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1.
Bone Joint J ; 103-B(9): 1514-1525, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34465156

RESUMO

AIMS: The aims of this study were to investigate the ability to kneel after total knee arthroplasty (TKA) without patellar resurfacing, and its effect on patient-reported outcome measures (PROMs). Secondary aims included identifying which kneeling positions were most important to patients, and the influence of radiological parameters on the ability to kneel before and after TKA. METHODS: This prospective longitudinal study involved 209 patients who underwent single radius cruciate-retaining TKA without patellar resurfacing. Preoperative EuroQol five-dimension questionnaire (EQ-5D), Oxford Knee Score (OKS), and the ability to achieve four kneeling positions were assessed including a single leg kneel, a double leg kneel, a high-flexion kneel, and a praying position. The severity of radiological osteoarthritis (OA) was graded and the pattern of OA was recorded intraoperatively. The flexion of the femoral component, posterior condylar offset, and anterior femoral offset were measured radiologically. At two to four years postoperatively, 151 patients with a mean age of 70.0 years (SD 9.44) were included. Their mean BMI was 30.4 kg/m2 (SD 5.36) and 60 were male (40%). They completed EQ-5D, OKS, and Kujala scores, assessments of the ability to kneel, and a visual analogue scale for anterior knee pain and satisfaction. RESULTS: The ability to kneel in the four positions improved in between 29 (19%) and 53 patients (35%) after TKA, but declined in between 35 (23%) and 46 patients (30%). Single-leg kneeling was most important to patients. After TKA, 62 patients (41%) were unable to achieve a single-leg kneel, 76 (50%) were unable to achieve a double-leg kneel, 102 (68%) were unable to achieve a high-flexion kneel and 61 (40%) were unable to achieve a praying position. Posterolateral cartilage loss significantly affected preoperative deep flexion kneeling (p = 0.019). A postoperative inability to kneel was significantly associated with worse OKS, Kujala scores, and satisfaction (p < 0.05). Multivariable regression analysis identified significant independent associations with the ability to kneel after TKA (p < 0.05): better preoperative EQ-5D and flexion of the femoral component for single-leg kneeling; the ability to achieve it preoperatively and flexion of the femoral component for double-leg kneeling; male sex for high-flexion kneeling; and the ability to achieve it preoperatively, anterior femoral offset, and patellar cartilage loss for the praying position. CONCLUSION: The ability to kneel was important to patients and significantly influenced knee-specific PROMs, but was poorly restored by TKA with equal chances of improvement or decline. Cite this article: Bone Joint J 2021;103-B(9):1514-1525.


Assuntos
Artroplastia do Joelho , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Estudos Longitudinais , Masculino , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Medição da Dor , Dor Pós-Operatória/diagnóstico , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/fisiopatologia , Articulação Patelofemoral/cirurgia , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Inquéritos e Questionários
2.
Medicine (Baltimore) ; 100(27): e26572, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232202

RESUMO

CONTEXT: There are no scientific reports unambiguously describing the efficacy of alternating magnetic field therapy in patients after anterior cruciate ligament (ACL) reconstruction in the early postoperative period. OBJECTIVE: This study aims to evaluate the efficacy of using an alternating magnetic field in the resorption of postoperative joint effusion in patients after ACL reconstruction. STUDY DESIGN: A randomized, double-blind placebo-controlled study. SETTING: Inpatients. PARTICIPANTS: Forty patients were enrolled in the trial. However, the final study group consisted of 38 patients (28 men and 10 women) after ACL reconstruction who were randomly divided into an experimental group (19 patients) and a control group (19 patients). INTERVENTION: Each group received magnetic field therapy in the postoperative period, but only 1 apparatus emitted a magnetic field (the experimental group). Patients used the apparatus every day for 30 minutes for the next 11 days. The parameters in both devices were the same-3 mT and 10 Hz. MAIN OUTCOME MEASURES: The measurement of the knee circumference and range of motion were made. The knee circumference measurement was performed before magnetic field therapy began and for 11 days after magnetic field treatment. The active knee range of motion was evaluated before and after magnetic field therapy was completed. RESULTS: There were no statistically significant differences between the groups in the reduction of post-operative joint effusion or knee joint function. CONCLUSION: In patients after ACL reconstruction, in whom an alternating magnetic field was used to treat postoperative joint effusion, there were no beneficial effects on the analyzed variables compared to the control group.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Articulação do Joelho/cirurgia , Campos Magnéticos , Complicações Pós-Operatórias/terapia , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica/fisiologia , Adolescente , Adulto , Método Duplo-Cego , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Adulto Jovem
3.
Muscle Nerve ; 64(3): 357-361, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34105182

RESUMO

INTRODUCTION/AIM: This retrospective study aimed to quantify the changes in motor function in patients with Duchenne muscular dystrophy (DMD) due to the government-imposed travel restrictions associated with the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Twelve DMD patients were enrolled in this investigation (mean ± SD age: 9.8 ± 3.6 y). Their physical characteristics and motor function were evaluated approximately 3 mo before, immediately before, and approximately 3 mo after the travel restrictions were decreed. Statistical comparisons were performed of the changes in motor function before and after the travel restrictions. RESULTS: The change in range of motion (ROM) of ankle dorsiflexion was significantly decreased after the travel restrictions. Changes in body mass index and other motor function parameters were not significant. DISCUSSION: An apparent decrease in the amount of physical activity due to travel restrictions in response to COVID-19 negatively affected ankle dorsiflexion ROM but not other motor functions. A more sedentary lifestyle and lack of regular physical therapy services most likely contributed to this reduction. The use of remote rehabilitation tools with the involvement of physiotherapists may help mitigate such changes and prevent more severe physical decline.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Destreza Motora/fisiologia , Distrofia Muscular de Duchenne/terapia , Modalidades de Fisioterapia , Viagem , Adolescente , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/tendências , Feminino , Humanos , Masculino , Distrofia Muscular de Duchenne/diagnóstico , Distrofia Muscular de Duchenne/fisiopatologia , Modalidades de Fisioterapia/tendências , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Viagem/tendências
4.
J Back Musculoskelet Rehabil ; 34(4): 707-714, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34092596

RESUMO

BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. In the recent years application of non-linear indices seems to be showing the way. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar spine between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study. Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation - SD) and non-linear indices (Maximal Lyapunov Exponent - LyE and Approximate Entropy - ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.


Assuntos
Marcha/fisiologia , Dor Lombar/fisiopatologia , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Teste de Esforço , Feminino , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento/fisiologia , Pelve/fisiopatologia , Amplitude de Movimento Articular/fisiologia
5.
J Sports Sci ; 39(sup1): 62-72, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34092196

RESUMO

The current protocol for classifying Para swimmers with hypertonia, ataxia and athetosis involves a physical assessment where the individual's ability to coordinate their limbs is scored by subjective clinical judgment. The lack of objective measurement renders the current test unsuitable for evidence-based classification. This study evaluated a revised version of the Para swimming assessment for motor coordination, incorporating practical, objective measures of movement smoothness, rhythm error and accuracy. Nineteen Para athletes with hypertonia and 19 non-disabled participants performed 30 s trials of bilateral alternating shoulder flexion-extension at 30 bpm and 120 bpm. Accelerometry was used to quantify movement smoothness; rhythm error and accuracy were obtained from video. Para athletes presented significantly less smooth movement and higher rhythm error than the non-disabled participants (p < 0.05). Random forest algorithm successfully classified 89% of participants with hypertonia during out-of-bag predictions. The most important predictors in classifying participants were movement smoothness at both movement speeds, and rhythm error at 120 bpm. Our results suggest objective measures of movement smoothness and rhythm error included in the current motor coordination test protocols can be used to infer impairment in Para swimmers with hypertonia. Further research is merited to establish the relationship of these measures with swimming performance.


Assuntos
Paralisia Cerebral/fisiopatologia , Hipertonia Muscular/fisiopatologia , Desempenho Psicomotor/fisiologia , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Acelerometria , Adulto , Algoritmos , Ataxia/fisiopatologia , Atetose/fisiopatologia , Desempenho Atlético/fisiologia , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Masculino , Movimento/fisiologia , Hipertonia Muscular/classificação , Paratletas/classificação , Desempenho Físico Funcional , Amplitude de Movimento Articular/fisiologia , Ombro/fisiologia , Esportes para Pessoas com Deficiência/classificação , Natação/classificação , Gravação em Vídeo , Adulto Jovem
6.
J Sports Sci ; 39(sup1): 73-80, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34092197

RESUMO

This study examined the reliability of instrumented trunk assessment methods across two experiments to develop and improve evidence-based classification in Para swimming. Trunk coordination, range of motion (ROM), and strength were assessed in 38 non-disabled participants. Each test battery was completed on two occasions to determine inter-session reliability. Intra-session reliability was also determined in Experiment Two. Absolute agreement of two-way mixed intraclass correlation coefficients (ICC 3,1) was calculated to assess reliability. Standard errors of measurement (SEMs) were also reported to facilitate comparisons between different outcomes. Trunk coordination measures had low-to-moderate reliability (inter-session ICCs = 0.00-0.60; intra-session ICCs = 0.14-0.65) and variable SEMs (5-60%). Trunk ROM demonstrated moderate-to-excellent reliability (inter-session ICCs = 0.61-0.93; intra-session ICCs = 0.87-0.95) and good SEMs (<10%). Trunk strength measures demonstrated good-to-excellent reliability (ICCs = 0.87-0.98) and good SEMs (<10%). The strength values obtained for the load cell and hand-held dynamometer (HHD) were significantly different from each other with the HHD underestimating strength. Modifications provided in Experiment Two improved the reliability of strength and ROM assessments but did not improve coordination measures. Further research involving para swimmers is required to establish the validity of the methods.


Assuntos
Força Muscular/fisiologia , Desempenho Psicomotor/fisiologia , Amplitude de Movimento Articular/fisiologia , Natação/fisiologia , Tronco/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Voluntários Saudáveis , Humanos , Dinamômetro de Força Muscular , Paratletas/classificação , Reprodutibilidade dos Testes , Postura Sentada , Coluna Vertebral , Esportes para Pessoas com Deficiência/classificação , Esportes para Pessoas com Deficiência/fisiologia , Natação/classificação , Adulto Jovem
7.
Spine (Phila Pa 1976) ; 46(13): E743-E749, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34100842

RESUMO

STUDY DESIGN: Case report and literature review. OBJECTIVE: We present a case of a pathologic unstable fracture of the odontoid process due to vertebral osseous sarcoidosis. The surgical management of this unreported pathology is described and a review of the literature is given. SUMMARY OF BACKGROUND DATA: Sarcoidosis is a chronic inflammatory systemic disease of unknown etiology, characterized by multiorgan noncaseating granulomatous infiltrations. It affects primarily the lungs, lymphatic system, eyes, skin, heart, and nervous system. Osseous sarcoidosis is usually clinically asymptomatic and therefore frequently under-diagnosed. When it does affect the skull or vertebral column, specific surgical therapy is only necessary in cases with nonmanageable pain or where structural integrity is threatened. METHODS: Our patient underwent a so-called semiconservative approach, consisting of a minimally invasive transoral-transpharyngeal approach, surgical debridement of the lytic bony lesion, transplantation of cancellous homologous bone, and carbon chest halo-immobilization. Halo-immobilization was left for 8 weeks, followed by a further 6 weeks with a hard cervical collar. RESULTS: Routine computed tomography scans 3 days, 6, 12, 18 weeks, and 1 year after surgery showed good filling of the original defect with cancellous bone, correct alignment of the upper cervical spine, and progressive fracture consolidation and stability. Surgical site infection (SSI) was not observed. The patient had no neurological postoperative deficits. After initial dysphagia, swallowing was not permanently impaired. CONCLUSION: Sarcoidosis-induced odontoid fractures can be managed successfully using a semiconservative approach, consisting of transoral-transmucosal, minimally invasive surgical procedure for debridement of the lesion and transplantation of cancellous bone with additional halo-immobilization. Permanent fusion of C1-2 with loss of the cervical range of motion is avoided. Despite performing bone surgery in a potentially markedly contaminated site, bacterial infection was not an issue, possibly supported by the temporary discontinuation of immunosuppressive agents and the prudent use of antibiotics.Level of Evidence: 4.


Assuntos
Processo Odontoide , Sarcoidose , Fraturas da Coluna Vertebral , Humanos , Pescoço/diagnóstico por imagem , Processo Odontoide/diagnóstico por imagem , Processo Odontoide/lesões , Amplitude de Movimento Articular/fisiologia , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Sarcoidose/fisiopatologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/fisiopatologia , Fraturas da Coluna Vertebral/terapia , Tomografia Computadorizada por Raios X
8.
Medicine (Baltimore) ; 100(22): e26208, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087893

RESUMO

ABSTRACT: Sit-to-stand (STS) motion is one of the most important and energy-consuming basic motions in everyday life. Kinematic analysis provides information regarding what strategy or motion pattern is used by the healthy people, and through which, we can understand and obtain the law of the STS motion. The objective of this article is to study the law of STS motion through the experiment to determine a suitable description of STS motion in healthy adults, so as to provide a starting point and bases for future design and control of STS assistive devices.Thirty healthy adult subjects participated in this study and carried out STS motion experiment of standing up naturally. The STS motions were recorded using a high-definition camera. The experimentally collected kinematic data and a link segment model of the human body were used to obtain the coordinates of joints and to calculate the coordinates, velocity, and momentum of center of gravity; the postures of human body during STS are also obtained. The relationship between human body parameters and motion parameters is analyzed by using Pearson correlation method.The STS motion is divided into 4 phases; the phases are differentiated in terms of STS motion characteristics and postures, and momentum of center of gravity of human body. The main factors determining the differences in STS motion among individuals are horizontal distance between hip joint and ankle joint, lower leg length, thigh length, and the length of the transition period. The horizontal distance between hip joint and ankle joint is positively correlated with the duration from motion begin to trunk stops flexing forward (P = .021 < .05), but not so with the duration from motion begin to the end of phase 2 (P = .15 > .05).The results suggest that when designing the sit-to-stand assistive devices, one should pay attention to the whole-body posture control in STS motion, such as the posture guidance of trunk and lower leg, and should carry out specific training according to different STS phases. Sit-to-stand assistive devices should provide the same horizontal distance between hip joint and ankle joint for different individuals during the STS motion. Transition period should be properly controlled, and the degree of freedom of the lower leg should not be limited.


Assuntos
Fenômenos Biomecânicos/fisiologia , Movimento/fisiologia , Postura/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto , Algoritmos , Articulação do Tornozelo/fisiologia , Trajetória do Peso do Corpo , Discinesias/reabilitação , Articulação do Quadril/fisiologia , Corpo Humano , Humanos , Perna (Membro)/anatomia & histologia , Masculino , Equilíbrio Postural/fisiologia , Equipamentos de Autoajuda/efeitos adversos , Coxa da Perna/anatomia & histologia , Tronco/fisiologia
9.
Medicine (Baltimore) ; 100(22): e26247, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087913

RESUMO

RATIONALE: Open total dislocation of ankle joint is rare and often caused by high-energy injury. The present study describes a patient with open total lateral dislocation of ankle joint without fractures and obtained a satisfactory clinical result following early debridement and irrigation, one-stage repairment of ligaments, and plaster external fixation. PATIENT CONCERNS: The patient, a 45-year-old male, complained of right foot pain with bleeding and limited motion. Physical examination showed a 15-cm open wound at the medial ankle region, with soft tissues impaired and ankle bones exposed. The 3 dimensional reconstruction computed tomography (CT) examination showed an open total dislocation of ankle joint without concomitant fractures. DIAGNOSES: open total lateral dislocation of ankle joint without fractures. INTERVENTIONS: Early modern wound care including thorough debridement and irrigation on the wound was performed to remove contaminated soft tissues. Subsequently, the dislocated ankle joint was reduced by hand and the medial and lateral collateral ligaments were repaired using wire anchors. OUTCOMES: The medial wound healed at 2 weeks after surgery, and several common complications such as infection and skin necrosis did not occur. The last follow-up showed a good range of metatarsal flexion and extension of the injured foot, and obvious signs of traumatic arthritis were not observed. According to Kaikkonen ankle function score, the patient was assessed with 90 points. LESSONS: For open total dislocation of ankle joint, early treatment should focus on debridement and irrigation, reduction and fixation of the dislocated ankle, protection of the weak soft tissues, and stable external fixation to promote wound healing and reduce the incidence of related complications.


Assuntos
Articulação do Tornozelo/patologia , Desbridamento/métodos , Luxações Articulares/cirurgia , Irrigação Terapêutica/métodos , Assistência ao Convalescente , Articulação do Tornozelo/diagnóstico por imagem , Humanos , Imageamento Tridimensional/instrumentação , Luxações Articulares/diagnóstico , Ligamentos Laterais do Tornozelo/lesões , Ligamentos Laterais do Tornozelo/cirurgia , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Lesões dos Tecidos Moles/patologia , Lesões dos Tecidos Moles/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ferimentos e Lesões/patologia , Ferimentos e Lesões/cirurgia
10.
Med Sci Monit ; 27: e928982, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34006820

RESUMO

BACKGROUND Early failure of osteosyntheses is common even with use of locking plates. In patients with comminuted fractures and epiphyseal osseous defects, we performed a series of osteosyntheses by locking plate in combination with an allograft bone augmentation. Because of encouraging short-term results in the literature, we assumed that the method could be a potential alternative to a reverse shoulder prosthesis. MATERIAL AND METHODS Twenty-six patients with a dislocated proximal humeral fracture (Neer IV/V/VI) were studied. A lyophilized allogeneic bone graft was used to reinforce the humeral head fragments before locking plate osteosynthesis. The outcomes of fractures were assessed with Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley (Constant) scores, range of motion, a visual analog scale, and with radiological testing. The Constant-Murley scores were the endpoint of our study. RESULTS The Neer classification of the fractures was type IV in 4 patients, type V in 20 patients, and type VI in 2 patients. The mean DASH score was 52.85 (range, 4.17-79.3) and the mean Constant score was 39.26 (range, 17-88). We observed late necrosis of the humeral head in 15 of 24 patients (62.5%), although early radiological follow-up showed that the humeral head had been anatomically reconstructed. CONCLUSIONS Long-term follow-up demonstrated inferior functional results, as displayed by poor Constant scores. There was a high incidence of necrosis, in spite of initial anatomical reconstruction. Biointegration of the allogeneic bone graft and revascularization of the humeral head fragments could be impaired in geriatric patients who have gross dislocation. Therefore, augmentation of the humeral head with allogeneic bone grafts cannot be recommended in these patients.


Assuntos
Aloenxertos/cirurgia , Cabeça do Úmero/cirurgia , Fraturas do Ombro/cirurgia , Idoso , Idoso de 80 Anos ou mais , Placas Ósseas , Transplante Ósseo/métodos , Feminino , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia/métodos , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento
11.
Orthop Nurs ; 40(3): 169-179, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34004616

RESUMO

Osteoporosis is a public health problem affecting individuals globally. Yoga has been found to prevent and reverse bone loss. Yoga may result in better balance, improved posture, and greater range of motion, strength, and coordination, all factors that also mitigate the risk of falls and fractures. A 12-minute, 12-pose yoga regimen is discussed in detail. Once learned, the ongoing use of yoga is safe, without cost, and may be done lifelong.


Assuntos
Densidade Óssea/fisiologia , Osteoporose/terapia , Postura/fisiologia , Ioga/psicologia , Acidentes por Quedas/prevenção & controle , Humanos , Amplitude de Movimento Articular/fisiologia
12.
Chiropr Man Therap ; 29(1): 18, 2021 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034773

RESUMO

BACKGROUND: In clinical diagnosis, the maximum motion of a cervical joint is thought to be found at the joint's end-range and it is this perception that forms the basis for the interpretation of flexion/extension imaging studies. There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified. PURPOSE: To provide a quantitative assessment of the difference between maximum joint motion and joint end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types. STUDY DESIGN: This is an observational study. SUBJECT SAMPLE: Thirty-three healthy subjects participated in the study. OUTCOME MEASURES: Maximum motion, end-range motion and surplus motion (the difference between maximum motion and end-range) in degrees were extracted from each cervical joint. METHODS: Thirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10% epochs, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range. RESULTS: For flexion 48.9% and for extension 47.2% of joints produced maximum motion before joint end-range (type S). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at joint end-range (type C). For flexion 5.2% of joints and for extension 6.1% of joints concluded their motion anti-directionally (type A). Significant differences were found for C2/C3 (P = 0.000), C3/C4 (P = 0.001) and C4/C5 (P = 0.005) in flexion and C1/C2 (P = 0.004), C3/C4 (P = 0.013) and C6/C7 (P = 0.013) in extension when comparing the joint end- range of type C and type S. The average pro-directional (motion in the direction of neck motion) surplus motion was 2.41° ± 2.12° with a range of (0.07° -14.23°) for flexion and 2.02° ± 1.70° with a range of (0.04°-6.97°) for extension. CONCLUSION: This is the first study to categorise joints by type of motion. It cannot be assumed that end-range is a demonstration of a joint's maximum motion, as type S constituted approximately half of the joints analysed in this study.


Assuntos
Vértebras Cervicais/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
13.
Orthopedics ; 44(3): e326-e330, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34039192

RESUMO

Rotator cuff tears as a consequence of shoulder instability, which are uncommon among patients younger than 40 years, have been found to be more prevalent in active duty service members in this age group. As a result, this population provides a unique opportunity to study concurrent arthroscopic treatment of rotator cuff and inferior labrum tears in young, active patients, a topic that has not been studied extensively. The goal of this study was to report clinical outcomes of rotator cuff and inferior labral tears managed concurrently with all-arthroscopic repair for military patients younger than 40 years. Data were collected prospectively from 30 arthroscopic rotator cuff repair procedures with concurrent inferior labral repair performed on 29 individual military patients younger than 40 years (mean, 33.5 years; range, 21-39 years) and retrospectively analyzed. Preand postoperative evaluations conducted during a minimum 2-year follow-up period (mean, 35 months; range, 24-68 months) included visual analog scale (VAS) score, Subjective Shoulder Value (SSV), American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion. Mean VAS score improved from 7.63±1.85 to 1.00±1.44 (P<.0001). Mean SSV improved from 54.83±17.10 to 90.83±9.75 (P<.0001). Mean ASES shoulder score improved from 45.37±12.99 to 90.43±10.67 (P<.0001). No significant improvement was found in range of motion; however, improved mean measurements were consistently noted in all directions. Complications (10%; 3 of 30) included 1 re-tear of the rotator cuff repair and 2 postoperative frozen shoulders. Arthroscopic repair of rotator cuff tears with concurrent repair of inferior labral tear in active patients younger than 40 years produced excellent patient outcomes, with high rates of return to preoperative level of recreational and military job activity and low risk of complications. [Orthopedics. 2021;44(3):e326-e330.].


Assuntos
Artroscopia/métodos , Instabilidade Articular/cirurgia , Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Articulação do Ombro/cirurgia , Adulto , Feminino , Humanos , Instabilidade Articular/complicações , Masculino , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Lesões do Manguito Rotador/etiologia , Resultado do Tratamento , Adulto Jovem
14.
J Sport Health Sci ; 10(3): 379-386, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34024352

RESUMO

PURPOSE: This study was aimed to analyze the associations of objectively measured physical activity (PA), sedentary time, and physical fitness with mental health in the early second trimester (16 ± 2 gestational weeks) of pregnancy. METHODS: From 229 women initially contacted, 124 pregnant women participated in the present cross-sectional study. Data were collected between November 2015 and March 2017. The participants wore Actigraph GT3X+ Triaxial accelerometers for 9 consecutive days to objectively measure their PA levels and sedentary time. A performance-based test battery was used to measure physical fitness. Self-report questionnaires assessed psychological ill-being (i.e., negative affect, anxiety, and depression), and psychological well-being (i.e., emotional intelligence, resilience, and positive affect). Linear regression analyses were adjusted for age, educational level, accelerometer wear time, miscarriages, and low back pain. RESULTS: Moderate-to-vigorous PA was negatively associated with depression (ß = -0.222, adjusted R2 = 0.050, p = 0.041). Higher levels of sedentary time were negatively associated with positive affect (ß = -0.260, adjusted R2 = 0.085, p = 0.017). Greater upper-body flexibility was positively associated with better emotional regulation (ß = 0.195, adjusted R2= 0.030, p = 0.047). The remaining associations were not significant (all p > 0.05). CONCLUSION: An active lifestyle characterized by higher levels of moderate-to-vigorous PA and lower levels of sedentary time during pregnancy might modestly improve the mental health of pregnant women. Although previous research has focused on the benefits of cardiorespiratory exercise, the present study shows that only upper-body flexibility is related to emotional regulation in early pregnant women. If the present findings are corroborated in further experimental research, physical exercise programs should focus on enhancing flexibility to promote improvements in emotional regulation during early second-trimester of pregnancy.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Exercício Físico/fisiologia , Saúde Mental , Segundo Trimestre da Gravidez/fisiologia , Comportamento Sedentário , Actigrafia , Adulto , Ansiedade/diagnóstico , Aptidão Cardiorrespiratória/psicologia , Estudos Transversais , Depressão/diagnóstico , Inteligência Emocional , Regulação Emocional , Exercício Físico/psicologia , Feminino , Humanos , Modelos Lineares , Negativismo , Otimismo , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Segundo Trimestre da Gravidez/psicologia , Amplitude de Movimento Articular/fisiologia , Resiliência Psicológica , Autorrelato
15.
Nat Commun ; 12(1): 2692, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33976216

RESUMO

Rapid developments of robotics and virtual reality technology are raising the requirements of more advanced human-machine interfaces for achieving efficient parallel control. Exoskeleton as an assistive wearable device, usually requires a huge cost and complex data processing to track the multi-dimensional human motions. Alternatively, we propose a triboelectric bi-directional sensor as a universal and cost-effective solution to a customized exoskeleton for monitoring all of the movable joints of the human upper limbs with low power consumption. The corresponding movements, including two DOF rotations of the shoulder, twisting of the wrist, and the bending motions, are detected and utilized for controlling the virtual character and the robotic arm in real-time. Owing to the structural consistency between the exoskeleton and the human body, further kinetic analysis offers additional physical parameters without introducing other types of sensors. This exoskeleton sensory system shows a great potential of being an economic and advanced human-machine interface for supporting the manipulation in both real and virtual worlds, including robotic automation, healthcare, and training applications.


Assuntos
Desenho de Equipamento/instrumentação , Exoesqueleto Energizado , Aparelhos Ortopédicos , Amplitude de Movimento Articular/fisiologia , Robótica/instrumentação , Extremidade Superior/fisiologia , Simulação por Computador , Desenho de Equipamento/economia , Desenho de Equipamento/métodos , Humanos , Articulações/fisiologia , Movimento/fisiologia , Robótica/economia , Robótica/métodos
16.
Nat Commun ; 12(1): 2950, 2021 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-34011979

RESUMO

Human motions, such as joint/spinal bending or stretching, often contain information that is useful for orthopedic/neural disease diagnosis, rehabilitation, and prevention. Here, we show a badge-reel-like stretch sensing device with a grating-structured triboelectric nanogenerator exhibiting a stretching sensitivity of 8 V mm-1, a minimum resolution of 0.6 mm, a low hysteresis, and a high durability (over 120 thousand cycles). Experimental and theoretical investigations are performed to define the key features of the device. Studies from human natural daily activities and exercise demonstrate the functionality of the sensor for real-time recording of knee/arm bending, neck/waist twisting, and so on. We also used the device in a spinal laboratory, monitoring human subjects' spine motions, and validated the measurements using the commercial inclinometer and hunchback instrument. We anticipate that the lightweight, precise and durable stretch sensor applied to spinal monitoring could help mitigate the risk of long-term abnormal postural habits induced diseases.


Assuntos
Articulações/fisiologia , Amplitude de Movimento Articular/fisiologia , Coluna Vertebral/fisiologia , Dispositivos Eletrônicos Vestíveis , Sistemas Computacionais , Desenho de Equipamento , Humanos , Cifose/diagnóstico , Cifose/fisiopatologia , Sistemas Microeletromecânicos/instrumentação , Monitorização Fisiológica/instrumentação , Movimento/fisiologia , Postura/fisiologia
17.
Medicine (Baltimore) ; 100(18): e25671, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950946

RESUMO

BACKGROUND: The incidence of knee osteoarthritis is increasing year by year, which seriously affects people's quality of life, especially the elderly, and has become a major public health problem. A lot of evidence shows that physical therapy has advantages in the treatment of knee joints, but there are a number of physical therapy schemes, and the efficacy of each scheme is different. This study will evaluate the clinical efficacy of different physical therapy regimens in the treatment of knee osteoarthritis (KOA) by means of network meta-analysis. METHODS: According to the search strategy, we will retrieve the randomized controlled studies of non-invasive physical therapy in the treatment of knee osteoarthritis from CNKI, Wanfang, VIP, China Biomedical medicine, PubMed, Embase, Web of Science, and The Cochrane Library databases. The retrieval time was from the establishment of the database to March 2021. We will assess the quality of the studies using the Cochrane Risk Bias Assessment Tool and assess the strength of the evidence using the GRADE methodology. All data analyses will be performed by RevMan5.3, GEMTC 0.14.3, and Stata 14.0. RESULTS: This study will evaluate the efficacy of different physical therapy in the treatment of knee osteoarthritis by evaluating the total response rate, pain relief degree, joint function score, quality of life score, adverse reactions, etc. CONCLUSIONS: This study will provide a reliable evidence-based basis for the selection of better physical therapy for the treatment of knee osteoarthritis. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/VX98B.


Assuntos
Artralgia/terapia , Osteoartrite do Joelho/terapia , Modalidades de Fisioterapia , Amplitude de Movimento Articular/fisiologia , Artralgia/diagnóstico , Artralgia/etiologia , Humanos , Articulação do Joelho/fisiopatologia , Metanálise em Rede , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Medição da Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Resultado do Tratamento
18.
J Neuroeng Rehabil ; 18(1): 84, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-34020668

RESUMO

BACKGROUND: Neuromuscular disorders (NMD) commonly affect the upper extremity. Due to muscle weakness, performance of daily activities becomes increasingly difficult, which leads to reduced independence and quality of life. In order to support the performance of upper extremity tasks, dynamic arm supports may be used. The Yumen Arm is a novel dynamic arm support specially developed for people with NMD. The aim of this study is to evaluate the feasibility and effectiveness of the Yumen Arm in persons with Duchenne Muscular Dystrophy (DMD) and persons with Spinal Muscular Atrophy (SMA). METHODS: Three persons with DMD and three persons with SMA participated in this study. All participants conducted a set of measures with and without the Yumen Arm. Outcome measures were: active range of motion of the arm and trunk (i.e. Reachable Workspace, Functional Workspace, and trunk movement), fatigue (OMNI-RPE), Performance of Upper Limb (PUL) scale and some additional activities of daily living. User experiences were collected using a questionnaire. RESULTS: The Yumen Arm could be used by all participants. Results showed a median increase in active range of motion (4% relative surface area), and a median increase of function ability (> 11% PUL score) when using the Yumen Arm. In addition, three out of four (data from 2 participants was missing) participants indicated that activity performance was less fatiguing when using the Yumen Arm. Four out of five (data from 1 participant was missing) participants indicated that they would like to use the Yumen Arm in their daily lives. CONCLUSION: This study is one of the first studies describing a range of objective measures to examine the effectiveness of a dynamic arm support. Based on these measurements we can conclude that the Yumen Arm effectively improves arm function in NMD patients, however the effectiveness varies a lot between individual subjects. We provided detailed recommendations for the improvement of the Yumen Arm, and possible also for the development of other dynamic arm supports. This study showed a lot of variability between individual subjects, which emphasizes the importance of tuning dynamic arm supports based on individual user characteristics, such as scoliosis, functional capacity and muscle strength.


Assuntos
Exoesqueleto Energizado , Atrofia Muscular Espinal/reabilitação , Distrofia Muscular de Duchenne/reabilitação , Atividades Cotidianas , Adolescente , Adulto , Braço/fisiopatologia , Criança , Estudos de Viabilidade , Feminino , Humanos , Masculino , Atrofia Muscular Espinal/fisiopatologia , Distrofia Muscular de Duchenne/fisiopatologia , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
19.
J Manipulative Physiol Ther ; 44(3): 244-254, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33879352

RESUMO

OBJECTIVE: The objective of this study was to compare the hypoalgesic effects of isolated or combined use of transcutaneous electrical nerve stimulation (TENS) and cervical joint manipulation (JM) in asymptomatic participants. METHODS: One hundred and forty-four healthy participants aged 18 to 30 years old were randomly assigned to 1 of 4 groups (n = 36 per group): active TENS + active JM, active TENS + placebo JM, placebo TENS + active JM, and placebo TENS + placebo JM. Active or placebo TENS was applied to the dominant forearm. JM was applied to the C6-7 segments. The pressure pain threshold was measured pre- and postintervention and after 20 minutes on the forearm and tibialis anterior of the dominant side. RESULTS: Segmental hypoalgesia was greater in the group active TENS + active JM compared with active TENS + placebo JM (P = .002), placebo TENS + active JM (P < .0001), and placebo TENS + placebo JM (P < .0001). For the extrasegmental hypoalgesia, active TENS + active JM had greater hypoalgesic effect compared with active TENS + placebo JM (P = .033), placebo TENS + active JM (P = .002), and placebo TENS + placebo JM (P < .0001). CONCLUSION: TENS and JM produced hypoalgesia when used alone and, when the treatments were combined, a higher segmental and extrasegmental hypoalgesic effect was obtained in asymptomatic participants.


Assuntos
Vértebras Cervicais/fisiologia , Manipulação da Coluna/métodos , Amplitude de Movimento Articular/fisiologia , Estimulação Elétrica Nervosa Transcutânea/métodos , Adolescente , Adulto , Terapia Combinada , Humanos , Masculino , Manejo da Dor , Medição da Dor/métodos , Limiar da Dor/fisiologia , Adulto Jovem
20.
J Manipulative Physiol Ther ; 44(3): 236-243, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33926742

RESUMO

OBJECTIVE: This study aimed to determine the intra- and interrater reliability of active and passive range of motion in the shoulders of individuals with subacromial impingement syndrome using a digital inclinometer. METHODS: The raters evaluated active and passive range of motion in the shoulder of 50 individuals with unilateral subacromial impingement syndrome in movements including flexion, abduction, extension, external rotation in a neutral position, external rotation with the arm at 90° of abduction, and internal rotation with the arm at 90° of abduction. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and were repeated by 1 examiner after a 2- to 4-day interval. Reliability was analyzed using the intraclass correlation coefficient (ICC2,3). RESULTS: There was moderate to excellent interrater (ICC2,3 = 0.50-0.95) and intrarater (ICC2,3 = 0.74-0.94) reliability. In the interrater analysis, the standard error of measurement (SEM) ranged from 4.1° to 10°, the percentage SEM (%SEM) ranged from 2% to 17%, and the minimum detectable change ranged from 9.5° to 23.4°. In the intrarater analysis, the SEM ranged from 4° to 9.2°, %SEM ranged from 3% to 14%, and the minimum detectable change ranged from 9.3° to 21.4°. CONCLUSION: The digital inclinometer showed moderate to excellent reliability for measuring active and passive range of motion in shoulders with unilateral subacromial impingement syndrome.


Assuntos
Artrometria Articular/normas , Amplitude de Movimento Articular/fisiologia , Síndrome de Colisão do Ombro/fisiopatologia , Articulação do Ombro/fisiologia , Adulto , Artrometria Articular/instrumentação , Humanos , Masculino , Movimento , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Rotação
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