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1.
Sci Rep ; 14(1): 12994, 2024 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844574

RESUMO

Women frequently express heightened neck discomfort even though they exhibit smaller neck flexion (NF) during smartphone use. Differences in natural posture while using smartphones may result in varying muscle activation patterns between genders. However, no study focused on this issue. This study investigated the influence of gender on neck muscle activity and NF when using smartphones, ranging from slight (20°) to nearly maximal forward head flexion, across different postures. We analyzed smartphone usage patterns in 16 men and 16 women and examined these behaviors across different scenarios: standing, supported sitting, and unsupported sitting, at 20°, 30°, 40°, and the maximum head angles. During data collection, muscle activity was measured, expressed as a percentage of the maximum voluntary contraction (%MVC), in the cervical erector spinae (CES) and upper trapezius (UTZ), along with NF. Results show significant influences of gender, head angle, and posture on all measures, with notable interactions among these variables. Women displayed higher muscle activities in CES and UTZ, yet exhibited lesser NF, while using smartphones in both standing (12.3%MVC, 10.7% MVC, and 69.0°, respectively) and unsupported sitting (10.8%MVC, 12.3%MVC, and 71.8°, respectively) compared to men (standing: 9.5%MVC, 8.8%MVC, and 76.1°; unsupported sitting: 9.7%MVC, 10.8%MVC, and 76.1°). This study provides a potential rationale for gender-related disparities in injury outcomes, emphasizing that women experience higher neck and shoulder discomfort level, despite their smaller NF during smartphone use, as found in previous research. Additionally, the cervical flexion-relaxation phenomenon may occur when the head angle exceeded 40°. The near-maximum head angle during smartphone use might induce the cervical flexion-relaxation phenomenon, potentially aggravating neck issues. We recommend limiting smartphone usage postures that exceed the near-maximum head angle, as they are commonly adopted by individuals in the daily smartphone activities.


Assuntos
Cabeça , Músculos do Pescoço , Postura , Smartphone , Humanos , Feminino , Masculino , Músculos do Pescoço/fisiologia , Postura/fisiologia , Adulto , Cabeça/fisiologia , Adulto Jovem , Pescoço/fisiologia , Fatores Sexuais , Eletromiografia , Caracteres Sexuais , Cervicalgia/fisiopatologia , Contração Muscular/fisiologia , Amplitude de Movimento Articular/fisiologia
2.
BMC Musculoskelet Disord ; 25(1): 448, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844912

RESUMO

INTRODUCTION: Fractures of the scaphoid are the most common carpal injuries, account for 80-90% of all carpal fractures. 5-15% nonunion of scaphoid fractures were reported even with adequate primary treatment, which probably progresses to osteoarthritic changes several decades later. Researches regarding to scaphoid physiological characteristic in vitro and in vivo and kinds of trials in clinical practice are being kept on going, which contribute much to our clinical practice. With the advancing wrist arthroscopy, 3D-print patient-specific drill guide, and intraoperative fluoroscopic guidance, dorsal approach (mini-invasive and percutaneous technique) is being popular, through which we can implant the screw in good coincidence with biomechanics and with less disturbing tenuous blood supply of the scaphoid. Investigating the noncontact area of the dorsal proximal scaphoid in different wrist positions can facilitate preoperatively estimating insert point of the screw. MATERIALS AND METHODS: Eight volunteers were recruited to accept CT scans in six extreme wrist positions. The images of DICOM mode were imput into the Mimics analytical system, the segmented scaphoid, lunate and radius were exported in mode of ASCII STL and were opened in the software of Geomagic studio. We created four planes based on anatomic markers on the surface of the radius and scaphoid to confine the proximal scaphoid to form the so-called non-contact regions. We measured and compared the areas in six targeted positions. RESULTS: Amidst six extreme wrist positions, area of the non-contact region in extreme dorsal extension (59.81 ± 26.46 mm2) was significantly the smallest, and it in extreme palmar flexion significantly was largest (170.51 ± 30.44 mm2). The non-contact regions increased in order of dorsal extension, supination, ulnar deviation, radial deviation, pronation and palmar flexion. As for two-group comparison, the non-contact region showed significantly larger (p < 0.05) in palmar flexion than the others except for in pronation individually, and in radial deviation (p < 0.05) than in dorsal extension. CONCLUSIONS: Sufficient space was available for the screw started from the dorsal approach despite the wrist positions.


Assuntos
Osso Escafoide , Articulação do Punho , Humanos , Osso Escafoide/cirurgia , Osso Escafoide/lesões , Osso Escafoide/diagnóstico por imagem , Masculino , Adulto , Articulação do Punho/cirurgia , Articulação do Punho/diagnóstico por imagem , Feminino , Tomografia Computadorizada por Raios X , Parafusos Ósseos , Adulto Jovem , Amplitude de Movimento Articular , Pronação/fisiologia , Fenômenos Biomecânicos
3.
BMC Musculoskelet Disord ; 25(1): 439, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835042

RESUMO

BACKGROUND: The use of reverse total shoulder arthroplasty (RTSA) has increased at a greater rate than other shoulder procedures. In general, clinical and functional outcomes after RTSA have been favorable regardless of indication. However, little evidence exists regarding patient specific factors associated with clinical improvement after RTSA. Predicting postoperative outcomes after RTSA may support patients and physicians to establish more accurate patient expectations and contribute in treatment decisions. The aim of this study was to determine predictive factors for postoperative outcomes after RTSA for patients with degenerative shoulder disorders. METHODS: EMBASE, PubMed, Cochrane Library and PEDro were searched to identify cohort studies reporting on predictive factors for postoperative outcomes after RTSA. Authors independently screened publications on eligibility. Risk of bias for each publication was assessed using the QUIPS tool. A qualitative description of the results was given. The GRADE framework was used to establish the quality of evidence. RESULTS: A total of 1986 references were found of which 11 relevant articles were included in the analysis. Risk of bias was assessed as low (N = 7, 63.6%) or moderate (N = 4, 36.4%). According to the evidence synthesis there was moderate-quality evidence indicating that greater height predicts better postoperative shoulder function, and greater preoperative range of motion (ROM) predicts increased postoperative ROM following. CONCLUSION: Preoperative predictive factors that may predict postoperative outcomes are: patient height and preoperative range of motion. These factors should be considered in the preoperative decision making for a RTSA, and can potentially be used to aid in preoperative decision making. LEVEL OF EVIDENCE: Level I; Systematic review.


Assuntos
Artroplastia do Ombro , Amplitude de Movimento Articular , Articulação do Ombro , Humanos , Artroplastia do Ombro/efeitos adversos , Resultado do Tratamento , Articulação do Ombro/cirurgia , Articulação do Ombro/fisiopatologia
4.
PeerJ ; 12: e17403, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827299

RESUMO

Background: Effective rehabilitation of upper limb musculoskeletal disorders requires multimodal assessment to guide clinicians' decision-making. Furthermore, a comprehensive assessment must include reliable tests. Nevertheless, the interrelationship among various upper limb tests remains unclear. This study aimed to evaluate the reliability of easily applicable upper extremity assessments, including absolute values and asymmetries of muscle mechanical properties, pressure pain threshold, active range of motion, maximal isometric strength, and manual dexterity. A secondary aim was to explore correlations between different assessment procedures to determine their interrelationship. Methods: Thirty healthy subjects participated in two experimental sessions with 1 week between sessions. Measurements involved using a digital myotonometer, algometer, inclinometer, dynamometer, and the Nine-Hole Peg test. Intraclass correlation coefficients, standard error of the mean, and minimum detectable change were calculated as reliability indicators. Pearson's correlation was used to assess the interrelationship between tests. Results: For the absolute values of the dominant and nondominant sides, reliability was 'good' to 'excellent' for muscle mechanical properties, pressure pain thresholds, active range of motion, maximal isometric strength, and manual dexterity. Similarly, the reliability for asymmetries ranged from 'moderate' to 'excellent' across the same parameters. Faster performance in the second session was consistently found for the Nine-Hole Peg test. No systematic inter-session errors were identified for the values of the asymmetries. No significant correlations were found between tests, indicating test independence. Conclusion: These findings indicate that the sensorimotor battery of tests is reliable, while monitoring asymmetry changes may offer a more conservative approach to effectively tracking recovery of upper extremity injuries.


Assuntos
Antebraço , Mãos , Amplitude de Movimento Articular , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Adulto , Amplitude de Movimento Articular/fisiologia , Mãos/fisiologia , Antebraço/fisiologia , Adulto Jovem , Voluntários Saudáveis , Músculo Esquelético/fisiologia , Limiar da Dor/fisiologia
5.
Clin Orthop Surg ; 16(3): 493-505, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38827752

RESUMO

Background: Distal metaphyseal-diaphyseal junction fractures of the humerus are a subset of injuries between humeral shaft fractures and distal intra-articular humerus fractures. A lack of space for distal fixation and the unique anatomy of concave curvature create difficulties during operative treatment. The closely lying radial nerve is another major concern. The aim of this study was to determine whether anterolateral dual plate fixation could be effective for a distal junctional fracture of the humerus both biomechanically and clinically. Methods: A right humerus 3-dimensional (3D) model was obtained based on plain radiographs and computed tomography data of patients. Two fractures, a spiral type and a spiral wedge type, were constructed. Three-dimensional models of locking compression plates and screws were constructed using materials provided by the manufacturer. The experiment was conducted by using COMSOL Multiphysics, a finite element analysis, solver, and simulation software package. For the clinical study, from July 2008 to March 2021, a total of 72 patients were included. Their medical records were retrospectively reviewed to obtain patient demographics, elbow range of motion, Disabilities of the Arm, Shoulder and Hand (DASH) scores, Mayo Elbow Performance Scores (MEPS), and hand grip strength. Results: No fracture fixation construct completely restored stiffness comparable to the intact model in torsion or compression. Combinations of the 7-hole and 5-hole plates and the 8-hole and 6-hole plates showed superior structural stiffness and stress than those with single lateral plates. At least 3 screws (6 cortices) should be inserted into the lateral plate to reduce the load effectively. For the anterior plate, it was sufficient to purchase only the near cortex. Regarding clinical results of the surgery, the range of motion showed satisfactory results in elbow flexion, elbow extension, and forearm rotation. The average DASH score was 4.3 and the average MEPS was 88.2. Conclusions: Anterolateral dual plate fixation was biomechanically superior to the single-plate method in the finite element analysis of a distal junctional fracture of the humerus model. Anterolateral dual plate fixation was also clinically effective in a large cohort of patients with distal junctional fractures of the humerus.


Assuntos
Placas Ósseas , Análise de Elementos Finitos , Fixação Interna de Fraturas , Fraturas do Úmero , Humanos , Fraturas do Úmero/cirurgia , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/instrumentação , Masculino , Pessoa de Meia-Idade , Feminino , Adulto , Estudos Retrospectivos , Fenômenos Biomecânicos , Idoso , Amplitude de Movimento Articular , Úmero/cirurgia
6.
Clin Orthop Surg ; 16(3): 413-421, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38827750

RESUMO

Background: Posterior femoral condylar osteophytes were frequently observed in patients with the ultra-congruent (UC) deep-dish design prosthesis. Therefore, the purpose of the present study was to verify the clinical relevance of osteophyte formation in the UC design. Methods: From March 2014 to February 2018, a comparative study was conducted on 96 knees using the UC design. They were divided into 2 groups (group 1: osteophyte +, group 2: osteophyte -). Intraoperative findings, indirect femoral rollback assessment using 30° flexion and active full flexion lateral radiographs, serial change of the osteophyte, and outcomes were compared. Results: The mean follow-up period was 49.35 ± 3.47 months in group 1 and 47.52 ± 3.37 months in group 2. Posterior component coverage was significantly different between the groups: group 1 exhibited more underhang and group 2 exhibited more overhang (p = 0.022). On the indirect assessment of the femoral rollback, there was a statistically significant difference in deep flexion and change in distance (p < 0.001 and p < 0.001, respectively). There was no statistical difference between the 2 groups in the American Knee Society knee and function score, and group 2 showed significant improvement in pain compared to group 1 in Western Ontario and McMaster University Arthritis Index pain score (p = 0.029). Conclusions: Posterior condylar osteophyte formation was related to posterior impingement. It was more frequently observed in the underhang of the femoral component and insufficient femoral rollback. In addition, it changed with time and caused negative effects, including a gradual decrease in flexion and more pain.


Assuntos
Artroplastia do Joelho , Osteófito , Humanos , Osteófito/diagnóstico por imagem , Feminino , Masculino , Idoso , Artroplastia do Joelho/métodos , Pessoa de Meia-Idade , Radiografia , Prótese do Joelho , Desenho de Prótese , Amplitude de Movimento Articular , Estudos Retrospectivos , Osteoartrite do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Relevância Clínica
7.
Clin Orthop Surg ; 16(3): 448-454, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38827751

RESUMO

Background: Altering wrist biomechanics, Kienbock's disease leads to progressive carpal collapse that results in early arthritis and degenerative changes. By shifting the loading axis toward the radioscaphoid joint, scaphocapitate arthrodesis (SCA) has been reported as a salvage procedure effective in treating symptomatic patients with advanced Kienbock's disease. In this study, we aimed to evaluate the clinical and radiological outcomes of arthroscopic SCA in symptomatic patients with advanced stages of Kienbock's disease. Methods: Between March 2010 and February 2021, we included 15 patients with symptomatic stage IIIA (n=2) and stage IIIB (n=13) Kienbock's disease who were followed up for a minimum of 24 months after arthroscopic SCA with or without lunate excision. The lunate was excised in 6 patients and retained in 9. Visual analog scale (VAS) pain score, grip strength, range of motion (ROM), active flexion-extension arc, and modified Mayo wrist score (MMWS) were measured preoperatively and at each follow-up examination after surgery. Operation-related complications and radiographic changes were also assessed. Results: There were 13 women and 2 men, with a mean age of 57.6 years (range, 21-74 years) at the time of undergoing arthroscopic SCA. Follow-up ranged from 24 to 116 months, with an average of 56.9 ± 32.3 months. Bony union was achieved in all patients. At preoperative examination, wrist ROM (67%) and grip strength (48%) significantly decreased, compared to the contralateral wrist. At the final follow-up, there were significant improvements in VAS, grip strength, and MMWS, whereas the active wrist ROM showed no significant change. Radioscaphoid angle recovered after surgery, while radiographic carpal collapse and ulnar translation of the carpus occurred. In subgroup analysis according to excision of the lunate, there were no significant differences in VAS, MMWS, grip strength, or total ROM. However, increased ulnar translation and decreased radial deviation were noted in the lunate excision group. Conclusions: Arthroscopic SCA achieved significant improvements in pain and wrist function in patients with advanced Kienbock's disease without any complications. Excision of the lunate when performing arthroscopic SCA seemed to induce progressive carpal ulnar translation, with no apparent clinical benefits over retaining it.


Assuntos
Artrodese , Artroscopia , Osteonecrose , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Artrodese/métodos , Adulto , Artroscopia/métodos , Osteonecrose/cirurgia , Osteonecrose/diagnóstico por imagem , Idoso , Adulto Jovem , Força da Mão , Amplitude de Movimento Articular , Osso Escafoide/cirurgia , Osso Escafoide/diagnóstico por imagem , Medição da Dor , Radiografia , Capitato/cirurgia , Capitato/diagnóstico por imagem , Estudos Retrospectivos , Articulação do Punho/cirurgia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/fisiopatologia
8.
Clin Orthop Surg ; 16(3): 455-460, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38827760

RESUMO

Background: Total ankle arthroplasty (TAA) enhances patients' subjective outcomes with respect to pain and function. The aim of this study was to analyze the biomechanical changes of the affected limb following TAA using gait analysis with a 3-dimensional multi-segment foot model (3D MFM). Methods: We reviewed medical records, simple radiographs, and gait analyses using a 3D MFM of patients who underwent TAA for severe varus ankle arthritis. Preoperative and postoperative gait data of 24 patients were compared. Postoperative gait analyses were done at least 1 year after surgery. Results: TAA significantly increased stride length (p = 0.024). The total range of motion of all planes in the hindfoot and forefoot showed no significant changes between preoperative and postoperative states. Hindfoot was significantly plantarflexed and pronated after TAA, while forefoot was significantly supinated in all phases. After appropriate calculations, the genuine coronal motion of the hindfoot showed no changes after TAA in all phases. Conclusions: TAA did not result in biomechanical improvements of segmental motions in the forefoot and hindfoot, except for changes to the bony structures. Therefore, it is important to point out to patients that TAA will not result in significant improvement of ankle function and range of motion. Clinicians can consider this information during preoperative counseling.


Assuntos
Artroplastia de Substituição do Tornozelo , Amplitude de Movimento Articular , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Articulação do Tornozelo/cirurgia , Articulação do Tornozelo/fisiopatologia , Articulação do Tornozelo/diagnóstico por imagem , Fenômenos Biomecânicos , Análise da Marcha , Imageamento Tridimensional , Estudos Retrospectivos , Marcha/fisiologia , Idoso de 80 Anos ou mais
9.
J Orthop Surg Res ; 19(1): 327, 2024 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-38825673

RESUMO

BACKGROUND: Ankle fractures are frequent, and despite numerous publications on their treatment and outcome, there is a lack of precise data on the functional results in young, healthy and physically active patients. We hypothesized that patients who underwent open reduction and internal fixation (ORIF) for simple ankle fractures would have similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes. METHODS: A set of specific provocation tests was developed to evaluate the postoperative possibility of weight bearing, stop-and-go activities and range of motion. In combination with three questionnaires and a radiographic evaluation, the true functional outcome and the possibility of participating in sporting activities were investigated and compared with those of an age- and sex-matched control group. RESULTS: A significant impairment was found in unilateral and simple ankle fractures. This impairment increased in tests including stop-and-go activities in combination with load bearing and with the complexity of the fractures. Concerning the subjective outcome, there was a significant adverse effect for daily activities without any difference in preoperative or postoperative sporting activity between the groups. No difference was found in the radiological assessment. CONCLUSIONS: Both simple and complex ankle fractures treated with ORIF have a significant and long-lasting impact on functional outcome in young and active patients. The radiological result is not associated with a good functional outcome. TRIAL REGISTRATION: BASEC-Nr. 2018 - 01124.


Assuntos
Fraturas do Tornozelo , Fixação Interna de Fraturas , Humanos , Feminino , Fraturas do Tornozelo/cirurgia , Fraturas do Tornozelo/diagnóstico por imagem , Masculino , Fixação Interna de Fraturas/métodos , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento , Radiografia , Suporte de Carga , Adulto Jovem , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Idoso
10.
Clin Orthop Surg ; 16(3): 430-440, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38827763

RESUMO

Background: Computer-assisted navigation surgery (CAS) during primary total knee arthroplasty (TKA) may help improve outcomes for patients with extra-articular deformity (EAD); however, this has not been extensively studied. Therefore, we aimed to investigate the clinical and radiological outcomes following primary TKA using CAS in patients with EAD. Methods: We searched Medline, Embase, and the Cochrane Library up to March 3, 2023 for studies investigating surgical outcomes of using the navigation system for TKA to treat patients with EAD. From 14 studies, 539 knees with EAD that underwent navigation TKA were enrolled. We investigated the knee range of motion (ROM), outcome scores at final follow-up (Knee Society Score [KSS] and Knee Functional Score [KFS]), and pre- and postoperative mechanical hip-knee-ankle (mHKA) angle using lower extremity scanogram. The meta-analysis was based on the single-arm method, and all data were pooled using a random-effects model. Results: Following our meta-analyses, the mean knee ROM changed from 87.0° (95% confidence interval [CI], 75.9°-98.1°) preoperatively to 109.4° (95% CI, 97.9°-120.8°) postoperatively. The adjusted KSS was 93.45 points (95% CI, 88.36-98.54 points), and the adjusted KFS was 91.57 points (95% CI, 86.80-96.33 points) in knees with EAD that underwent CAS-TKA. As a radiological outcome, the mHKA angle changed from 169.53° (95% CI, 166.90°-172.16°) preoperatively to 178.81° (95% CI, 178.31°-179.30°) postoperatively. Conclusions: CAS-TKA yielded positive clinical results and demonstrated a satisfactory alignment of the lower limb's mechanical axis. CAS-TKA showed promise for primary TKA procedures, demonstrating favorable clinical and radiological outcomes even in complex cases involving EAD.


Assuntos
Artroplastia do Joelho , Amplitude de Movimento Articular , Cirurgia Assistida por Computador , Humanos , Artroplastia do Joelho/métodos , Cirurgia Assistida por Computador/métodos , Articulação do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem
11.
PLoS One ; 19(6): e0304511, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38848409

RESUMO

Change of direction, stops, and pivots are among the most common non-contact movements associated with anterior cruciate ligament (ACL) injuries in soccer. By observing these dynamic movements, clinicians recognize abnormal kinematic patterns that contribute to ACL tears such as increased knee valgus or reduced knee flexion. Different motions and physical demands are observed across playing positions, which may result in varied lower limb kinematic patterns. In the present study, 28 college and sub-elite soccer players performed four dynamic motions (change of direction with and without ball, header, and instep kick) with the goal of examining the effect of on-field positioning, leg dominance, and gender in lower body kinematics. Motion capture software monitored joint angles in the knee, hip, and ankle. A three-way ANOVA showed significant differences in each category. Remarkably, centrally positioned players displayed significantly greater knee adduction (5° difference, p = 0.013), hip flexion (9° difference, p = 0.034), hip adduction (7° difference, p = 0.016), and dorsiflexion (12° difference, p = 0.022) when performing the instep kick in comparison to their laterally positioned counterparts. These findings suggest that central players tend to exhibit a greater range of motion when performing an instep kicking task compared to laterally positioned players. At a competitive level, this discrepancy could potentially lead to differences in lower limb muscle development among on-field positions. Accordingly, it is suggested to implement position-specific prevention programs to address these asymmetries in lower limb kinematics, which can help mitigate dangerous kinematic patterns and consequently reduce the risk of ACL injury in soccer players.


Assuntos
Extremidade Inferior , Futebol , Humanos , Futebol/fisiologia , Fenômenos Biomecânicos , Masculino , Feminino , Adulto Jovem , Extremidade Inferior/fisiologia , Adulto , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Articulação do Joelho/fisiologia , Adolescente , Atletas , Articulação do Tornozelo/fisiologia , Articulação do Quadril/fisiologia
12.
BMC Musculoskelet Disord ; 25(1): 453, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849773

RESUMO

BACKGROUND: Posttraumatic wrist osteoarthritis is an irreversible and often progressive condition. Many surgical treatments, used in (daily) practice, aim to relieve symptoms like pain and restore function. The aim of this systematic review is to assess the patient reported and functional outcomes of the most common surgical interventions in patients with posttraumatic wrist osteoarthritis. This overview can help clinicians select the best treatment and manage patient's expectations. METHODS: A literature search was performed in Pubmed, Embase and Cochrane for articles published between 1990 and November 2022 according to the PRISMA guidelines. The study protocol has been registered in the PROSPERO database (CRD42017080427). Studies that describe patient reported outcomes (pain and Disability of Arm, Shoulder and Hand (DASH) -score) and functional outcomes (range of motion (ROM) and grip strength) after surgical intervention with a minimal follow-up of 1 year were included. The identified surgical procedures included denervation, proximal row carpectomy, interpositional- and total arthroplasty, and midcarpal-, radiocarpal- and total arthrodesis. The pre-and postoperative outcomes were pooled and presented per salvage procedure. RESULTS: Data from 50 studies was included. Pain score improved after all surgeries except denervation. Flexion/extension decreased after radiocarpal arthrodesis, did not show significant changes after proximal row carpectomy, and improved for all other surgeries. DASH score improved after arthroplasty, proximal row carpectomy and midcarpal arthrodesis. Grip strength improved after interposition arthroplasty and partial arthrodesis. CONCLUSION: Evidence from this review did not support the indication for denervation in this particular patient population. In patients with SLAC/SNAC II, proximal row carpectomy might be favourable to a midcarpal arthrodesis solely based on better FE ROM of the radiocarpal joint after proximal row carpectomy. In terms of radiocarpal mobility, total wrist arthroplasty might be preferred to radiocarpal arthrodesis in patients with osteoarthritis after a distal radius fracture. More uniform measurements of outcomes would improve the understanding of the effect of surgical treatments of the posttraumatic osteoarthritic wrist.


Assuntos
Osteoartrite , Medidas de Resultados Relatados pelo Paciente , Amplitude de Movimento Articular , Terapia de Salvação , Articulação do Punho , Humanos , Osteoartrite/cirurgia , Articulação do Punho/cirurgia , Articulação do Punho/fisiopatologia , Terapia de Salvação/métodos , Artrodese/métodos , Força da Mão , Resultado do Tratamento , Traumatismos do Punho/cirurgia , Traumatismos do Punho/fisiopatologia , Recuperação de Função Fisiológica , Denervação/métodos
13.
J Orthop Surg Res ; 19(1): 336, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38849918

RESUMO

BACKGROUND: Arthroscopic tuberoplasty is an optional technique for managing irreparable rotator cuff tears. However, there is a lack of studies investigating the resistance force during shoulder abduction in cases of irreparable rotator cuff tears and tuberoplasty. HYPOTHESES: In shoulders with irreparable rotator cuff tears, impingement between the greater tuberosity (GT) and acromion increases the resistance force during dynamic shoulder abduction. Tuberoplasty is hypothesized to reduce this resistance force by mitigating impingement. STUDY DESIGN: Controlled laboratory study. METHODS: Eight cadaveric shoulders, with a mean age of 67.75 years (range, 63-72 years), were utilized. The testing sequence included intact rotator cuff condition, irreparable rotator cuff tears (IRCTs), burnishing tuberoplasty, and prosthesis tuberoplasty. Burnishing tuberoplasty refers to the process wherein osteophytes on the GT are removed using a bur, and the GT is subsequently trimmed to create a rounded surface that maintains continuity with the humeral head. Deltoid forces and actuator distances were recorded. The relationship between deltoid forces and actuator distance was graphically represented in an ascending curve. Data were collected at five points within each motion cycle, corresponding to actuator distances of 20 mm, 30 mm, 40 mm, 50 mm, and 60 mm. RESULTS: In the intact rotator cuff condition, resistance forces at the five points were 34.25 ± 7.73 N, 53.75 ± 7.44 N, 82.50 ± 14.88 N, 136.25 ± 30.21 N, and 203.75 ± 30.68 N. In the IRCT testing cycle, resistance forces were 46.13 ± 7.72 N, 63.75 ± 10.61 N, 101.25 ± 9.91 N, 152.5 ± 21.21 N, and 231.25 ± 40.16 N. Burnishing tuberoplasty resulted in resistance forces of 32.25 ± 3.54 N, 51.25 ± 3.54 N, 75.00 ± 10.69 N, 115.00 ± 10.69 N, and 183.75 ± 25.04 N. Prosthesis tuberoplasty showed resistance forces of 29.88 ± 1.55 N, 49.88 ± 1.36 N, 73.75 ± 7.44 N, 112.50 ± 7.07 N, and 182.50 ± 19.09 N. Both forms of tuberoplasty significantly reduced resistance force compared to IRCTs. Prosthesis tuberoplasty further decreased resistance force due to a smooth surface, although the difference was not significant compared to burnishing tuberoplasty. CONCLUSION: Tuberoplasty effectively reduces resistance force during dynamic shoulder abduction in irreparable rotator cuff tears. Prosthesis tuberoplasty does not offer a significant advantage over burnishing tuberoplasty in reducing resistance force. CLINICAL RELEVANCE: Tuberoplasty has the potential to decrease impingement, subsequently reducing resistance force during dynamic shoulder abduction, which may be beneficial in addressing conditions like pseudoparalysis.


Assuntos
Cadáver , Lesões do Manguito Rotador , Humanos , Lesões do Manguito Rotador/cirurgia , Lesões do Manguito Rotador/fisiopatologia , Pessoa de Meia-Idade , Idoso , Fenômenos Biomecânicos , Masculino , Feminino , Articulação do Ombro/cirurgia , Articulação do Ombro/fisiopatologia , Manguito Rotador/cirurgia , Manguito Rotador/fisiopatologia , Artroscopia/métodos , Amplitude de Movimento Articular , Síndrome de Colisão do Ombro/cirurgia , Síndrome de Colisão do Ombro/fisiopatologia
14.
Sci Rep ; 14(1): 13181, 2024 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-38849364

RESUMO

The biomechanical aspects of adjacent segment degeneration after Adult Idiopathic Scoliosis (AdIS) corrective surgery involving postoperative changes in motion and stress of adjacent segments have yet to be investigated. The objective of this study was to evaluate the biomechanical effects of corrective surgery on adjacent segments in adult idiopathic scoliosis by finite element analysis. Based on computed tomography data of the consecutive spine from T1-S1 of a 28-year-old male patient with adult idiopathic scoliosis, a three-dimensional finite element model was established to simulate the biomechanics. Two posterior long-segment fixation and fusion operations were designed: Strategy A, pedicle screws implanted in all segments of both sides, and Strategy B, alternate screws instrumentation on both sides. The range of motion (ROM), Maximum von Mises stress value of intervertebral disc (IVD), and Maximum von Mises stress of the facet joint (FJ) at the fixation adjacent segment were calculated and compared with data of the preoperative AdIS model. Corrective surgery decreased the IVD on the adjacent segments, increased the FJ on the adjacent segments, and decreased the ROM of the adjacent segments. A greater decrease of Maximum von Mises stress was observed on the distal adjacent segment compared with the proximal adjacent segment. The decrease of Maximum von Mises stress and increment of Maximum von Mises stress on adjacent FJ in strategy B was greater than that in strategy A. Under the six operation modes, the change of the Maximum von Mises stress on the adjacent IVD and FJ was significant. The decrease in ROM in the proximal adjacent segment was greater than that of the distal adjacent segment, and the decrease of ROM in strategy A was greater than that in strategy B. This study clarified the biomechanical characteristics of adjacent segments after AdIS corrective surgery, and further biomechanical analysis of two different posterior pedicle screw placement schemes by finite element method. Our study provides a theoretical basis for the pathogenesis, prevention, and treatment of adjacent segment degeneration after corrective surgery for AdIS.


Assuntos
Análise de Elementos Finitos , Amplitude de Movimento Articular , Escoliose , Fusão Vertebral , Humanos , Escoliose/cirurgia , Escoliose/fisiopatologia , Adulto , Masculino , Fenômenos Biomecânicos , Fusão Vertebral/métodos , Parafusos Pediculares , Tomografia Computadorizada por Raios X , Estresse Mecânico , Disco Intervertebral/cirurgia , Disco Intervertebral/fisiopatologia , Disco Intervertebral/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Vértebras Torácicas/fisiopatologia
15.
BMC Musculoskelet Disord ; 25(1): 456, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851687

RESUMO

BACKGROUND: Osteosynthesis using antegrade intramedullary nailing for humeral shaft fractures yields satisfactory bone union rates; however, it may adversely affect postoperative shoulder function. To date, factors affecting mid- or long-term shoulder functional outcomes following intramedullary nail fixation have not been clarified. In this study, we aimed to identify the risk factors for poor mid-term functional outcomes over 5 years postoperatively following antegrade intramedullary nail osteosynthesis for humeral shaft fractures. METHODS: We retrospectively identified 33 patients who underwent surgery using an antegrade intramedullary nail for acute traumatic humeral shaft fractures and were followed up for at least 5 years postoperatively. We divided the patients into clinical failure and no clinical failure groups using an age- and sex-adjusted Constant score of 55 at the final follow-up as the cutoff value. We compared preoperative, perioperative, and postoperative factors between the two groups. RESULTS: Five of the 33 patients had poor shoulder functional outcomes (adjusted Constant score < 55) at a mean follow-up of 7.5 years postoperatively. Proximal protrusion of the nail at the time of bone union (P = 0.004) and older age (P = 0.009) were significantly associated with clinical failure in the univariate analyses. Multivariate analysis showed that proximal protrusion of the nail (P = 0.031) was a risk factor for poor outcomes. CONCLUSIONS: The findings of this study provide new information on predictive factors affecting mid-term outcomes following osteosynthesis using antegrade nails. Our results demonstrated that proximal protrusion of the nail was significantly associated with poor mid-term functional shoulder outcomes. Therefore, particularly in older adults, it is essential to place the proximal end of the intramedullary nail below the level of the articular cartilage.


Assuntos
Pinos Ortopédicos , Fixação Intramedular de Fraturas , Fraturas do Úmero , Humanos , Estudos Retrospectivos , Feminino , Masculino , Fixação Intramedular de Fraturas/métodos , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/instrumentação , Fraturas do Úmero/cirurgia , Pessoa de Meia-Idade , Adulto , Seguimentos , Fatores de Risco , Idoso , Resultado do Tratamento , Amplitude de Movimento Articular , Articulação do Ombro/cirurgia , Articulação do Ombro/fisiopatologia , Consolidação da Fratura , Recuperação de Função Fisiológica , Adulto Jovem
16.
J Bodyw Mov Ther ; 39: 126-131, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876616

RESUMO

BACKGROUND AND OBJECTIVE: Cervical spondylosis is a chronic degenerative process of the cervical spine characterized by pain in neck, degenerative changes in intervertebral disc and osteophyte formation. Cervical spondylosis is translated as Waja' ur Raqaba, a type of joint pain. The present study was aimed to evaluate the effect of wet cupping in the pain management of cervical spondylosis. METHODS: This Open, randomized, controlled, clinical study was conducted on 44 patients. Subjects in the test group (n = 22) received a series of three-staged wet cupping treatment, performed on 0, 7th and 14th day. Subjects in the control group (n = 22) received 12 sittings of Transcutaneous Electrical Nerve Stimulation (TENS): 6 sittings per week for two weeks. The objective findings of treatment were assessed with the help of VAS, Neck Disability Index (NDI) and Cervical range of motion. RESULTS: Intra group comparison in test group from baseline to 21st day were found highly significant (p < 0.001) in terms of VAS, NDI, Flexion, Extension and Left rotation score. While in Right rotation, Left rotation and Left lateral flexion score were found moderately significant (p < 0.01). Statistically significant difference was observed between two groups at 21st day in VAS scale, NDI, and Cervical range of motion score (p < 0.001). INTERPRETATION AND CONCLUSION: Hijama Bish Shart was found better in the management of pain due to cervical spondylosis than TENS. It can be concluded that Hijama Bish Shart may a better option for the pain management of cervical spondylosis. CLINICAL TRIAL REGISTRATION: The trial was registered on clinical trial registry website (www.ctri.nic.in) bearing a CTRI Number, CTRI/2020/03/024,249.


Assuntos
Ventosaterapia , Cervicalgia , Amplitude de Movimento Articular , Espondilose , Humanos , Espondilose/complicações , Espondilose/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Cervicalgia/terapia , Amplitude de Movimento Articular/fisiologia , Ventosaterapia/métodos , Medição da Dor , Estimulação Elétrica Nervosa Transcutânea/métodos , Manejo da Dor/métodos , Vértebras Cervicais
17.
J Bodyw Mov Ther ; 39: 170-175, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876622

RESUMO

BACKGROUND AND AIM: Cerebral palsy (CP) is the most common childhood motor disability, and the Cerebral Palsy Follow-Up Program (CPUP) in Nordic countries uses a traffic light system for passive range of motion (ROM) assessment to aid interpretation and guide decisions regarding interventions. However, the arbitrary chosen ROM threshold values and their potential clinical impact are uncertain. We investigated whether lower extremity ROM values were positively associated with gross motor function and whether gross motor function scores differ between the CPUP ROM thresholds. METHODS: This was a cross-sectional analysis of CPUP data for 841 ambulatory children and adolescents with CP, at a mean (SD) age of 9 (3). Regression analyses were employed to explore the relationship between gross motor capacity and performance (using the Gross Motor Function Measure (GMFM-66) and the Functional Mobility Scale (FMS) 5/50/500 m, respectively) and lower extremity ROM, measured with a goniometer. ROM was assessed both as continuous and categorical variables. RESULTS: We found that two out of ten continuous ROM measures were positively associated with gross motor function. Limited differences in gross motor function between the ROM thresholds were seen for seven out of ten ROM measures. The CPUP traffic light thresholds primarily differentiated gross motor function between the red and green categories, predominantly for the subgroup of participants with bilateral spastic CP. CONCLUSION: Limited associations between passive ROM and gross motor function in children and adolescents with CP were observed, indicating that there is more to consider than ROM when identifying whether interventions are needed.


Assuntos
Paralisia Cerebral , Extremidade Inferior , Amplitude de Movimento Articular , Humanos , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/reabilitação , Estudos Transversais , Criança , Masculino , Feminino , Adolescente , Amplitude de Movimento Articular/fisiologia , Extremidade Inferior/fisiopatologia , Extremidade Inferior/fisiologia , Destreza Motora/fisiologia
18.
J Bodyw Mov Ther ; 39: 195-200, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876625

RESUMO

INTRODUCTION: Neck pain is a leading cause of disability worldwide. Visceral referred pain is a common form of disease-induced pain, with visceral nociception being referred to somatic tissues. OBJECTIVE: The aim of this case report was to evaluate the immediate and long term effects of a novel osteopathic visceral technique (OVT) on pain and cervical range of motion (CROM) in a patient with nonspecific neck pain (NS-NP). METHOD: A case of a 47-year-old female suffering with NS-NP for four months. The patient had sought physiotherapy treatment several times, and occasionally used anti-inflammatory medication to relieve symptoms. The patient presented muscle cervical tenderness and hyperalgesia over the spinous processes of C3-C4 spinal segments with limited CROM. A novel osteopathic visceral manipulation (OVM) technique was applied in the epigastric region targeting the pancreas. Immediately after the treatment, the patient reported reduction in pain evaluated with the numerical evaluation scale (NRS), and a clinically significant increase in pressure pain threshold (PPT) in C3 spinous process. Improvement in CROM was also observed. The post-treatment improvements have been maintained at 1-month of follow-up assessment. CONCLUSION: A single OVT was effective in reducing cervical pain and increasing CROM in a patient with NS-NP caused by a viscerosomatic reflex. The results of this case study provides preliminary evidence that OVM can produce hypoalgesia in somatic tissues with segmentally related innervation. This finding encourages future research to gain a better understanding of the mechanisms of regional inhibitory interdependence involving the viscerosomatic reflexes of OVM.


Assuntos
Osteopatia , Cervicalgia , Amplitude de Movimento Articular , Humanos , Feminino , Cervicalgia/terapia , Cervicalgia/reabilitação , Osteopatia/métodos , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Pâncreas , Vértebras Cervicais , Medição da Dor
19.
J Bodyw Mov Ther ; 39: 24-31, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876633

RESUMO

BACKGROUND: Limited knowledge exists about the effectiveness of dry needling (DN) concerning the torso kinematics in patients with non-specific low back pain (NS-LBP). Acute effects of DN in NS-LBP patients from a functional perspective were investigated. METHODS: Sixteen NS-LBP patients and 11 healthy individuals (HG) were examined. NS-LBP patients received a single session of DN at the lumbar region. Baseline and immediate post-treatment measurements during flexion-extension and lateral bending of the trunk were conducted for the NS-LBP patients. HG were measured only at baseline to be used as a reference of NS-LBP patients' initial condition. Algometry was applied in NS-LBP patients. Centre of pressure, range of motion of the trunk and its' derivatives were obtained. FINDINGS: HG performed significantly faster, smoother and with greater mobility in the performed tasks compared to the pre intervention measurements of the NS-LBP patients. For the NS-LBP patients, significant greater angular velocity in frontal plane and significant lower jerk in the sagittal plane were demonstrated post intervention. DN alleviated pain tolerance significantly at the L5 level. Regarding the effectiveness of the DN upon spine kinematics, their derivatives were more sensitive. INTERPRETATION: It appeared that the pathological type of torso movement was acutely affected by DN. NS-LBP patients showcased smoother movement immediately after the intervention and better control as imprinted in the higher derivative of motion although range of motion did not improve. This quantitative variable may not be subjected to acute effects of DN but rather need additional time and training to be improved.


Assuntos
Agulhamento Seco , Dor Lombar , Amplitude de Movimento Articular , Tronco , Humanos , Dor Lombar/terapia , Dor Lombar/fisiopatologia , Fenômenos Biomecânicos , Masculino , Feminino , Adulto , Tronco/fisiologia , Tronco/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Agulhamento Seco/métodos , Equilíbrio Postural/fisiologia , Pessoa de Meia-Idade
20.
J Bodyw Mov Ther ; 39: 225-230, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876630

RESUMO

BACKGROUND: To evaluate the effect of the Mulligan mobilization technique on pain intensity and range of motion in individuals with neck pain. METHODS: Forty individuals with mechanical neck pain were enrolled in the study. The patients were randomly divided into 2 groups and a total of 10 sessions of treatment were administered to all 2 groups for 2 weeks, 5 days a week. Mulligan mobilization technique, electrophysical agents, active range of motion, and stretching exercises were carried out in the Mulligan group. In contrast, only electrophysical agents and exercises were applied to the conventional physiotherapy group. Range of motion (ROM) of the neck, Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), and Short-Form 36 Health Survey (SF-36) were used for evaluation. RESULTS: Statistical analyses were done to compare the amounts at the baseline and immediately after treatment. Statistically significant improvements were found in the post-treatment ROM, VAS, NPDS values in both groups (p < 0.05). When the differences were compared, the results of the Mulligan group were significantly better than the conventional physiotherapy group (p < 0.05). There was no significant difference between the groups in terms of SF-36 parameters (p > 0.05). CONCLUSIONS: This study showed that the Mulligan mobilization technique plus conventional physiotherapy is more effective than conventional physiotherapy in increasing joint range of motion, reducing pain, and reducing neck disability. TRIAL REGISTRATON: ClinicalTrials.gov (NCT05074576).


Assuntos
Cervicalgia , Medição da Dor , Modalidades de Fisioterapia , Amplitude de Movimento Articular , Humanos , Cervicalgia/reabilitação , Cervicalgia/terapia , Amplitude de Movimento Articular/fisiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Terapia por Exercício/métodos , Técnicas de Exercício e de Movimento/métodos , Avaliação da Deficiência
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