Assessment of Muscle Stiffness Using the MyotonPro: Effects of Fatigue on Vastus Lateralis and Medialis Muscles.

BACKGROUND: The investigation of soft tissue stiffness has garnered increasing interest due to its potential applications in detecting tissue conditions, monitoring therapy effects, and preventing sports injuries. This study utilized the MyotonPro as a reliable measurement device to assess muscle stiffness and muscle frequency in the vastus lateralis and medialis muscles of both the dominant and non-dominant legs. METHODS: Sixteen young, healthy subjects (seven males and nine females, age 25 ± 3.46 years) participated in this study. To induce maximal muscle fatigue, the vastus lateralis and vastus medialis muscles were subjected to a 30 kg load using a single-leg leg press. Pre- and post-fatigue measurements were conducted by two testers on the dominant and non-dominant legs, respectively, employing the MyotonPro. RESULTS: We revealed a significant increase in muscle stiffness after maximal muscle fatigue. Specifically, on the dominant side, the vastus lateralis exhibited a stiffness increase of 6.5%, while the vastus medialis showed a 6.3% increase. On the non-dominant side, the vastus lateralis demonstrated a 7.6% increase, and the vastus medialis exhibited a 6.7% increase in muscle stiffness. Furthermore, muscle frequency increased by 8.6% (vastus lateralis) and 13.5% (vastus medialis) on the dominant side and by 15.1% (vastus lateralis) and 6.3% (vastus medialis) on the non-dominant side. The reliability of the measurements varied, with Cronbach's alpha values ranging from inadequate 0.49 to very good 0.88. CONCLUSION: This study affirms the efficacy of the MyotonPro as a measurement device for assessing muscle stiffness and establishes its reliability. The observed increase in muscle stiffness after maximal muscle fatigue, accompanied by changes in muscle frequency, underscores the device's utility. However, further research is warranted to validate the reproducibility of these findings and explore additional facets of the muscular response to fatigue.

Patient-related Predictors for the Functional Outcome of SuperPATH Hemiarthroplasty versus Conventional Approach Hemiarthroplasty: A Systematic Review and Meta-regression Analysis of Randomized Controlled Trials.

Specialist literature lacks evidence that explores associations between patient characteristics and the beneficial treatment effect of SuperPATH hemiarthroplasty (HA) compared with conventional approach (CA) HA. To investigate and identify patient-related predictors of the effect size of the short-term functional outcome of SuperPATH HA and CA HA by performing a systematic review and meta-regression analysis of randomized controlled trials (RCTs). A systematic search of literature was performed in PubMed, CNKI, CENTRAL of The Cochrane Library, Clinical trials, and Google Scholar until August 25, 2023. For the continuous outcome parameter Harris hip score (HHS) ≤1 week and 3 months postoperatively, mean differences (MDs) with 95% confidence intervals (CIs) were calculated. A meta-regression analysis was based on random-effects meta-analysis using the Hartung-Knapp-Sidik-Jonkman method for continuous covariates. A total of five RCTs with 404 patients were found. The following predictors of HHS ≤1 week postoperatively were identified: patient age (predictor estimate = 1.29; p < 0.01), patient age groups (predictor estimate = 14.07; p < 0.01), time to mobilization (predictor estimate = 5.51; p < 0.01). The following predictors of HHS 3 months postoperatively were identified: incision length (predictor estimate = -2.12; p < 0.01); intraoperative blood loss (predictor estimate = 0.02; p < 0.01). Patient age, time to mobilization, incision length, and intraoperative blood loss were identified as predictors of the effect size of early postoperative functional outcome as measured by HHS. Elderly patients, particularly those over 70 years of age, appear to benefit from SuperPATH HA. Based on these findings, and taking into account our limitations, we recommend that the use of minimally invasive SuperPATH HA in elderly patients should be more widely considered and not limited to elective THA patients.

Human-Written vs AI-Generated Texts in Orthopedic Academic Literature: Comparative Qualitative Analysis.

BACKGROUND: As large language models (LLMs) are becoming increasingly integrated into different aspects of health care, questions about the implications for medical academic literature have begun to emerge. Key aspects such as authenticity in academic writing are at stake with artificial intelligence (AI) generating highly linguistically accurate and grammatically sound texts. OBJECTIVE: The objective of this study is to compare human-written with AI-generated scientific literature in orthopedics and sports medicine. METHODS: Five original abstracts were selected from the PubMed database. These abstracts were subsequently rewritten with the assistance of 2 LLMs with different degrees of proficiency. Subsequently, researchers with varying degrees of expertise and with different areas of specialization were asked to rank the abstracts according to linguistic and methodological parameters. Finally, researchers had to classify the articles as AI generated or human written. RESULTS: Neither the researchers nor the AI-detection software could successfully identify the AI-generated texts. Furthermore, the criteria previously suggested in the literature did not correlate with whether the researchers deemed a text to be AI generated or whether they judged the article correctly based on these parameters. CONCLUSIONS: The primary finding of this study was that researchers were unable to distinguish between LLM-generated and human-written texts. However, due to the small sample size, it is not possible to generalize the results of this study. As is the case with any tool used in academic research, the potential to cause harm can be mitigated by relying on the transparency and integrity of the researchers. With scientific integrity at stake, further research with a similar study design should be conducted to determine the magnitude of this issue.

Postoperative Activity and Knee Function of Patients after Total Knee Arthroplasty: A Sensor-Based Monitoring Study.

Inertial measurement units (IMUs) are increasingly being used to assess knee function. The aim of the study was to record patients' activity levels and to detect new parameters for knee function in the early postoperative phase after TKA. Twenty patients (n = 20) were prospectively enrolled. Two sensors were attached to the affected leg. The data were recorded from the first day after TKA until discharge. Algorithms were developed for detecting steps, range of motion, horizontal, sitting and standing postures, as well as physical therapy. The mean number of steps increased from day 1 to discharge from 117.4 (SD ± 110.5) to 858.7 (SD ± 320.1), respectively. Patients' percentage of immobilization during daytime (6 a.m. to 8 p.m.) was 91.2% on day one and still 69.9% on the last day. Patients received daily continuous passive motion therapy (CPM) for a mean of 36.4 min (SD ± 8.2). The mean angular velocity at day 1 was 12.2 degrees per second (SD ± 4.4) and increased to 28.7 (SD ± 16.4) at discharge. This study shows that IMUs monitor patients' activity postoperatively well, and a wide range of interindividual motion patterns was observed. These sensors may allow the adjustment of physical exercise programs according to the patient's individual needs.

Development of the INpaTiEnt Rehabilitation App Compliance QuesTionnaire [INTERACT].

BACKGROUND: The elements of previously designed questionnaires do not take into consideration the burdens encountered in an inpatient hospital setting. The purpose of this study is to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with telerehabilitative physiotherapy in the early postoperative period. METHODS: A literature search was conducted to identify elements that prevent patients from performing their prescribed physical therapy exercises. These items were then evaluated by the expert review technique as described by Ikart. Afterwards, the synthesized survey was handed out to patients for the assessment of the quality of its items. RESULTS: The results of the expert review technique identified some conceptual and grammatical problems. This led to the adjustment of some of the elements. The quality of the resulting questionnaire was deemed to be good, as patients were able to fully understand the concepts and answer accordingly. A statistical analysis was conducted to evaluate the responses. CONCLUSIONS: The items of this second questionnaire have proven to be reliable to assess the compliance of patients in an in-hospital setting. These items will be added to the cross-culturally adapted items of a previous questionnaire.

Non-Adherence with Physiotherapeutic Rehabilitation-A Cross-Cultural Adaption of Compliance Parameters into German.

BACKGROUND: Compliance with rehabilitative physiotherapeutic measures leads to an improvement in outcomes in patients suffering from a variety of musculoskeletal conditions. To date, a tool for assessing the parameters that lead to non-adherence to physical therapy does not exist in the German language. The objective of this paper is to cross-culturally adapt a non-compliance questionnaire to German. METHODS: In reference to the "Guidelines for the Process of Cross-Cultural Adaption of Self-Reported Measures", the questionnaire was translated into German followed by a back-translation into the original language. An expert committee met and refined the pre-final version. A preliminary version was handed out to patients for evaluation of the quality of the resulting German version. RESULTS: After the forward- and back-translation of the questionnaire, some discrepancies were discovered between the translators on the one hand and between the back-translations and the original document on the other. The statistical analysis showed satisfactory results regarding the quality of the questionnaire. CONCLUSION: The translation and adaption of the items proved to have a high degree of reliability. The German version will be made available for German-speaking researchers and used for evaluating a mobile-application-based physical therapy regimen by the authors of the paper.