Systematic Review of Mobile Health Applications in Rehabilitation.

OBJECTIVE: To conduct systematic review to better define how medical mobile applications (apps) have been used in environments relevant to physical medicine and rehabilitation. DATA SOURCES: PUBMED, IEEE, ACM Digital Library, SCOPUS, INSPEC, and EMBASE. STUDY SELECTION: A 10-year date limit was used, spanning publication dates from June 1, 2006, to June 30, 2016. Terms related to physical medicine and rehabilitation as well as mobile apps were used in 10 individual search strategies. DATA EXTRACTION: Two investigators screened abstracts and applied inclusion and exclusion criteria. Full-length articles were retrieved. Duplicate articles were removed. If a study met all criteria, the article was reviewed in full. DATA SYNTHESIS: Specific variables of interest were extracted and added to summary tables. Summary tables were used to categorize studies according themes, and a list of app features was generated. CONCLUSIONS: The search yielded abstracts from 8116 studies, and 102 studies were included in the systematic review. Approximately one-third of the studies evaluated apps as interventions, and the remaining two-thirds of the studies assessed functioning of the app or participant interaction with the app. Some apps may have positive benefits when used to deliver exercise or gait training interventions, as self-management systems, or as measurement tools. REGISTRATION: The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) network (no. CRD42016046672).

Document analysis of adaptive sport opportunities at Division-1 universities in the United States.

BACKGROUND: Individuals with disabilities are less likely to participate in physical activity, with the greatest decline in participation during college years. Despite known health benefits, there are significant barriers that limit sport and exercise participation for students with disabilities, including adaptive access. To our knowledge, there has been no comprehensive review conducted to examine the number of adaptive sport offerings on a collegiate level. OBJECTIVE: Assess the availability of adaptive sport opportunities for students at National Collegiate Athletic Association (NCAA) Division-1 Universities to better understand university-affiliated adaptive sport opportunity for students. METHODS: Website document analysis was conducted by systematically querying the general homepage, athletics page, and campus recreation websites of each NCAA Division-1 University in the United States (US). Institutional and sport-related characteristics were recorded. RESULTS: Of the 358 NCAA Division-1 Universities, 20.4 % (73/358) marketed adaptive sport opportunities (recreational, club, and/or intercollegiate), with 3.9 % (11/358) acknowledging intercollegiate adaptive sport programs on their websites. Five percent (6/121) of private institutions, and 28.3 % (67/237) of public institutions reported adaptive sport opportunities. The Northeast region had the fewest number of institutions reporting adaptive sport offerings (4/67, 6.0 %). The most commonly offered sport was adaptive recreation (36/358, 10.2 %), followed by wheelchair basketball (26/358, 7.4 %). CONCLUSION: Over three-quarters of Division-1 Universities in the US lack an online description of adaptive sport opportunity, highlighting the need for expanded resourcing and marketing of adaptive sport at the university level. Future studies are necessary to identify appropriate strategies to effectively promote sport, maximize participation and improve social inclusion.

Orthobiologic Interventions for Muscle Injuries.

Muscle injuries represent a common problem in active populations. Orthobiologics continue to be studied for their ability to improve muscle healing. To date, the basic science research for treating muscle injuries with platelet-rich plasma or stem cell remains novel. Furthermore, there are even fewer clinical studies on these topics, and their findings are inconclusive. Reviewing the literature, muscle injuries treated with ultrasound-guided leukocyte-rich PRP injections appear to have the strongest evidence. Scar formation remains a major barrier in muscle injury healing, and there is optimism for future orthobiologic treatments that target the downregulation of TGF-B, resulting in decreased scar development.

Introductory Resident-Led Physical Medicine and Rehabilitation Case-Based Ultrasound Workshop for Medical Students.

ABSTRACT: The core clinical ultrasound milestones for medical students in the United States do not cover the majority of clinical topics pertinent to the specialty of physical medicine and rehabilitation. In addition, one of the major barriers to teaching physical medicine and rehabilitation residents ultrasound is a lack of instructors with sufficient experience. A solution to both of these problems is the establishment of a resident-led case-based ultrasound workshop for medical students that introduces them to the field of physical medicine and rehabilitation. This novel workshop involved 30 medical students and 9 resident instructors. The students participated in five hands-on interactive physical medicine and rehabilitation clinical cases where each student had 5 mins per case to scan. A program evaluation survey showed that the workshop achieved the objectives of increasing medical student confidence in describing the role of a physical medicine and rehabilitation physician and physical medicine and rehabilitation patient populations as well as confidence using ultrasound for evaluating the peripheral nervous system and musculoskeletal system. Resident instructors endorsed that the workshop was beneficial for improving their physical medicine and rehabilitation ultrasound teaching skills and also increased their interest for contributing to future workshops. The intention of this project is to reproduce similar initiatives in physical medicine and rehabilitation residency training programs across the United States.

Risk Factors for the Development of Shoulder Pain in Elite Sled Hockey Players.

BACKGROUND: Shoulder pain is one of the most common injuries in adaptive athletes. There are minimal prior studies that investigate shoulder pain prevalence and associated risk factors in sled hockey players. OBJECTIVE: To characterize the prevalence of shoulder pain in elite-level adaptive sled hockey athletes and identify associated risk factors. DESIGN: Cross-sectional observational study. SETTING: 2019 USA Sled Hockey Classic in Chicago, IL from 7 February 2019 to 10 February 2019. PARTICIPANTS: Eighty-two elite sled hockey athletes who participated in a nationally sanctioned sports event. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary outcome of the study was to describe the experience of shoulder pain using player-reported outcomes of pain including: binary (yes/no) pain reporting in the last month, Performance-Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI) reporting pain in the last week, and Visual Analog Scale (VAS) reporting pain in the last month. Associations were assessed between the measurements of pain and characteristics of participants. RESULTS: Of all participants, 70.5% endorsed shoulder pain in the last month. The average VAS for the past month was 2.13 and average PC-WUSPI for the past week was 15.46. Statistically significant associations were found between endorsement of pain in the last month and specific correlative factors including increased weight (P value .008; odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01-1.07) and increased duration of manual wheelchair use (P-value .002; OR 1.13, 95% CI 1.04-1.22). CONCLUSION: Elite-level sled hockey athletes commonly report experiencing shoulder pain. There is evidence that an elite-level sled hockey player's weight and longer duration of manual wheelchair use are both associated with a greater likelihood for self-reporting shoulder pain rather than number of years of playing the sport.

Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging.

Scapular winging represents a rare phenomenon that most commonly results from nerve damage to either the long thoracic nerve, spinal accessory nerve, or, less commonly, the dorsal scapular nerve. This injury results in an abnormal scapulohumeral interaction during kinetic motion known as scapular dyskinesis. In this case report, the patient presented with scapular dyskinesis and medial scapular winging caused by overhead weight-lifting exercises, and a long thoracic nerve injury was diagnosed. Physicians are encouraged to consider long thoracic nerve damage in a patient with a history of repetitive overhead movements who presents with scapular dyskinesis and the corresponding restriction of overhead arm motions. Potential mechanisms of injury and treatment options are also discussed.