Parsonage-Turner syndrome, affecting suprascapular nerve and especially to infraspinatus muscles after COVID-19 vaccination in a professional wrestler, a case report and literature review of causes and treatments.

BACKGROUND: Acute peripheral neuropathy, also known as Parsonage-Turner syndrome or neuralgic amyotrophy, mostly affects the upper brachial plexus trunks, which include the shoulder girdle. It is typically accompanied by abrupt, intense pain, weakness, and sensory disruption. The etiology and causes of this disease are still unknown because of its low prevalence, however viral reactions-induced inflammation is one of its frequent causes. CASE PRESENTATION: Here, we introduce a professional wrestler patient who was diagnosed with PTS after vaccination and was treated, and we review some articles in this field. CONCLUSION: When it comes to shoulder-girdle complaints and pain, Parsonage-Turner syndrome can be a differential diagnosis. Corticosteroids during the acute period, followed by physical therapy, appear to be an efficient way to manage pain, inflammation, muscular atrophy, and the process of recovering to full nerve regeneration.

The immediate effect of a single whole-body vibration session on balance, skin sensation, and pain in patients with type 2 diabetic neuropathy.

Purpose: Patients with diabetic neuropathy usually suffer from impaired balance, pain, and decreased sole-foot sensation. The present research was designed to appraise the relic of whole-body vibration (WBV) on balance, pain, and sole-foot sensation in diabetic neuropathy patients. Methods: Present study was a single-blind randomized controlled clinical trial. Thirty-four patients with type 2 diabetic neuropathy were randomly divided into intervention groups (n=17) and control (n=17). The therapeutic program in the intervention group included standing on the platform of the WBV device, and in the control group included using the device in off mode. Dynamic balance (including overall, anterior-posterior, and medial-lateral stability indices) was measured using Biodex device, functional balance with timed up and go (TUG) test, pain using the visual analog scale (VAS), and sole-foot sensation of both feet with a monofilament. The outcomes were measured in both groups before and after the interventions. Results: Sixteen people in each group were analyzed. Intra-group comparison showed a significant improvement in the mean pain (P = 0.000), functional balance (P = 0.011), right and left sole-foot sensation (P = 0.001), and overall (P = 0.000), anterior-posterior (P = 0.000) and medial-lateral (P = 0.000) stability indices for the intervention group in post-intervention compared to pre-intervention. However, changes in the control group were not statistically significant. Results of inter-group comparison indicated a significant improvement in all parameters in the intervention group, except for functional balance. Conclusion: WBV can be effective in reducing pain and improving the sole-foot sensation and dynamic balance.

Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy.

PURPOSE: To compare the effects of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy. MATERIALS AND METHODS: Twelve children with hemiplegic cerebral palsy and 12 typically developing children ages 5 to 12 years (GMFCS I-II) were evaluated with the Timed Up and Go (TUG) and Biodex Balance System during three upper extremity (UE) conditions: 1) Free UEs (no constraints), 2) Simple UE constraint (unaffected/dominant UE constrained with a sling), and 3) Difficult UE constraint (Simple constraint plus the other UE holding cup of water). RESULTS: The UE condition had significant effects on Overall Stability Index (OSI) (F(2,44) = 24.899, p < .001), Medial-Lateral Stability Index (MLSI) (F(2,44) = 4.380, p = .018), Anterior-Posterior Stability Index (F(2,44) = 6.187, p = .004), and TUG scores (F(2,44) = 113.372, p < .001). Group was significant for OSI (F(1,22) = 7.906, p = .010), MLSI (F(1,22) = 13.113, p = .002), and TUG (F(1,22) = 36.282, p < .001). CONCLUSIONS: The upper extremity appears to have a role in maintaining functional balance and postural stability in children with hemiplegic cerebral palsy and should be considered during intervention programs.

Electromyographic activity of the hip and knee muscles during functional tasks in males with and without patellofemoral pain.

BACKGROUND: Patellofemoral pain (PFP) is a common overuse injury in physically active individuals. It is characterized by anterior knee, retropatellar, or prepatellar pain associated with activities that increase patellofemoral joint stress such as squatting, stair ascending and descending, running, jumping, prolonged sitting, and kneeling. The etiology of PFP is believed to be multifactorial. Recently, proximal factors have been shown to influence the biomechanics of patellofemoral joint. OBJECTIVE: The aim of the study was to assess hip and knee muscle activity during single leg stance and single leg squat in males with PFP and a control group without PFP. METHODS: Eighteen males with PFP (age 24.2 ±â€¯4.4 years) and 18 healthy subjects as controls (age 23.5 ±â€¯3.8 years) were included. We evaluated gluteus medius, gluteus maximus, vastus medialis oblique (VMO), and vastus lateralis (VL) electromyographic (EMG) activity. The muscle activity and reaction time of the proposed muscles were assessed during single leg stance and single leg squat tasks. Independent t-test was used to identify significant differences between PFP and control groups. RESULTS: No difference in activity of the gluteus maximus muscle was found in either task (p > 0.5). Significant differences were found in activity of gluteus medius and VMO in both tasks (p < 0.05). VL muscle activity had significant difference in single leg stance (p = 0.01), however, had no significant difference in single leg squat (p = 0.1). No significant differences were found in reaction time of the four studied muscles during both single leg stance and single leg squat (p > 0.5). CONCLUSION: Males with PFP demonstrated altered gluteus medius, VMO, and VL muscle activity during single leg stance and single leg squat compared to healthy subjects. Gluteus maximus activity did not show any changes between groups. Moreover, muscle recruitment patterns were different between PFP and healthy groups.

Effect of kinesio taping direction on force sense in wrist flexor muscles in healthy persons.

The aim of this study was to investigate the effect of direction of kinesio taping of wrist flexor muscles on force sense. Forty-five healthy women took part in this study, in three groups: kinesio taping application from origin to insertion (OI group) or from insertion to origin (IO group), and no kinesio taping (control group). Absolute and relative force sense errors were calculated with 50% maximal grip strength as the target force value. Absolute and relative force sense errors in the dominant hand were recorded before and 24 h after the application of kinesio tape to the forearm. Relative force sense error was significantly lower in the OI group than in the control group (P = 0.028). However, absolute force sense error did not differ significantly among the three groups (P = 0.431). Our results suggest that kinesio taping in the OI direction enhances relative force sense compared to no taping.

A comparison of foot kinetic parameters between pronated and normal foot structures during forward jump landing.

BACKGROUND: Pronated foot is one of the most important factors that may lead to musculoskeletal injuries of the lower extremities. It is known that in a pronated foot, excessive mechanical loads are applied to the lower limb structures, which result in the altered foot biomechanics, including vertical ground reaction forces (VGRFs) and rate of loading (ROL). Therefore, the aim of this study was to determine the changes in foot kinetic parameters in the pronated compared to the normal foot structures. METHODS: In this cross-sectional study, 15 individuals (mean age of 23.27 ± 3.28 years) with asymptomatic pronated feet and 15 normal subjects (mean age of 23.40 ± 3.11 years) were recruited from both genders by using a simple non-random sampling method. VGRF, ROL, and the resultant vector of time to stabilization (RVTTS) were evaluated during the forward jump landing task by using a force plate. RESULTS: The findings showed that the following parameters were significantly higher in the group of pronated feet than in the normal subjects: VGRF (3.30 ± 0.17 vs. 2.81 ± 0.15, p = .042), ROL (0.10 ± 0.01 vs. 0.07 ± 0.006, p = .020), and RVTTS (2592.80 ± 141.24 vs. 2114.00 ± 154.77, p = .030). CONCLUSION: All the measured foot kinetic parameters were higher in the pronated foot subjects than in the normal participants. An impaired movement control and greater forces imposed on the foot region of the pronated foot, compared to the normal foot individuals, were discovered indicating the former group's possible increase of susceptibility to various musculoskeletal injuries.

Measurement of force sense reproduction in the knee joint: application of a new dynamometric device.

[Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint.

Altered Hip Mechanics and Patellofemoral Pain. A Review of Literature.

Patellofemoral pain (PFP) is a common knee disorder in orthopedic clinics. In the last decade, several investigations have considered the role of proximal factors in addition to local and distal factors in development of PFP. There is a hypothesis which suggests that impaired neuromuscular control and altered hip joint kinematic affect tibiofemoral and patellofemoral biomechanics. Hence, PFP may develop as a result. This article reviews studies assessing the relationship between altered hip mechanics and PFP. The Medline and PubMed databases were searched between January 2004 and October 2014. Two authors independently selected related articles using the same search strategy and key words. Among 149 articles, 16 met the review inclusion criteria. The study results were described in three sections: 1) kinematic studies, 2) muscle activity studies, and 3) postural stability studies. Increased hip adduction and internal rotation, gluteal muscle weakness, and neuromuscular impairment were common findings in patients with patellofemoral pain. Precise assessment of hip mechanics, including hip kinematic, muscle performance and postural stability, should be considered in the examination of patients with patellofemoral pain.

A study on the effects of general fatigue on head and neck proprioception in healthy young adults.

BACKGROUND: Fatigue is one of the factors causing disturbance in proprioception which can be manifested in two ways: general and local. Due to the important role of cervical proprioception on body stability and posture, research on the effects of general fatigue on proprioception helps to better understand its mechanism and to improve the strategies to prevent injury. Therefore, the aim of this study was to identify the effects of general fatigue on head and neck proprioception in young healthy adults. MATERIAL AND METHODS: This clinical study was done by implementing pre- and post-test measurements in 112 young healthy subjects aged between 18-30 years and able to walk at a speed of 10Km for 5 minutes. They were randomly divided into an experimental and control group. The patients in the control (not exposed to a general fatigue task) and experimental (exposed to a general fatigue task) groups were matched for age, height and weight. In the first step, the zero absolute reposition angle of the head and neck was measured in all participants. Then the subjects in the experimental group did a five-minute run on the treadmill to achieve the level of general fatigue, following which the head and neck reproduction angle was measured in all subjects for the second time. RESULTS: There was a statistical significant difference between pre- and post-test absolute angular error in the experimental group; however, there was no noticeable difference between the pre- and post-test data in the control group. CONCLUSIONS: 1. General fatigue increased the repositioning angular error of head and neck. 2. Neck proprioception decreased due to general fatigue. 3. General fatigue increased the risk of neck injury.

Correlation between Hip Rotation Range-of-Motion Impairment and Low Back Pain. A Literature Review.

BACKGROUND: Hip rotation range-of-motion (ROM) impairment has been proposed as a contributing mechanical factor in the development of low back pain (LBP) symptoms. There is a hypothesis which suggests that a limited range of hip rotation results in compensatory lumbar spine rotation. Hence, LBP may develop as the result. This article reviews studies assessing hip rotation ROM impairment in the LBP population. MATERIAL AND METHODS: The MEDLINE and EMBASE databases were searched without time restriction. Two authors independently selected related articles using the same search strategy and key words. RESULTS: Among 124 articles 12 met the review inclusion criteria. The results of the studies are assessed in three sections, investigating the relationship between low back pain and 1) hip internal rotation ROM, 2) hip external rotation ROM and 3) hip total rotation ROM. Asymmetrical (right versus left, lead versus non-lead) and limited hip internal rotation ROM were common findings in patients with LBP. Reduced and asymmetrical total hip rotation was also observed in patients with LBP. However, none of the studies explicitly reported limited hip external rotation ROM. CONCLUSION: The precise assessment of hip rotation ROM, especially hip internal rotation ROM, must be included in the examination of patients with LBP symptoms.

The impact of load and base of support on electromyographic onset in the shoulder muscle during push-up exercises.

OBJECTIVE: To investigate the effects of base of support (BOS) and external loads on electromyographic (EMG) onset in the shoulder muscles during push-up exercises. METHODS: Two levels of external load were applied at two levels of BOS stability during push-up exercises. EMG onset in six shoulder muscles was measured in 30 healthy participants. RESULTS: With load set at 4% of body weight (BW), EMG onset in the lower trapezius (LT) (P = 0.003) and biceps brachia (BB) (P = 0.001) was significantly decreased with no load. Conversely, in other muscles (the upper trapezius (UT), teres major (TM), seratus anterior (SA) and deltoid posterior (DP)), time to EMG onset did not change significantly. No significant changes in EMG onset were observed with load at 2% of BW. The average time to EMG onset was significantly decreased for different stages of BOS instability in the LT (P = 0.04) and UT (P = 0.001). CONCLUSION: Both load and BOS instability reduce time to EMG onset, but BOS instability produces greater reductions.