Search

Introduction: The elbow joint plays a significant role in upper extremity function. Limited elbow function may prevent the ability to perform daily life activities, physical exercise as well as impairing workability. A number of different treatment measures for rehabilitation after elbow fractures has been described in the literature, but the effects of the various measures is not known. The current paper aims to identify recommendations for rehabilitation after elbow fractures with an evidence-based practice model. Main section: This article is based on current studies on patients with elbow fractures and relevant knowledge-based medical encyclopaedias on the subject. In particular, early mobilisation is a recurring treatment measure both postoperatively and after the immobilisation period. Apart from motion exercise, the effect of immobilisation and other mentioned treatment measures on elbow function is assessed, as well as the duration and extent of the rehabilitation period. End section: The review of the literature gives no clear recommendations for rehabilitation after elbow fracture. Some recommendations seem to have a strong empirical base and the lack of knowledge is evident on several areas. In spite of this, the value of the various treatment measures should not be depreciated. Early mobilisation can be recommended both postoperatively and after the immobilisation period. Immobilisation following a fracture may not have a negative effect on joint motion and elbow function following a fracture. Individually adapted treatment is recommended and should be adapted to the patient's progression. Most elbow fractures regain their range of motion within three months, while complex injuries require longer and more extensive rehabilitation. There is a need for high quality research on rehabilitation for elbow patients.

Achilles tendon rupture is a common injury with established surgical treatments, but optimizing postoperative recovery remains challenging. Dynamic tendon gliding is necessary for normal ankle function, yet its role in recovery is not fully understood. This report highlights a novel approach using dynamic ultrasound imaging and ultrasound-guided manual therapy to improve Achilles tendon gliding post-surgery. A 65-year-old man presented eight weeks after surgical repair of a left Achilles tendon rupture. Despite full weight-bearing ability and normal range of motion, the patient exhibited persistent dysfunction, such as an inability to perform single-leg stands and single-leg heel raises. Suspecting a dynamic issue with the Achilles tendon, dynamic ultrasound revealed significant adhesion between the Achilles tendon and Kager's fat pad. To address this, ultrasound-guided manual therapy, involving specific mobilization of the tendon under ultrasound visualization, was initiated. The patient underwent 16 sessions over eight weeks, during which real-time ultrasound confirmed gradual improvement in tendon gliding. Post-treatment, the patient achieved marked functional recovery, demonstrated by the ability to perform single-leg heel raises and toe walking. His Achilles tendon Total Rupture Score improved from 47 to 75 points, with sustained benefits observed at the 26-week follow-up. Ultrasound-guided manual therapy targeting tendon gliding dysfunction improved functional recovery in this patient. This approach underscores the importance of addressing tendon gliding in rehabilitation protocols to optimize outcomes. Further research is needed to validate these findings with a broader patient population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Watanabe et al.)

Background: Postoperative shoulder stiffness complicates functional recovery after arthroscopic rotator cuff repair. Purpose: To compare early passive range of motion (ROM) exercise with a delayed rehabilitation protocol with regard to the effectiveness of stiffness reduction and functional improvements and rates of improper healing in patients undergoing arthroscopic repair for torn rotator cuffs. Study Design: Systematic review and meta-analysis. Methods: Randomized controlled trials (RCTs) comparing both rehabilitation approaches were identified in PubMed and Scopus. Between-group differences in shoulder function were transformed to effect sizes for comparisons, whereas the effectiveness against stiffness and the risk of tendon failure were reported using standardized mean differences of ROM degrees and odds ratios (ORs) of recurrent tears, respectively. Results: Six RCTs were included, consisting of 482 patients. No significant difference in shoulder function existed across both protocols. The early ROM group demonstrated more improvement in shoulder forward flexion than the delayed rehabilitation group, with a standardized mean difference of 7.45 (95% CI, 3.20-11.70) at 6 months and 3.51 (95% CI, 0.31-6.71) at 12 months. Early ROM exercise tended to cause a higher rate of recurrent tendon tears (OR, 1.43; 95% CI, 0.90-2.28), and the effect became statistically significant (OR, 1.93; 95% CI, 1.04-3.60) after excluding 2 RCTs that recruited only those patients with small to medium-sized tears. Conclusion: Early ROM exercise accelerated recovery from postoperative stiffness for patients after arthroscopic rotator cuff repair but was likely to result in improper tendon healing in shoulders with large-sized tears. The choice of either protocol should be based on an accommodation of the risks of recurrent tears and postoperative shoulder stiffness. [ABSTRACT FROM AUTHOR]

In the hand therapy clinic, smartphones can be used as an educational resource, to view a photo or video of a home exercise program, or as a method of electronically documenting progress related to healing from an injury. Smartphone applications may also serve as appropriate therapy interventions to address deficits often presenting with common hand injuries. For individuals with trapeziometacarpal arthrosis, gaming can encourage radial abduction range of motion and neuromuscular control required for joint stability. People with distal radius fractures may benefit from smartphone applications for range of motion and proprioceptive training. These treatments may assist with addressing client-centered goals and be motivating in the current technology driven times. [ABSTRACT FROM AUTHOR]

[Purpose] In this study, we examined the effect of ROM exercises on joint fixation. [Subjects] Wistar rats (male, 330-380 g) were used in this study. [Methods] The rats were randomly divided into a non-treated group, a joint- immobilization group, and groups which did ROM exercises weekly (1day-group), three days a week (3 daysgroup) or five days a week (5 days-group). All rats had their joints fixed except during the ROM exercises. After five weeks, the knee joint ROMs were measured and histologically evaluated. [Results] The knee joint ROMs were not maintained in the ROM exercises groups. However, decrease in the knee joint ROMs was inhibited in proportion to the frequency of ROM exercise. The knee joint cavities in the joint-immobilized group and the 1day group were filled with connective tissue. [Conclusion] These results suggest that ROM exercise inhibits decrease in ROM, although development of a decrease in the movable range of the joint could not be prevented. [ABSTRACT FROM AUTHOR]

Objective: Osteoarthritis (OA) is highly prevalent among older adults and is associated with increased pain, loss of strength and joint range of motion (ROM), as well as to an overall decrease in functional status. Therapeutic strength exercises are recommended as part of the standard intervention programme for the patient with OA in an effort to control pain and improve functional and health status. The purpose of this meta-analysis is to review the strength and quality of evidence supporting the effectiveness of therapeutic strengthening exercises for improving a variety of measured outcomes relevant for OA. Methods: A systematic review was conducted, following a protocol of methods recommended by the Cochrane Collaboration. Trials were identified by a literature search of Medline, EMBASE, and the Cochrane Controlled Trials Register. Only randomised controlled trials using strengthening exercises as an intervention and treating clients with OA were eligible. Twenty-two trials were included with 2325 patients undergoing various forms strengthening exercises (e.g. isometric, isotonic, isokinetic, concentric, concentric/eccentric, dynamic). The exercises were implemented either in stand-alone format or in combination with other exercises, such as stretching and ROM. Interventions were either facility-based, home-based or a combination of the two. Results: Evidence is provided for the inclusion of strengthening exercises in the rehabilitation programme for the patient with OA. Improvements were found for strength, pain, function and quality of life (QOL). Important components of the exercise programme that influence outcome include: (i) the combination of joint-specific strengthening with general strength, flexibility and functional exercises; (ii) progression of the exercise programme; and (iii) level of client self-reliance to sustain the programme. There is no evidence that the type of strengthening (i.e. isometric, isotonic or isokinetic) has an important impact on programme outcome. However, evidence is provided that the control of pain may be a dominant mechanism by which strengthening exercise produces beneficial effects for the patient with OA. Conclusion: Strengthening exercises alone have some effects on improving pain and functional outcomes in clients with OA. However, in order to maximise the effectiveness of strengthening exercise for these clients, it is necessary to combine strengthening exercises with a more complete exercise programme including ROM, stretching, functional balance and aerobic exercises. [ABSTRACT FROM AUTHOR]