Effects of clamshell exercises in terminal extension lag after ACL reconstruction.

BACKGROUND: Terminal extension lag (TEL) is common following anterior cruciate ligament reconstruction (ACLR). Clamshell exercises have been suggested as a potential intervention to address TEL, but limited research has been conducted in this area. OBJECTIVE: This study aimed to determine the effects of Clamshell exercises in terminal extension lag after anterior cruciate ligament reconstruction. METHODS: This randomized controlled trial included 40 participants with a history of ACLR between 1 and 3 years prior. Participants were randomly assigned to either the experimental group (Group A) or the control group (Group B). Group A received conventional exercises along with isolated hip strengthening rehabilitation, while Group B received conventional exercises without specific hip strengthening. The primary outcomes were pain levels (Numeric Pain Rating Scale), knee function (International Knee Documentation Committee scores, (IKDC)), range of motions (goniometer) and strength (sphygmomanometer). RESULTS: In between the group comparison shows that all outcome measures (NPRS, IKDC, Goniometer, Sphygmomanometer) show significant results (p < 0.05). Within-group comparisons (paired sample t-test) show that there was a significant difference (p < 0.05) in all outcome measures of both groups. CONCLUSION: The addition of Clamshell exercises to the rehabilitation program resulted in a significantly greater reduction in TEL compared to the control group. These findings suggest that Clamshell exercises were found to be an effective intervention for addressing TEL after ACLR.

The status of rubella IgG antibody titer between antenatal and postnatal among pregnant non-immune to rubella.

Background: The infection of rubella in pregnancy is worrisome due to the fact that it causes miscarriages, congenital defects, and Congenital Rubella Syndrome (CRS). The purpose of this study was to determine the status of Rubella IgG antibody levels both during the antenatal and postnatal periods among pregnant women nonimmune to rubella and the incidence of exposure to rubella in pregnancy. Methods: This was a prospective cohort study that included 4770 pregnant, who attended the obstetric clinics and delivered in Women's Specialized Hospital, King Fahad Medical City, between January and December 2015. The study utilized the following measures for rubella screening tests (IgG and IgM) during the antenatal and postnatal period. Pregnant women with recent rubella infection (IgM antibody positive), history of rubella infection, or had immunity against rubella (IgG antibody concentration ≥10 IU/ml) were excluded from the study. Results: The prevalence of pregnant women nonimmune to rubella was 6.3% (n = 301). The majority (93.7%) were immune (IgG antibody concentration ≥10 IU/ml). No patients tested positive for rubella (IgM +ve). Overall, The Median (IQR) Rubella (IgG) in the antenatal period (6.3 (8.30-5.00) IU/m) was significantly less in comparison to the postnatal period (5.0 (6.40-5.00) IU/m). The difference was statistically significant, p <.001. Conclusion: There is a significant decrease in the Rubella (IgG) titer between antenatal and postpartum periods, and we report a very low incidence of rubella infection and CRS among pregnant women nonimmune to rubella.