Range of Motion Following Flexor Tendon Repair: Comparing Active Flexion and Extension With Passive Flexion Using Rubber Bands Followed by Active Extension.

PURPOSE: This study aimed to compare the outcome in terms of range of motion between early active flexion and extension (early active motion, [EAM]) and passive flexion using rubber bands followed by active extension (sometimes referred to as a Kleinert regimen) after flexor tendon repair in zones 1 and 2. METHODS: Data were collected from the Swedish national health care registry for hand surgery (HAKIR). Rehabilitation regimens were decided by the preference of each caregiver. At 3 months, 828 digits (656 EAM and 172 passive flexion) and at 12 months, 448 digits (373 EAM and 75 passive flexion) were available for analysis. Thumbs were analyzed separately. RESULTS: No notable difference in total active motion was found between the groups at 12 months of follow-up. CONCLUSIONS: This large registry study supports the hypothesis that EAM rehabilitation may not lead to better range of motion long-term than passive motion protocols. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Temporary halo fixation and radiotherapy as alternative to long-construct spondylodesis in patients with multiple unstable cervical metastases.

Background and purpose: Currently no minimally invasive surgical treatment exists to provide immediate stability for unstable cervical/cervicothoracic metastases. Long-construct spondylodesis carries a high complication risk and has severe impact on residual range of motion. This study explores temporary halo fixation and radiotherapy as an alternative to long-construct cervical spondylodesis. Materials and methods: This retrospective cohort study included twenty patients with multiple unstable cervical metastases treated between 2013-2023. All patients underwent halo fixation for an intended duration of three months to allow for safe reossification of lytic lesions following radiotherapy, with a dose fractionation scheme best suited to the histological origin of the tumor. Results: Immobilization with halo fixation lasted a median 83 days (range, 41-132 days). Radiotherapy started on average 7 days after halo fixation (range, -35-118 days). The median pain score at baseline was 8, and was 0 at halo removal and at last follow-up. All patients had no or minor neurological deficits at baseline and did not develop new neurological deficits. At halo removal, 17/18 patients showed radiographic evidence of reossification. The majority of patients experienced minor limitations or had full range of motion of the neck at last follow-up. Conclusion: Patients with multiple unstable cervical metastases treated with halo fixation and radiotherapy showed complete pain response or substantial pain reduction, reossification of the vertebrae and a, mostly, preserved range of motion. In selected neurologically intact patients, this treatment might be a patient-friendly alternative to fixation. Prospective evaluation of this treatment combination is needed.

Critical appraisal of Genelyn soft embalming for cadaveric surgical skill training: A systematic review.

Genelyn is a proprietary embalming solution used for preserving cadavers for surgical skill training (SST) and undergraduate teaching. The aim of this review is to examine the Genelyn embalming method critically by analyzing scientific publications that have employed this method for SST and undergraduate education. The systematic review process involved searching for all relevant articles in PubMed, Google Scholar, and Embase using the keywords "Genelyn," Genelyn embalming," "Genelyn embalmed cadaver," and "surgical skill training. All studies on Genelyn embalming published up to August 14, 2024, in the English language were eligible for inclusion. The literature review yielded 92 studies, 43 of which met the inclusion criteria. The Anatomical Quality Assurance (AQUA) tool from the International Evidence-Based Anatomy (iEBA) working group was used to assess and analyze the risk of bias in all the selected full-text articles. The selected studies reported that Genelyn embalming provided life-like joint range of motion, tissue pliability, and color. Cadaveric studies assessing embalming solutions typically had smaller sample sizes, and few of them compared Genelyn embalmed cadavers (GECs) with the other soft embalming solutions. Unlike Theil's embalming, Genelyn embalming is cost-effective, with easy steps for the preparation and storage of the solution and convenient handling of cadavers. Therefore, GECs serve as an efficient tool for SSTs.

Intra- and inter-rater reliability of goniometric finger range of motion using a written protocol.

Introduction: Goniometric finger range of motion (ROM) is the most common outcome measure used for functional evaluation of finger joints, but its reliability is not well-evaluated. This study aimed to investigate intra- and inter-rater reliability of goniometric finger ROM using a written protocol for active, passive, and composite movements in healthy adults. Methods: The design was a single-center, cross-sectional, reliability study. Participants were 20 healthy adults (mean ± standard deviation, 36.4 ± 10.9 years). ROM for active, passive, and composite movements of the fingers was assessed by three occupational therapists with at least 5 years clinical experience in the field of physical disabilities. To standardize the measurement method used, we developed a written protocol, stabilized the wrist position, and trained the evaluators. Intraclass correlation coefficient (ICC) values were used for the reliability analysis. ICC (1,1) was used for intra-rater reliability. ICC (2,1) was used for inter-rater reliability. Hand-shaped heatmaps were used to summarize the reliability data. Results: Most of the results (88.7%) showed moderate to good intra-rater reliability (ICC ≥ 0.50), while inter-rater reliability showed less (69.0%). Both intra- and inter-rater reliability showed no trends between dominant and non-dominant hands, type of movement, finger, or joint. Conclusions: Intra-rater reliability was relatively high and using a written protocol was beneficial. Inter-rater reliability tended to be lower, and differences in the physical structure of both raters and participants may have affected inter-rater reliability values.

Comparison of staggered and conventional posterior single-door laminoplasty.

OBJECTIVE: This study aimed to delineate the clinical and radiological outcomes between two different single-door laminoplasty techniques, the staggered approach and the conventional one-sided approach, in treating cervical spondylotic myelopathy (CSM). METHODS: This is a retrospective chart review that involved 67 patients who had CSM with symptoms lasting for ≥3 months, and underwent staggered laminoplasty (Group A, n=35) or conventional laminoplasty (Group B, n=32). Outcomes measures included intraoperative parameters, the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) for pain, cervical curvature, cervical range of motion (ROM), and radiographic parameters that reflected the level of post-operative muscle atrophy. Follow-up assessments were available at 3-, 6-, and 12-months post-operation. RESULTS: The mean ages in Group A and Group B were 57.11 (SD, 8.02) and 55.28 (SD, 8.47) years, respectively, with a gender distribution of 40.00% female in Group A and 40.63% in Group B (P>0.05). The average operative times were 130.86 (SD, 11.80) and 129.84 (SD, 10.51) minutes, respectively (P>0.05). However, intraoperative blood loss in milliliters was significantly higher in Group A (196.06; SD, 32.69) compared to Group B (155.03; SD, 37.80) (P<0.001). JOA scores revealed no significant post-operative differences between the two groups. Nevertheless, Group A exhibited less VAS pain, reduced post-operative ROM loss at 6 and 12 months, and less alteration in cervical curvature and decreased severity in muscle atrophy at 3-, 6-, and 12-months post-surgery. CONCLUSION: Patients who underwent staggered single-door laminoplasty experienced more favorable outcomes in some metrics than those who received the conventional technique.

The Impact of Muscle Energy Techniques on the Temporomandibular Motions Following Extraction Surgery of the Third Molar Tooth: A Randomised Clinical Trial.

BACKGROUND: Trismus and subsequent restricted range of motion in the temporomandibular joint may impede vital activities of daily living. OBJECTIVE: The primary purpose of the current study was to explore the impact of muscle energy techniques on the range of temporomandibular motions in individuals with trismus and restricted range of the temporomandibular motions after third molar extraction surgery. METHODS: Eligible volunteers were randomly assigned to either the intervention or control group. Participants in the intervention group received muscle energy techniques over seven consecutive postoperative days, while those in the control group did not receive any intervention. Both groups adhered to the recommended postoperative healthcare protocol provided by a single dentist. The range of cardinal and linear intra-articular motions of the temporomandibular joint was assessed on the first, second and seventh postoperative days in each group using a vernier calliper and an ultrasound machine, respectively. RESULTS: The range of linear intra-articular motion (p-value < 0.001) and cardinal motion (p-value < 0.032) of the TMJ significantly increased within groups after the first postoperative week. The range of temporomandibular motions, except for the forward displacement of the mandibular condyle (p-value = 0.193), and the range of mandibular retrusion (p-value = 0.339) exhibited a significant difference between groups (p-value < 0.017) after the first postoperative week. CONCLUSION: The current study revealed, for the first time, that muscle energy techniques increase the range of cardinal and linear intra-articular motions in individuals with trismus and restricted range of the temporomandibular motions following third molar extraction surgery. TRIAL REGISTRATION: Clinical Trials: IRCT20211016052783N1.

Relationship of Physical Factors to the Occurrence of Injuries in Young Gymnasts.

Background: There is a large population of young athletes who participate in gymnastics, and the prevention of injury in junior athletes is considered important. However, few studies have prospectively investigated the relationship between physical factors and the occurrence of injury. Purpose: To investigate the physical characteristics that are factors in the injury occurrence in elementary and junior high school gymnasts. Study Design: Prospective observational study. Methods: A total of 36 healthy young gymnasts (at national competition level) were enrolled in the study. Once a week for 23 weeks, injuries were prospectively investigated using self-report questionnaires under the supervision of a research staff. Joint range of motion (hip, ankle, shoulder, and wrist), tightness (Thomas test, Ely test, straight leg raise [SLR], triceps surae, combined abduction test [CAT], horizontal flexion test [HFT]), and muscle elasticity (multifidus) were assessed to compare differences in physical function between injured and non-injured participants. Results: Injuries occurred most commonly in the wrist (42.1%), lower back (30.2%), and foot (9.5%) among males, whereas heel (22.2%), knee (16.0%), and lower back (12.8%) were the most common injury sites among females. Wrist injuries in male athletes showed decreased shoulder joint range of motion, and lower back injuries showed decreased hip and shoulder joint range of motion. Lower back injuries in female athletes showed decreased hip extension mobility. Heel and knee joint injuries in females also showed increased range of motion and decreased tightness. Conclusions: The results of this study indicate that the factors related to flexibility differ according to injury location. Further studies are required to clarify the physical factors that influence injury occurrence by examining the effects of the gymnasts' muscle strength, age, individual factors, and left-right differences. Level of Evidence: 3.

Enhanced Achilles Tendon Gliding Through Ultrasound-Guided Manual Therapy Post-surgical Repair: A Case Report.

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.

Minimally Invasive Quadricepsplasty Using the Adolphson-Cerqueira Technique: A Retrospective Study after 1-Year of Follow-up.

Aim: Knee stiffness limits activities of daily living with treatment having no gold standard technique currently. We present follow-up data 1-year after quadricepsplasty using the Adolphson-Cerqueira technique for the treatment of knee stiffness in a Brazilian population sample. Materials and methods: This retrospective study included patients who underwent a quadricepsplasty using the Adolphson-Cerqueira technique between January 2006 and March 2023 at our institution. The inclusion criteria were: (1) Knee stiffness with a range of motion <70°; (2) Patellar excursion ≥2 mm on physical examination; (3) Available knee radiography in the anteroposterior and lateral views; and (4) A follow-up at 1 year postoperatively. The Judet Classification was used to assess the outcome of the quadricepsplasty. Results: Sixty-seven patients were included. The results were 6% poor, 31.3% fair, 44.8% good, and 17.9% excellent according to the Judet Classification. A correlation was observed between age and the gain in range of motion at the 1-year postoperative follow-up, and between the gain in range of motion intraoperatively and that at the 1-year follow-up. There were five cases of complications (7.46%): one of patellar fracture, three of quadriceps tendon rupture, and one of avulsion fracture in the superior pole of the patella. Conclusion: Quadricepsplasty using the Adolphson-Cerqueira technique produced satisfactory results overall for improving knee joint stiffness and had a complication rate comparable with other currently used techniques. Clinical significance: Loss of knee range of motion remains a difficult problem without there being a clear gold standard in treatment. Many different options are described in the literature. We provide a further option with follow-up results. How to cite this article: Cerqueira FS, Silva L, Kropf LL, et al. Minimally Invasive Quadricepsplasty Using the Adolphson-Cerqueira Technique: A Retrospective Study after 1-Year of Follow-up. Strategies Trauma Limb Reconstr 2024;19(2):87-93.

How does cruciate ligament rupture treatment affect range of motion in dogs?

This study aimed at evaluating the changes in passive range of motion (ROM) of the stifle joint associated with cranial cruciate ligament (CCL) rupture in dogs and assessing whether the surgical treatment carried out on the affected joints affected additional changes. A retrospective cohort study design was used. The clinical records of dogs treated with tibial tuberosity advancement (TTA), tibial plateau leveling osteotomy (TPLO) and tight rope (TR) were reviewed as were the extension angle (EA), flexion angle (FA) and lameness. The data recorded at T0, before surgery, were compared with the data at 1 month and 6 months post-surgery. The data were classified as normal or abnormal. The main results obtained one month after surgery indicated that dogs treated with TTA showed a significant worsening of flexion (the FA was abnormal in 69.6% of dogs at T0 and 80.4% at T1 with p = 0.0208). Dogs treated with TPLO achieved asignificant improvement in extension (the EA was normal in 16.7% of dogs at T0 and in 33.3% at T1 with p < 0.0001), and in flexion (the FA was normal in 23.8% of dogs at T0 and 43.5% at T6 with p = 0.0434). The dogs treated with TR showed a significant worsening of extension (the EA was abnormal in 68.8% of dogs at T0 and in 81.3% at T1 with p = 0.0024). Six months post-surgery, the ROM value was not normal in 100% of the stifle joints; however, the lameness significantly improved with each procedure. This study confirmed the influence of surgical procedures on changes in ROM and provided useful indications for planning therapy to improve and speed up the postoperative rehabilitation process in dogs.

Robotic Assisted TKA achieves adjusted mechanical alignment targets more consistently compared to manual TKA without improving outcomes.

Introduction: Robotic total knee arthroplasty (rTKA), with its purported advantages of more accurate alignment, greater functional outcomes and patient satisfaction, is gaining popularity in patients undergoing TKA. The purpose of our study was to compare these parameters along with gait pattern and kneeling ability in a cohort of patients who underwent simultaneous TKA with manual instrumentation (mTKA) and rTKA in contralateral knees at a 1-year follow-up. Methods: This was a retrospective review of 135 consecutive patients who underwent simultaneous bilateral TKA using robotic assistance on one side and manual instrumentation on the contralateral side between January 2022 and June 2022. The target alignment in both cohorts was adjusted mechanical. Patients were followed up at 3, 6 and 12 months to assess and compare alignment, range of motion (ROM) and patient-reported outcome measures (PROM) data. Gait parameters and kneeling ability were assessed at 1-year follow-up. Results: While adjusted mechanical alignment was achieved in all rTKA patients, we recorded five outliers (≥3° with relation to 180° HKA axis) in the mTKA cohort (three varus and two valgus). There were no significant differences between both cohorts with regards to ROM, PROM scores, gait analysis parameters and kneeling ability at 1-year follow-up. Conclusion: rTKA helps in achieving the adjusted mechanical alignment more consistently than mTKA. This, however, does not contribute to better functional outcomes and patient satisfaction at 1-year follow-up. Level of Evidence: Level III.

Efficacy of a Combination of Functional Exercise and Psychological Interventions in Improving Postoperative Rehabilitation and Intervention Compliance in Patients With Breast Cancer.

OBJECTIVE: This study aimed to investigate the effect of a combination of functional exercise and psychological interventions on postoperative rehabilitation and intervention compliance in patients with breast cancer (BC). METHODS: This study involved 100 patients with BC who underwent a radical mastectomy in our hospital between April 2020 and April 2021. We assigned patients to a control group (with a functional exercise intervention for patients) and an observation group (where patients received psychological interventions based on functional exercise) using a random number table. We observed and recorded the general data, intervention compliance, range of motion (ROM) of the shoulder joint pre and postintervention, pre and postintervention quality of life scores, and anxiety and depression scores before and after the interventions. RESULTS: There were no significant differences in general data between the 2 groups (P > .05). Repeated measures analysis showed no preintervention differences in compliance, shoulder ROM, quality of life, or anxiety and depression scores (P > .05). Postintervention, compliance and shoulder ROM improved in both groups, with the observation group significantly outperforming the control group (P < .05). Quality of life scores improved significantly in both groups, with higher scores in the observation group at 1 and 3 months (P < .05). Anxiety and depression scores decreased in both groups, with the observation group showing lower scores than the control group (P < .05). CONCLUSION: Combining functional exercise with psychological interventions improves treatment compliance, psychological status, postoperative shoulder ROM, and quality of life in breast cancer patients.

Effect of thoracic manipulation on neck pain in the mobility group: A randomized controlled trial.

Background and aims: Thoracic spine manipulation (TSM) increases the thoracic spine's range of motion (ROM), effectively reducing pain intensity and disability in patients with mechanical neck pain. We aimed to determine the effect of TSM on neck pain intensity and functional impairment in patients classified under the "mobility" category in Childs' classification. Methods: In this randomized controlled trial, patients with mechanical neck pain who met the inclusion criteria were randomly assigned to either the TSM (n = 21) or sham manipulation (n = 20) group. The primary outcomes were pain during neck rotation and subjective improvement assessed using the Numerical Pain Rating Scale (NPRS) and Global Rating of Change (GROC), respectively. The secondary outcomes were NPRS at rest, disability (assessed using the Neck Disability Index [NDI]), and ROM of the cervical and thoracic spine rotation. Outcome measurements were performed at baseline, immediately after treatment, 1 week after treatment, and at the 4-week follow-up. Linear mixed models were used to analyze the NPRS, NDI, and ROM. The GROC was analyzed using a chi-square test for the percentage recording ≥+4; the means of each group were compared using an unpaired t-test. Results: The NPRS with neck rotation, neck and thoracic ROM, and NDI showed significant interactions between the groups. The NPRS with neck rotation was significantly lower in the TSM group than in the sham group at all time points after the treatment (p < 0.001). There was no difference between the groups in the proportion showing moderate (≥+4) improvement according to the GROC; however, there was a significant difference in the mean values (p = 0.013). Conclusion: Incorporating TSM into treatment protocols may improve clinical outcomes in patients with neck pain, potentially leading to better pain management and functional recovery. Therefore, physiotherapists should consider TSM as a viable and effective intervention to improve patient outcomes in neck pain rehabilitation.

Comparative effects of fascial distortion model with and without neuromuscular inhibition technique on pain, range of motion and quality of life in patients with piriformis syndrome.

PURPOSE: This study aimed to compare the effects of the fascial distortion model (FDM) with and without neuromuscular inhibition technique (NIT) on pain, range of motion and quality of life in patients with piriformis syndrome. METHODS: The study was a randomized controlled trial and 54 participants were randomly allocated by lottery method into two groups. Group A (27 participants) received the FDM with NIT and Group B (27 participants) received the FDM alone. The patients were treated for six weeks, three sessions each week on alternate days. Outcome measurements were taken before the first treatment session and after the last (sixth week) session. Numeric Pain Rating Scale, Sciatica Bothersomeness Index (SBI), and Goniometer were used as outcome measures. SPSS version 25 was used for statistical analysis. RESULTS: Data was normally distributed by the Shapiro-Wilk Test. Statistically significant improvements (p < 0.05) were observed in the FDM with NIT than in FDM alone. Both groups show significant results in all outcome measures with paired sample t-tests (p < 0.05). CONCLUSION: This study concluded that participants with piriformis syndrome show more improvement in the FDM with NIT than the FDM group alone. TRIAL REGISTRATION NUMBER: NCT05404607.

This study provides the evidence-based result of the Fascial Distortion Model in patients with piriformis syndrome.The combined effects of both treatment techniques; Fascial Distortion Model and Neuromuscular Inhibition Technique can provide more effective results for piriformis syndrome.

The Effects of Static Stretching 2-Hours Prior to a Traditional Warm-Up on Performance.

Whereas prolonged static stretching (SS: >60-seconds per muscle) can increase range of motion (ROM) for up to 2-hours, it can also decrease maximal voluntary isometric contraction (MVIC) forces, countermovement (CMJ) and drop jump (DJ) heights, and muscle activation immediately after the stretching exercise. When an appropriate SS duration (<60-seconds per muscle) is incorporated into a dynamic warm-up, performance decrements are often trivial. However, there is a lack of studies that observed the effects of extensive SS (180-seconds) 2-hours prior to a dynamic warm-up. The objective was to investigate ROM and performance effects of prolonged SS, 2-hours prior to a traditional warm-up. This study investigated 9 female and 8 male healthy recreationally active, young adult participants on the effects of prolonged SS (180-seconds per muscle) of the quadriceps and hamstrings, 2-hours before a traditional warm-up compared to an active control condition on hip flexion ROM, knee extension and flexion MVIC forces, CMJ, DJ, and quadriceps and hamstrings electromyography (EMG). There were no significant changes in knee flexion/extension MVIC forces, EMG, CMJ, or DJ height. However, there was significant, small magnitude (p = 0.002) greater post-warm-up left hip flexion ROM (115.4° ± 17.2) than pre-SS (108.9° ± 17.13, Effect size [ES]: 0.28) and control post-warm-up (p = 0.05, ES: 0.31, 109.5° ± 20.55). Similarly, right hip flexion ROM (117.2° ± 16.5) also demonstrated significant small magnitude (p = 0.003) greater than the pre-SS (112.4° ± 18.4, ES: 0.22) and control post-warm-up (p = 0.046, ES: 0.33, 110.8° ± 20.5). Additionally, significant, large magnitude greater hip flexion ROM was observed with the women vs. men (ES: 1.29 - 1.34). Significant hip flexion ROM increases were not accompanied by significant changes in knee flexion/extension MVIC forces, EMG, or jump heights, suggesting that extensive SS can positively impact ROM without performance deficits when followed by a traditional warm-up, 2-hours after SS.

The effect of kinesio taping on joint range of motion and balance in total knee replacement patients.

We adopted a within-subjects quasi-experimental approach to assess the impact of kinesio taping (KT) on joint range of motion (ROM), static balance, and dynamic balance. The research subjects were 15 patients who had, within the previous 3 weeks, undergone total knee replacement (TKR) by an orthopedic surgeon in 2022. We measured the ROM, static balance, and dynamic balance of the knee joint before and after applying KT. We then compared the pre- and post-tape measurements to assess the effects of KT on joint function and balance. The ROM of the knee joint was measured using a goniometer in the supine position before the KT application. The static and dynamic balance were assessed using a balance assessment device by measuring the sway area and length of the center of gravity during the measurement period. The effects of KT on the ROM and static and dynamic balance of the knee joint were investigated. The differences in joint ROM and static and dynamic balance between pre- and post-KT applications were analyzed using a paired-sample t-test. This study found that the ROM of the knee joint was significantly increased after applying KT. For static and dynamic balance, both the sway area and length of the center of gravity decreased after applying KT, indicating a significant improvement in static and dynamic balance. KT, when combined with standard physiotherapy, can be a useful therapeutic approach for TKR patients, effectively enhancing joint ROM and balance function.

Concussion Reduction in Division I and II Athletes: Effects of Simple Cervical Spine Exercise Regimen.

INTRODUCTION:  Primary preventative medicine lacks a consensus on effective concussion prevention strategies for collegiate athletes. Cervical strength has been identified as a potential factor in concussion risk reduction. This study evaluates the impact of a commercially available, portable cervical muscle stretching and strengthening device, NeckX®, on cervical strength, range of motion (ROM), and concussion incidence in collegiate athletes participating in high-concussion-risk sports. METHODS:  A single-arm prospective cohort study was conducted with 162 collegiate athletes from various sports. Participants underwent a 12-week neck exercise protocol using the NeckX® device. Clinical data, including neck strength and ROM, were collected at weeks 0, 6, and 12. Concussion incidence was self-reported by participants and cross-referenced with records from the athletic department. Data were analyzed for significant neck strength and ROM changes throughout the 12-week study. A two-way analysis of variance multiple comparisons with the Tukey-Kramer significant difference test was utilized, using the Holm-Sidak method, with an alpha of 0.05. RESULTS:  All athletic teams experienced a significant increase in cervical strength during the 12-week intervention (α = 0.05, p < 0.05). Increases in cervical flexion and extension force were most consistent between teams. Cervical ROM increased significantly in male and female soccer players (α = 0.05, p < 0.05). The overall incidence of head and neck injuries, including concussions, was reduced to 6.60% during the study period, the lowest recorded value in the university's athletic department history. CONCLUSION:  The use of the NeckX® device for 12 weeks was effective in enhancing pericervical muscle strength and ROM while reducing concussion incidence in collegiate athletes participating in high-concussion-risk sports. Interestingly, the positive outcomes were consistent for both males and females, indicating the universal advantages of neck training among collegiate athletes. These findings support existing research on the benefits of cervical strengthening exercises for reducing concussions in collegiate athletes and highlight the convenience and affordability of using this device.

How is range of motion of the fingers measured in hand therapy practice? A survey study.

Introduction: A variety of techniques for measuring finger range of motion (ROM) are available for hand therapist use, however, there is no clear description of which finger ROM methods are preferred in practice. This study explored the preferred measurement techniques, the factors influencing clinical decision-making, and the clinical reasoning processes employed when faced with practice-based measurement scenarios. Methods: This was a cross-sectional online survey study of hand therapists and American or Canadian Society of Hand Therapists members. Quantitative methods were employed for participant demographics and categorical clinical questions about practice patterns. Qualitative descriptive questions and vignettes were analysed using inductive and deductive content analysis, respectively. Results: Four hundred and eighty-one responses were included, representing hand therapists with a median age of 51 years and median experience of 19 years. Participants preferred measuring individual joints with a goniometer (N = 210, 44%) for perceived utility in informing treatment decisions, reliability, and confidence in measurement skills. Participants also preferred active functional ROM (N = 117, 24%) for being quick, easy, and useful in informing treatment decisions. Participants reported using different methods with time constraints in a busy clinic, taking precautions with pins/wounds, bulky dressings/casts, pain tolerance levels of patients, or with specific pathologies. Participants' responses to the multi-stage vignette identified distinct patterns of clinical reasoning approaches within individual vignettes. Conclusions: Hand therapists use multiple methods to measure finger ROM while preferring to use goniometers to measure individual finger joints. They engage procedural and pragmatic reasoning modified by contextual factors when measuring finger ROM.

Reliability of the Moover® 3D Inertial Motion Sensor in Greek Patients With Chronic Neck Pain in a Primary Care Urban Setting.

Introduction Neck pain has a high lifetime prevalence and represents a significant health issue. Reduced active cervical range of motion (ACROM) has been found in neck pain patients. Inertial sensor technology can provide objective measurements to assess the impaired ACROM. Purpose Primarily, this study investigated the inter- and intra-rater reliability of the Moover® three-dimensional (3D) inertial motion sensor (Sensor Medica, Rome, Italy) in Greek patients with non-specific chronic neck pain. Secondly, the intra-rater reliability of the Neck Disability Index (NDI) was also assessed. Methods Fifty patients (18 males and 32 females) suffering from non-specific chronic neck pain participated in this study. Two physiotherapists measured separately each participant's ACROM in three planes, within a 48-hour period. The participants' position and the sequence and direction of the three cervical movements (cervical rotation, lateral flexion, and flexion-extension) were standardized. Results The inter-rater reliability intraclass correlation coefficient (ICC) values were good to excellent ranging from 0.77 to 0.95 for the first measurement and 0.85 to 0.95 for the second (p < 0.001). The intra-rater reliability ICC values were moderate to excellent ranging from 0.74 to 0.92 for the first rater and good to excellent ranging from 0.83 to 0.94 for the secondrater (p < 0.001). Intra-rater reliability of the overall NDI was indicated as good, and ICC was 0.80 (95%CI: 0.65-0.89; p < 0.001). ICC values for all sections were significant and ranged from 0.40 to 0.88. Conclusion This study showed the reliability of the Moover 3D inertial sensor for ACROM measurement in Greek patients with chronic neck pain. The NDI scale also showed good intra-rater reliability in the same sample. Both intra- and inter-rater reliability of the Moover 3D were proven to be acceptable over a 48-hour period. The specific sensor might have a potential application in a clinical setting.

The Impact of Fascial Manipulation® on Posterior Shoulder Tightness in Asymptomatic Handball Players: A Randomized Controlled Trial.

This prospective study aimed to determine the impact of Fascial Manipulation® by Stecco (FM) on the range of motion (ROM) of internal rotation (IR) and horizontal adduction (HADD) in asymptomatic handball players, representing significant risk factors for shoulder injuries. A randomized controlled trial was conducted, with participants randomly assigned to either the investigated group (N = 29) receiving a single session of FM or the control group (N = 27) receiving no treatment. The ROM for IR and HADD were measured before, immediately after, and one month after the FM session. The investigated group experienced a statistically significant acute increase in glenohumeral IR (14 degrees, p < 0.001) and HADD (14 degrees, p < 0.001) compared to the control group (p < 0.001). The positive effects of FM persisted one month post-treatment, with increased IR ROM by 12 degrees (p < 0.001) and HADD ROM by 11 degrees (p < 0.001). Participants in the investigated group reported lower subjective tightness/stiffness immediately after (p < 0.001) and one month after treatment (p = 0.002) compared to the control group. This study demonstrates that a single application of FM effectively improves glenohumeral ROM in the dominant throwing shoulder of asymptomatic handball players. It highlights the immediate and sustained positive effects of FM on IR and HADD. These findings support the use of FM as an effective method for enhancing shoulder ROM and reducing subjective tightness/stiffness. The study was registered at ClinicalTrials.gov (NCT06009367).