic functional assessment method. The purpose of this study was to investigate the correlation of these two observational tests in asymptomatic population Methods: Eighty-three healthy participants (mean age 21.74±2.3 years, 166 arms, 32 Female-51 Male) were recruited. Participants were eligible if they were ≥18 years of age, having active full shoulder motion, and who have no health problem to hinder them from participate. Individuals with symptoms produced by cervical spine motion, impingement syndrome, frozen shoulder, shoulder instability and a history of shoulder fracture/surgery were excluded. All participants performed SDT and LSST in a random order. Pearson's chi-squared test was used for statistical analysis. Results: SDT detected SD in 44 participants (53%), LSST detected SD in 30 participants (36%). 20 participants (24%) determined as having SD in both tests. There was a moderate significant correlation between SDT and LSST (p=0.000, Pearson Chi-Square value=32.856, Phi=0.445). Conclusion: SDT and LSST have moderate correlation in identifying SD. In recent years, it is suggested that scapula shouldn’t be assessed in static positions/postures. Although both SDT and LSST show the presence of SD, they don’t evaluate SD in the same way because of the fact that LSST is a static assessment method whereas SDT is a dynamic method. Furthermore, SDT has higher reliability rather than other static assessment methods. Moderate correlation between these two tests may not always provide compatible outcome. For these reasons, we don’t recommend the use of LSST solely or instead of SDT in examination of SD. LSST’s complementary role in determination of SD with other assessment methods is arguable due to reliability issues. Optimal observational assessment algorithm in determination of SD should be investigated in future studies.

Objectives: Alterations in scapular kinematics were found in individuals with shoulder problems compared with healthy individuals. These alterations in scapular kinematics such as changes in the normal position or any abnormal motion of the scapula during active motions are defined as “’Scapular Dyskinesis (SD)”. Relationship between tight muscles and scapular kinematics has been investigated. Pectoralis Minor Muscle Tightness (PMMT) effects scapular motion and make changes in scapular kinematics. Although there are some studies indicating a possible relationship between PMM or Upper Trapezius Muscle Tightness (UTMT) and SD, this relationship hasn’t been investigated yet. The aim of this study was to evaluate the influence of PMMT and UTMT on SD in an asymptomatic population. Methods: One-hundred-eleven participants (mean age: 22.73±3.45 years old, 222 arms, 42 Female-69 Male) were recruited. Subjects were eligible if they were ≥18 years of age, having active full shoulder motion and who has no health problem to hinder them from participate. Individuals with symptoms produced by cervical spine motion, impingement syndrome, frozen shoulder, shoulder instability and a history of shoulder fracture/surgery were excluded. Scapular Dyskinesis Test (SDT) was used to identify SD. PMMT was determined by Pectoralis Minor Index (PMI), UTMT by UTMT Test. Logistic regression analysis performed to ascertain the effects of PMMT and UTMT on the likelihood that participants have SD. Results: SD was identified in 62 arms (27.9%), PMMT in 32 arms (14.4%), and UTMT in 75 arms (33.8%) in total number of participants. PMMT was determined in 23 arms (37.1%) and UTMT in 39 arms (62.9%) in participants with SD. The logistic regression model was statistically significant, X2=65.472, pConclusion: It was determined that people with PMMT and UTMT are more likely to exhibit SD than people who have normal muscle length in this asymptomatic population. Assessment of PMMT and UTMT could be included as a routine part of the scapula and scapular dyskinesia examination. This investigation should be repeated in symptomatic population who has shoulder problems. The effects of various interventions for lengthening these muscles in scapular dyskinesia, needs further research.