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Canine osteoarthritis (OA) is characterized by degenerative changes in the joints resulting in pain and lameness. The study objective was to compare treatment of OA with a novel peri-articular injection (aqua-acupuncture/aqua-AP) technique using platelet-rich plasma (PRP), with standard intra-articular (IA) injection. Sixteen dogs diagnosed with OA in appendicular skeletal joints were enrolled and assigned to Test (n=8) or Control (n=8) treatment groups. Each subject received an injection at Week 0 and again at Week 4. Treatment outcomes assessed included goniometry (flexion and extension), infrared thermal imaging (IRTI), lameness grading scores and Canine Brief Pain Inventory (CBPI) questionnaire. The flexion and extension assessments had no statistically significant changes at 4 or 8-week assessment. Significant score reductions (improvement) were observed in both groups (p<0.001) for pain severity (2, 4, 8 weeks) and activity interference (2, 4, 8 weeks) for CBPI data with no significant difference between study groups concluded (p>0.05). Infrared thermal imaging demonstrated statistically significant (p<0.001), decreased temperature in the inflamed joints for both injection techniques, however, aqua-AP treatment was statistically significant at both 4 and 8 weeks while IA technique didn't reach significance until 8 weeks post-treatment. Lameness scores had significant improvements at 4 and 8 weeks with no significant difference between groups. The findings suggest that PurePRP® treatment delivered with either the proposed aqua-AP or the standard IA injection may improve pain and thermal outcomes (decrease joint inflammation) with more rapid thermal improvement for aqua-AP. There were no clear effects on goniometry measurements. Further investigations with larger scale trials are warranted. [ABSTRACT FROM AUTHOR]

Introduction and aim. The whole-body vibration has become known for optimizing the production of muscle power due to mechanical oscillations that are dependent on vibration frequency. However, the effects of varying the vibration frequency on flexibility have still been little explored. Compare the effects of two frequencies of whole-body vibration on flexibility and extensibility of the lower limbs. Material and methods. Randomized clinical trial with a sample of 42 young adult volunteers of both sexes, who performed squatting sessions with individualized load on a platform and distributed into three groups of vibration frequency: control group (CG), with the platform off; low frequency group (LF), with a frequency of 30 Hz; high frequency group (HF), with a frequency of 45 Hz. In total, the intervention was carried out in 12 sessions and lasted 6 weeks, with 2 sessions per week. Flexibility, evaluated before and after the intervention by the sit and reach test (Wells bench) and by evaluating the extensibility of the ischiotibials by goniometry. Results. No statistical differences were observed for any of the outcomes evaluated. Conclusion. None of the proposed frequencies produced gains in flexibility and extensibility of the lower extremities and there was no superiority of one frequency over another. [ABSTRACT FROM AUTHOR]

Introduction: Chronic neck pain (CNP) is of the most common symptoms of musculoskeletal disorder. Diaphragmatic exercises can reduce pain, and disability, improve proprioception, and correct forward head posture (FHP) in patients with CNP. The present study aims to determine the effect of combining diaphragmatic exercises with physiotherapy on pain, disability, and active range of motions of cervical and FHP in individuals with CNP. Materials and Methods: Thirty women with CNP were randomly divided into two combined groups of diaphragmatic exercises and physiotherapy (DEPT) and PHYSIOTHERAPY ALONE (PT). Each person received ten sessions of treatment over two weeks. The results were assessed in the first and tenth sessions as well as two weeks later. Pain intensity was measured by visual analogue scale (VAS), disability by neck disability index (NDI), cervical active range of motions (CAROMs) by goniometry, and FHP by a lateral photograph. Results: The VAS, neck disability index (NDI), CAROMs, and FHP were improved after the tenth session and in a two-week follow-up (P<0.001). A significant difference was observed between the groups for average changes of VAS (P=0.04) and active extension (P<0.001) after the tenth session, while the average changes between the two groups of cervical active left lateral flexion (P=0.82) and left rotation (P=0.11) in the next two weeks was not significant. Conclusion: Both groups showed improvement in neck pain, disability, CAROMs, and FHP. However, diaphragmatic exercises and physiotherapy (DEPT) seem to have more lasting effects. Therefore, it is recommended to evaluate and modify the breathing patterns in the first line of treatment programs for patients with CNP. [ABSTRACT FROM AUTHOR]

Introduction. The study aimed to investigate the impact of body mass index (BMI) on the active range of motion (AROM) of the lower extremity joints in healthy sedentary young adults. Methods. Overall, 300 subjects of both genders (aged 18-30 years) were recruited in a way ensuring that the 4 BMI categories (underweight, normal, overweight, and obese) were well represented within the study sample. AROM of hip (flexion, extension, abduction, adduction, external and internal rotation), knee (flexion and extension), and ankle (dorsiflexion and plantar flexion) were measured by using standard manual goniometry. The average of 3 repetitions for each joint movement was recorded. Results. Hip and knee sagittal movement and ankle dorsiflexion were significantly different between the BMI categories. The underweight and normal participants had statistically significantly highest AROM measures when compared with the overweight and obese individuals. Sagittal hip (flexion: r = -0.344, p < 0.001; extension: r = -0.291, p < 0.001) and knee (r = -0.544, p < 0.001), as well as hip abduction (r = -0.127, p = 0.027) movements exhibited a significant negative correlation with BMI. Rotational hip and ankle joint movements were not correlated with BMI. Conclusions. Increasing BMI limits the sagittal AROM of the hip and knee joints in sedentary healthy young adults. Obesity and overweight could be listed among the factors affecting sagittal hip and knee AROM. [ABSTRACT FROM AUTHOR]

Aim: To develop and prove experimentally a rational integrated approach for using physical therapy for 30-50-year-old men suffering from pain in the thoracic spine at the training stage to achieve sustainable remission. Materials and Methods: The research was conducted in the clinical sanatorium ”Resort Berezovsky Mineral Waters”. We observed 40 men aged 30-50 years with complaints of the thoracic spine, a stable form, which was divided into the control group (20 persons) - CG and the main group (20 persons) – MG. All patients were at the training stage of rehabilitation in the conditions of sanatorium treatment. Medical and biological methods were used: pulsometry; arterial tonometry; hand dynamometry; linear measurement method; goniometry; measurement of thoracic spine mobility; spirometry. The results of the research were processed by the method of variation statistics with the calculation of mean values, mean quadratic deviation, error of mean value, probability criterion, and reliability of difference of indicators. Results: Reliable positive dynamics of the musculoskeletal system and cardiorespiratory system are established Conclusions: The effectiveness of a multidisciplinary approach is proved, namely application of therapeutic exercises with resistance, elements of traction action in the water in combination with physiotherapeutic procedures, psychotherapy, and therapeutic massage for 30-50-year-old men suffering from pains in the thoracic spine at the training stage of sanatorium treatment. [ABSTRACT FROM AUTHOR]

Introduction Pedaling therapy is defined as a plan of physical activity prescribed to facilitate rehabilitation from immobilizing diseases and any conditions that disrupt the movement and activity of daily life or maintain well-being through neuroreeducation, gait training, and therapeutic activities. Material and method. It was addressed in a case study of a 40 years female patient who presented with a physiotherapy indication for gait rehabilitation from the specialist physician after immobilization in plasterboard for four weeks, the postfracture status of the lateral malleolus of the left lower limb fibula. A personalized cycling program was applied for five weeks, period March-April 2022 using a pedaling system designed and built with plantar pressure sensors attached to the pedals to monitor outputs. There was performed gait analysis, joint and muscular testing using goniometry, Borg Cycling Scale for the perception of effort and rehabilitation zone correlations, and Visual Analog Scale (VAS) for pain. The patient's risk chart is based on the bioimpedance parameters for determining the body composition using Zepp Analyzer. Heart rate reserve, as well as heart rate training, was calculated according to Karvonen's formula supervised with Smartwatch Huawei Watch GT 2 during the cycling rehabilitation program. The sensor signals attached to the pedals are converted to analog values for both feet and the force in Newton is measured according to the values transmitted. Results and Conclusions Rehabilitation treatment consisted of applying to the therapeutic program according to the rehabilitation phases for 5 weeks maintaining a perceptual level of 4/10 Borg (maintaining the resistance zone 2) with progressive intensity from level 3 to 5. After the rehabilitation program, average analog values between the two members were 219/240 - left / right respectively 0.89 / 0.98 N showing an insignificant force difference of 0.09 N in absolute value. The final evaluation of the joint balance by goniometry enhances exceeding the values of the functional-coefficient. Muscle balance registered an optimal value of 5/5 for the left foot. The pulse corresponding to the target range not exceeded 130. The kinetic chain deficit has improved, the muscle testing indicating a range of motion of 53 degrees in the ankle left joint versus 11 degrees after immobilization. Remission of edema after phase I (first week) proved an anti-inflammatory effect. Left foot support on the ground became possible without pain (VAS = 0). The application of the proposed pedaling program using the built horizontal device led to the achievement of the objectives regarding the facilitation of the ambulance, the system is reliable and technically functional. [ABSTRACT FROM AUTHOR]

One of the most severe and slowly recovering injuries of the musculoskeletal system is the "O'Donoghue Triad" or the so-called "Unhappy Triad". It mainly affects athletes, excluding them for a long time from their sports activities. O’Donoghue’s triad includes rupture of the anterior cruciate ligament, rupture of the medial meniscus and rupture of the medial collateral ligament of the knee joint. Immediately after the injury there is static and dynamic instability of the knee joint, which hides a high risk of dislocation of the knee and damage to other tissues: rupture of the joint capsule, rupture of the chondral tissue, rupture of the lateral collateral ligament, damage to the lateral meniscus and others. The treatment is surgical and solves the problem of static instability immediately after surgery. Dynamic instability of the knee joint is restored over a long period of time by applying an analytically designed kinesitherapy program to patients after surgical treatment of the O’Donoghue Triad. For functional assessment and monitoring of the dynamics of recovery and correction of kinesitherapy, it is necessary to make an analytical selection of a test battery from functional indicators and tests corresponding to the dysfunctions of the operated knee. Purpose: The purpose of this study is to develop a diagnostic system for functional assessment of patients after surgical treatment of the O’Donoghue Triad. Research methodology: To realize the purpose of the research the following methods are applied: Analysis of literature sources (deductive method); Expert evaluation. Results: To establish the condition of various aspects of the knee recovery process, after analysis of literature sources and expert assessment in the diagnostic system for functional assessment include: for pain testing: quantitative measurement of pain on a visual-analog scale (VAS - from 0 to 10); goniometry, a method for measuring the range of motion in the knee joint, taking into account the results of the standard SFTR methodology; centimeter - a method for measuring the circumference of the lower limbs in centimeters; manual-muscular testing of the main muscles in the area of the knee complex, examination for the establishment of hypertensive and shortened muscles; test to study changes in the stability of the support; test for static muscular endurance of the sciatic muscles; static muscle endurance test of m. quadriceps femoris; test for assessment of the dynamic strength of the lower limbs (author's test); test for diagnosis of the explosive force of the lower extremities; scale for functional assessment of the condition of the knee joint; study of the locomotor abilities of patients. Conclusion: For functional assessment of the condition of the knee joint, a selection of functional tests has been made, prepared as a diagnostic system for functional assessment and for monitoring the dynamics of recovery of the knee complex in patients with "O'Donoghue's Triad" treated surgically. [ABSTRACT FROM AUTHOR]

BACKGROUND: Body-weight (BW) support during running can be accomplished using deep-water running (DWR; 100% BW support) and a lower-body positive-pressure (LBPP) treadmill. PURPOSE: To compare lower-extremity muscle activity during DWR and running on an LBPP treadmill at matched stride frequency. METHODS: Eight subjects (40 ± 6.5 y, 173 ± 7.2 cm, 66.9 ± 11.7 kg) completed 4 running conditions all at a preferred stride frequency that was determined while running with no support. Two conditions were running on the LBPP treadmill at 60% and 80% of BW, and the other 2 conditions were different DWR styles: high knee (DWR-HK) and cross-country (DWR-CC). Average (AVG) and root-mean-square (RMS) electromyography (rectus femoris, biceps femoris, gastrocnemius, and tibialis anterior) were each compared among conditions (repeated-measures analysis of variance). RESULTS: Results for AVG and RMS variables were identical for statistical tests for each muscle. Rectus femoris electromyography during DWR-HK was lower than that of DWR-CC (P < .05) but not different than either 60% BW or 80% BW (P > .05). Biceps femoris electromyography was less during DWR-HK than DWR-CC (P < .05) but greater during DWR-HK than either BW 60% or BW 80% (P < .05). Neither gastrocnemius nor tibialis anterior electromyography differed between conditions (P > .05). CONCLUSION: Neither the mechanism of BW support nor style of DWR influenced gastrocnemius or tibialis anterior muscle activity during running at the same stride frequency. However, rectus femoris and biceps femoris muscle activity were influenced by not only the mechanism of BW support but also the style of DWR. [ABSTRACT FROM AUTHOR]

Range of motion (ROM) is a measure often reported as an indicator of joint functionality. Both the angle of extension and that of flexion were measured in 234 stifle joints of dogs with cranial cruciate ligament (CCL) rupture. The aims of this study were to investigate the correlation between CCL rupture and alterations in the range of stifle joint motion and to determine whether there was a prevalence modification of one of the two angles. All the extension and flexion angles were obtained from clinical records and were analysed in various combinations. A significant relationship was found between normal angles and abnormal angles; concerning the reduction in the ROM, a significant prevalence in the alteration extension angle was found. Of the 234 stifles, 33 (13.7%) were normal in both angles. These results could offer important insights regarding the influence of CCL rupture on compromising the ROM. This awareness could be a baseline for understanding the ability of surgical treatment to restore one angle rather than another angle, to address the choice of treatment and to help physiotherapists in their rehabilitation program. [ABSTRACT FROM AUTHOR]

Muscle volume and strength of lower-limb muscles are often assessed to evaluate the effect of treatments or monitor the disease progression in children with cerebral palsy (CP) or Duchenne muscular dystrophy (DMD). Reference curves are useful to interpret subject-specific outcomes. For our recently published reference database for muscle morphology [1], centile curves were not yet established and reference data for muscle strength collected using a fixed dynamometer were still lacking. We aimed to establish centile curves for muscle volume and strength of TD children aged 0.5-18 years, and demonstrate their use on individual CP and DMD cases. We pooled available muscle morphology data in a total database of 175 TD children, including 99 (♂/♀=44/55) and 167 (♂/♀=81/86) datasets for rectus femoris muscle and medial gastrocnemius volume, respectively, while strength was assessed in 169 TD children (♂/♀=116/53). One girl with unilateral CP (7.8years, GMFCS-I) who was assessed pre and post progressive resistance training (PRT, 12 weeks, 4 sessions/week) and one boy with DMD (14.8years) who had follow-up data with 6-month interval, were included to illustrate the application of the centile approach. 3D freehand ultrasound was used to assess muscle volumes [2]. Knee extension and plantar flexion strength was measured using a fixed dynamometer [3]. Centile curves for the four outcomes with increasing age were constructed using generalized additive models for location, scale and shape (GAMLSS) in R [4]. Different models were compared and the best fitted model was selected based on the Akaike information criterion and visual inspection. Regression diagnostics were used to check the final model's fit. Z-scores were predicted based on the centile curves for the two cases. The centile curves are visualized in Fig. 1. Overall, muscle volumes and strength and their inter-subject variation increased with age. The increased variation was more evident for muscle volumes compared to strength. Plantar flexion strength showed high variation already in young children, which may be explained by the moderate reliability (ICC= 0.626) of this assessment [5]. Post-PRT, the z-scores increased in the girl with CP, except for rectus femoris volume. While the absolute values of rectus femoris muscle volume and knee extension strength remained stable, all z-scores decreased in the boy with DMD. [Display omitted] The muscle-specific centile curves for volumes and strength of TD children can successfully be used to express subject-specific outcomes in reference to TD peers. This can facilitate the interpretation of treatment-effect and disease-progress during growth in clinical research as well as for patient-specific follow-up in clinical practice. We can also construct reference curves for available morphology and strength datasets, and include body mass and length as well as longitudinal data in the models. This study was supported by Duchenne-Parent-Project-NL(17.011), Research Foundation Flanders project T005416N and fellowship 1188923 N. [ABSTRACT FROM AUTHOR]

Predictive simulations of gait can improve our understanding of how underlying impairments contribute to gait pathology in children with Duchenne muscular dystrophy (DMD). This is essential to make progress in gait rehabilitation and orthotic treatments aiming at prolonging ambulation in DMD. Yet, there is still a need to evaluate if predictive simulations can capture the key features of DMD gait. Can we simulate DMD gait pathology? 3D gait analysis was collected in three boys with DMD, who were situated at different stages of the disease progression. Muscle weakness was measured using a fixed dynamometer [1]. Muscle stiffness and contractures were assessed using goniometry and clinical scales. For each subject, a generic musculoskeletal model [2] was scaled to the subject's anthropometry based on marker data. The maximal isometric muscle forces (MIMF), joint stiffness, properties of the foot-ground contact model, weights of the cost function and imposed walking speed were scaled to reflect the child's dimensions. Subject-specific muscle weakness was modeled by decreasing active MIMF based on the individual's weakness scores. Muscle stiffness and contractures were modeled by shifting and increasing the steepness of the passive force-length relationship of the assessed muscles. Gait was predicted by minimizing a cost function while imposing the gait speed and periodicity of the gait pattern (without relying on motion capture data) [3]. For each subject, simulations were performed based on four models: (1) reference (child's dimensions), (2) weakness, (3) stiffness, and (4) combination of weakness and stiffness. Root mean squared error (RMSE) between the simulated kinematics and the mean experimental kinematics was calculated. Fig. 1 shows the experimental data and simulation results of DMD1 (10.6years), DMD2 (15.6years) and DMD3 (11.1years). The predicted gait patterns are closer to the experimental data when modeling weakness and stiffness. The sum of RMSEs between predicted and experimental kinematics decreased from 40.9 to 36.2 between model1 to model4 for DMD1, from 47.5 to 30.3 for DMD2 and from 48.2 to 39.2 for DMD3. The increasing gait pathology over the three cases with increasing severity of muscle impairments, was also reflected in the predictive simulations. [Display omitted] Several key features of the DMD gait, such as tiptoeing gait, increased anterior pelvic tilt, reduced knee flexion during stance and drop foot in swing, were reasonably captured in the predictive simulations. However, the exaggerated lumbar extension was not fully captured. Differences between simulations and experiments might be due to the use of a simple trunk model. In addition, foot deformities were not yet modeled. In the future, we will further refine the model and personalization workflow by using data from instrumented stiffness assessment. Nevertheless, the current results show the potential of predictive simulations to improve our insights in the progressive gait pathology in boys with DMD. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Sprints combined with changes in direction and repeated lunges are the most frequent movements during a squash game. These motions overload the iliopsoas muscle which may cause a lot of microinjuries. Accumulating microinjuries combined with a lack of stretching exercises may lead to iliopsoas contracture. Aim of the study: Assessment of the frequency and degree of iliopsoas contracture in regular squash players. Material and methods: The experimental group comprised 25 regular squash players (minimum 2 years of playing at least twice a week) and 21 non-players (control group). A modified Thomas Test was used to assess iliopsoas contracture using goniometric and linear measurements. Results: Iliopsoas contracture was observed in 96% of the squash players and 66.7% of the n on-players (p = 0 .0089). The degree of muscle contracture in the goniometric measurement was greater in squash players than in the non-players in both the left (p = 0.0303) and right (p = 0.0007) iliopsoas muscles. There were no statistically significant differences in the linear measurement. Conclusions: There is a positive relationship between regularly playing squash and the frequency of iliopsoas contracture occurrence being significantly greater in squash players than in non-players. [ABSTRACT FROM AUTHOR]

Background: Fingers of climbers are an area where operating forces reach the highest values, thus they are susceptible for overloading. The aim of this study was to determine what kind of morphological changes climbing causes in the anatomical structures of climbers' fingers and whether these changes affect their function. Material and methods: The study group consisted of 27 climbers and 26 non-climbers as a control group. Research consisted of an original questionnaire and measurements of the range of motion and circumferences of finger joints. Results: Limited finger flexion in all distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints in the study group was reported, as well as the contours of some DIP joints were enlarged. Correlation between the time of climbing and fingers' joints circumference value has been found. The examined climbers also declared affected grip precision in performing daily tasks. Conclusions: Climbers have limited flexion and increased finger joint circumferences, mostly in distal parts of fingers. There is a relationship between the duration of training and the intensity of morphological changes -- the longer the training duration, the smaller the joints' circumferences. Changes in anatomy of the fingers may cause functional limitation and thus difficulties in performing precise tasks during daily activities. [ABSTRACT FROM AUTHOR]

Copyright of Acta Balneologica is the property of Wydawnictwo ALUNA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Andaluza de Medicina del Deporte is the property of Centro Andaluza de Medicina del Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Highlights • A movement description and recognition method following ISB standards. • A clinically relevant motion recognition for interactive systems. • Motion analysis independent of user stature or its position in relation to sensor. • Motion recognition effectiveness analysis of the Kinect sensors (versions 1 & 2). • Motion recognition showed good efficacy in classifying the biomechanical movements. Abstract Since 1990, the International Society of Biomechanics (ISB) has made efforts to provide uniformity to motion description. However, the majority of user studies and technological systems that use motion recognition for rehabilitation, such as virtual and augmented reality (VR and AR), do not follows this standard. Typically, VR and AR techniques recognize motion by comparing human joint positions to a pre-recorded movement, direction, or position relative to an interactive object. Aiming to fill a lack of biomechanical reference on joint motion recognition and analysis for rehabilitation interactive systems, this paper proposes a movement description and recognition method following the ISB standard. The developed method aims to provide computational solutions which are clinically relevant and that uses clinical jargon known to the rehabilitation therapists. The proposed method will also allow motion analysis independent of user's height or its position relative to sensor. We conclude this paper by presenting a comparative analysis of the effectiveness of the Kinect sensors (versions 1 & 2) regarding the recognition of patient exercise motions related to the biomechanical standard. Our solution consists of biomechanical motion classification by identifying in which 3D plane the motion occurs. The motion recognition solution also provides patient posture, motion, and information about incorrect exercise performance. The method was developed by first implementing a body representation and Joint Coordinate System based on ISB standard and then motion angle and biomechanical classifications were performed. Specific methods to measure axial rotations were developed inspired by the traditional goniometry strategy. Also, experiments to evaluate if the method is able to classify the biomechanical motions and, thus, detect whether or not they are being performed correctly were performed using both Kinect v1 and Kinect v2. Motions were performed in correctly and wrongly to also verify false positives. Each classified motion was performed 100 times: 70 correct repetitions (35 at normal speed and 35 fast ones) and 30 wrong ones (out of their respective plane). The motion recognition method showed good efficacy in classifying the biomechanical motions correctly. Most of motions presented great success rate of recognition. higher than 80%, mainly using a 20 degrees tolerance. [ABSTRACT FROM AUTHOR]

The motion of wing joints is a critical factor for successful flight in avian patients, but little information is available about goniometry in birds. Elbow and carpus joints in flexed and extended positions from 10 orthopedically normal wings of 6 adult wild barred owls (Strix varia) were evaluated with the animals under general anesthesia using a modified universal plastic goniometer and an electrogoniometer. These measurements were compared to those obtained using radiographic assessment. Intra- and interobserver reliability was calculated. Measurements in live animals were compared to those obtained from frozen-thawed carcasses. Results showed that the modified universal plastic goniometer can be used to obtain accurate results for elbow flexion and extension and for carpal flexion with good to excellent reliability compared to measurements collected from radiographic assessment. Measurements obtained using an electrogoniometer were less accurate and less reliable than those obtained with a plastic goniometer, possibly because of the size and configuration of the model used. Comparison of measurements from live animals and carcasses revealed no significant differences between mean measurements and suggested that further evaluation of carcasses as a model for study of goniometry measurements in avian wing joints should be considered. [ABSTRACT FROM AUTHOR]

Background: Worldwide millions of people undergo joint replacement surgery to decrease the morbidity. The main indication for these surgeries is loss of function and pain. Similarly, knee replacement is done when degeneration and destruction of the knee create disability and decrease function of the knee. There are a number of implant types available but the use of an all-polyethylene tibial component in primary total knee replacement remains an att ractive option, considering the durability and lower cost. Objective: The objective of the study was to evaluate the pre-operative and post-operative range of motion (ROM) after total knee replacement at 6th, 12th and 48th weeks follow up using all poly implants. Material and Method: It is a prospective case series in which 111 subjects with total knee replacement in whom all poly implants were used and were assessed for range of motion at knee using simple goniometry examination at regular intervals were included. All data were analyzed using SPSS 17.0 version. Results: On goniometry examination, ROM at 6 weeks averaged 700 and at 12 weeks averaged 1,000 and on last follow up was 1,100. Conclusion: Total knee replacement with all poly implants has excellent results in terms of range of the motion of the knee. [ABSTRACT FROM AUTHOR]

Exoskeletons for gait training commonly use a rigid-linked “skeleton” which makes them heavy and bulky. Cable-driven exoskeletons eliminate the rigid-linked skeleton, providing a lighter and transparent design. Current cable-driven exoskeletons are aimed only at gait assistance by providing short bursts of forces to the leg during walking. It has not yet been shown if these designs are suitable for gait retraining, where rehabilitative forces need to be continuously applied to the leg in response to errors from a desired movement. The goal of this study is to investigate if a cable-driven leg exoskeleton can retrain the gait of human users. Nine healthy subjects were trained by a cable-driven leg exoskeleton to walk in a new gait pattern with 30% increase in step height from their natural gait. After 40 min of training, the gait of the subjects became significantly closer to the target gait than before the training. In three different post-training sessions, the step height of the subjects increased by 22%, 29%, and 31% on an average. In a fourth post-training session, when the subjects were instructed to ignore the training and walk naturally, the step height remained increased by 11%. These results confirm the potential of cable-driven designs in gait training applications. [ABSTRACT FROM PUBLISHER]

In this paper, we present a new approach for human action recognition using skeleton joints recovered from RGB-D cameras. We propose a descriptor based on differences of skeleton joints. This descriptor combines two characteristics including static posture and overall dynamics that encode spatial and temporal aspects. Then, we apply the mean function on these characteristics in order to form the feature vector, used as an input to Random Forest classifier for action classification. The experimental results on both datasets: MSR Action 3D dataset and MSR Daily Activity 3D dataset demonstrate that our approach is efficient and gives promising results compared to state-of-the-art approaches. [ABSTRACT FROM AUTHOR]

Objective: Objective of this study was to find the effects of conventional combination physical therapy treatment to improve the gross motor and functional movements in children with Erb's Palsy. Methodology: A sample of 05 children with erb's palsy was selected. Key physiotherapy interventions were strength training by using free weights, therabands and manual resistance, neurodevelopmental techniques to increase the proprioception input, orthosis and electrical current stimulation. A baseline measurement was taken on modified mallet scale, scapular elevation grading scale, and active ROM on goniometry. Treatment was continuing for 5 days in a week for 06 month. Post intervention measurement was taken after 02, 04 and 06 months. Results: Overall improvement on modified mallet scale in 06 months was from 14 to 27. Shoulder flexion show improve from 30 to 145 degree in 06 month and shoulder external rotation show limited improvement from 05 to 25 degree in 06 month. Scapular elevation grading was improved from 01 to 03 in 06 months. Patient show satisfactory improvement on modified mallet scale and active movement scale but restoring global external rotation was real challenge. Improvement of global external rotation was from 5 degree to 15 degree in six months as comparing with shoulder flexion and shoulder abduction which showed greater improvements i.e. flexion 95-145 and abduction 30- 145. On mallet scale global, external rotation show improvement from 2 to 4 when compared with other movements showed fewer improvements. Improvement in external rotation show limited improvement on mallet scale, active movement scale and AROM on goniometry. Mean of pre-intervention score on modified mallet scale was compared with mean post-intervention (06 months) score by using wilcoxon signed rank test, test statistics 0.025 showed significant change between baseline measurement and measurement after six months. Conclusion: This study concluded that, more researches and interventions are required to improve the external rotation in patients with erb's palsy. There is an immediate need for focus intervention to restore external rotation in children with Erb's palsy. [ABSTRACT FROM AUTHOR]

An inverse dynamics model has been designed, using control theory, to estimate elbow joint torque per unit moment of inertia based on a measured movement trajectory. The physiological parameters required by the model (undamped natural frequency and damping ratio of the elbow joint) were measured experimentally using the pendulum test at the elbow joint. Eight subjects participated in the experimental study, which included ten iterations of the standard pendulum test at the elbow joint, as well as ten iterations of the pendulum test with an additional known weight strapped to the wrist. Electrogoniometry was used to record the movement of the forearm during the tests, and surface electromyography of the elbow flexor and extensor muscles was used to ensure that the movements were purely passive. An equation was then derived to calculate the moment of inertia of the forearm as it rotated about the elbow joint. The inverse dynamics model developed in this study could be a useful tool for clinicians in analysing kinematics in patients with neuromuscular or orthopaedic disease. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine and compare mean standing extension and maximum flexion angles of various joints in healthy adult alpacas and llamas, and determine the reliability of goniometric data within and between 2 observers for each joint of interest. SAMPLE 6 healthy adult llamas and 6 healthy adult alpacas. PROCEDURES The shoulder joint, elbow joint, carpal, and metacarpophalangeal (MCP) joints of the forelimbs and the hip joint, stifle joint, tarsal, and metatarsophalangeal (MTP) joints of the hind limbs were investigated. Each articulation was measured with a universal goniometer by 2 observers, who each obtained 2 measurements when each joint was maintained in standing extension and in maximal passive flexion. Two sample (unpaired) t tests were performed for comparisons of mean standing extension and maximum passive flexion angles between alpacas and llamas. Intraclass correlation coefficients were calculated for each articulation to assess interobserver and intra-observer reliability of measurements. RESULTS Llamas had larger mean standing extension angles than alpacas for the tarsal and elbow joint, but there were no significant differences between species for all other joints. For all joints, flexion measurements did not differ significantly between the 2 species. For most joints, the reliability of goniometric data between observers was good to excellent (intraclass correlation coefficients, 0.6 to 0.95) CONCLUSIONS AND CLINICAL RELEVANCE Except for the elbow joint and tarsus in extension, the angle of limb articulations during flexion and extension can be considered similar for alpacas and llamas. These measurements have relevance for veterinary surgeons when assessing joint mobility and conformation and determining appropriate angles for arthrodesis. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate effects of simultaneous intra-articular and IV injection of autologous adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP) to dogs with osteoarthritis of the hip joints. ANIMALS 22 client-owned dogs (12 placebo-treated [control] dogs and 10 treated dogs). PROCEDURES Dogs with osteoarthritis of the hip joints that caused signs of lameness or discomfort were characterized on the basis of results of orthopedic examination, goniometry, lameness score, the Canine Brief Pain Inventory (CBPI), a visual analogue scale, and results obtained by use of a pressuresensing walkway at week 0 (baseline). Dogs received a simultaneous intraarticular and IV injection of SVF and PRP or a placebo. Dogs were examined again 4, 8, 12, and 24 weeks after injection. RESULTS CBPI scores were significantly lower for the treatment group at week 24, compared with scores for the control group. Mean visual analogue scale score for the treatment group was significantly higher at week 0 than at weeks 4, 8, or 24. Dogs with baseline peak vertical force (PVF) in the lowest 25th percentile were compared, and the treatment group had a significantly higher PVF than did the control group. After the SVF-PRP injection, fewer dogs in the treated group than in the control group had lameness confirmed during examination. CONCLUSIONS A ND CLINICAL RELEVANCE For dogs with osteoarthritis of the hip joints treated with SVF and PRP, improvements in CBPI and PVF were evident at some time points, compared with results for the control group. [ABSTRACT FROM AUTHOR]

Beach volleyball is a sport with a high demand of shoulder structures that may lead to adaptations in range of motion (ROM) and strength like in other overhead sports. Despite of these possible alterations, no study evaluated the shoulder adaptations in young beach volleyball athletes. The aim of this study was to compare the bilateral ROM and rotation strength in the shoulders of young beach volleyball players. Goniometric passive shoulder ROM of motion and isometric rotational strength were evaluated in 19 male and 14 female asymptomatic athletes. External and internal ROM, total rotation motion, glenohumeral internal rotation deficit (GIRD), external rotation and internal rotation strength, bilateral deficits and external rotation to internal rotation ratio were measured. The statistical analysis included paired Student's t-test and analysis of variance with repeated measures. Significantly lower dominant GIRD was found in both groups (p<0.05), but only 6 athletes presented pathological GIRD. For strength variables, no significant differences for external or internal rotation were evident. Young beach volleyball athletes present symmetric rotational strength and shoulder ROM rotational adaptations that can be considered as anatomical. These results indicate that young practitioners of beach volleyball are subject to moderate adaptations compared to those reported for other overhead sports. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate accuracy and reliability of 3 novel goniometers for measurement of canine stifle joint angles and compare the results with those obtained with a universal goniometer (UG). SAMPLE: 8 pelvic limbs from 4 canine cadavers. PROCEDURES: Each limb was secured to a wooden platform at 3 arbitrarily selected fixed stifle joint angles. Goniometry was performed with 2 smartphone-based applications (novel goniometers A and B), a digital goniometer (novel goniometer C), and a UG; 3 evaluators performed measurements in triplicate for each angle with each device. Results were compared with stifle joint angle measurements on radiographs (used as a gold standard). Accuracy was determined by calculation of bias and total error, coefficients of variation were calculated to estimate reliability, and strength of linear association between radiographic and goniometer measurements was assessed by calculation of correlation coefficients. RESULTS: Mean coefficient of variation was lowest for the UG (4.88%), followed by novel goniometers B (7.37%), A (7.57%), and C (12.71%). Correlation with radiographic measurements was highest for the UG (r = 0.97), followed by novel goniometers B (0.93),A (0.90), and C (0.78). Constant bias was present for all devices except novel goniometer B.The UG and novel goniometer A had positive constant bias; novel goniometer C had negative constant bias. Total error at 50° and 100° angles was > 5% for all devices. CONCLUSIONS AND CLINICA LRELEVANCE: None of the devices accurately represented radiographically measured stifle joint angles. Additional veterinary studies are indicated prior to the use of novel goniometers in dogs. [ABSTRACT FROM AUTHOR]

The anisotropy factor g, one of the optical properties of biological tissues, has a strong influence on the calculation of the scattering coefficient μ in inverse Monte Carlo (iMC) simulations. It has been reported that g has the wavelength and absorption dependence; however, few attempts have been made to calculate μ using g values by taking the wavelength and absorption dependence into account. In this study, the angular distributions of scattered light for biological tissue phantoms containing hemoglobin as a light absorber were measured by a goniometric optical setup at strongly (405 nm) and weakly (664 nm) absorbing wavelengths to obtain g. Subsequently, the optical properties were calculated with the measured values of g by integrating sphere measurements and an iMC simulation, and compared with the results obtained with a conventional g value of 0.9. The μ values with measured g were overestimated at the strongly absorbing wavelength, but underestimated at the weakly absorbing wavelength if 0.9 was used in the iMC simulation. [ABSTRACT FROM AUTHOR]

Posterior and anterior arthroscopy of the ankle and hindfoot may have to be undertaken at the same surgical sitting. Standard arthroscopic practice does not allow to approach both compartments without changing the position of the patient. In the supine position, most intra-articular structures of posterior portion of the ankle joint can be accessed from anterior portals with judicious traction, but visualization of posterior extra-articular compartment and hindfoot are not possible. To avoid repositioning of the patient, we have developed a procedure that allows access to the posterior compartment of the ankle with the patient supine. We describe a 2 posteromedial ankle portals procedure, which allows to reach both the posterior side of the ankle joint and the hindfoot extra-articular compartments keeping the patient supine throughout the procedure. After treatment of anterior compartment disorders using standard anterior portals, 2 posteromedial entry portals permit to visualize and treat pathologies of the posterior ankle and of the hindfoot, without prolonging surgery. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the difference between two nailing approaches of intramedullary screw fixation, the retrograde nailing versus the anterograde nailing, on the radiological and clinical outcomes in patients with clavicle shaft fractures. Methods: From April 2002 to August 2014, we enrolled a total of 22 patients with clavicle shaft fractures to participate in this study. Twelve patients received retrograde intramedullary nailing and 10 received anterograde nailing. The average duration of follow-up was 12 months. In all the patients, we took follow-up radiographs of the anteroposterior and the axial views to assess the postoperative radiological outcomes. We measured the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and the range of motion (ROM). Results: Clinically, we did not find a statistically significant difference in the retrograde group and the anterograde group in terms of the duration to bone union, the VAS score the ASES score and the ROMs. Radiologically, we found that the difference in the clavicle shortening of the affected arm and the unaffected arm did not show a statistically significant difference at the immediate postoperative assessment. we found that the difference in the clavicle shortening of the affected arm between the immediate postoperative and the final follow-up value did not show a statistically significant difference. Conclusions: We found that both the retrograde nailing and the anterograde nailing gave a favorable outcome for clavicle shaft fractures. Although we saw evidence of clavicle shortening after intramedullary screw fixation, this was not a factor that influenced clinical outcome. [ABSTRACT FROM AUTHOR]

Purpose: To better understand the anatomical variation in angles that each of the three facets of the subtalar joint has with relation to the transverse, frontal and sagittal planes along the facet's long axis. Design: An investigation of Calcaneo-Talo interaction. Samples: Calcaneal samples were obtained from the Smithsonian Institute from the Terry, Argentina, Aleutian Islands, Peru, Virginia, Seminole Indian, and Egyptian skeletal collections. Methods: Photographs were obtained of each calcaneus held at a 27 degree calcaneal inclination angle, angles were determined by a bisection of the facet measured against the transverse plane via a round ground protractor level. Sagittal and Frontal plane deviations were determined via ImageJ angle tool from the transverse plane photographs. Main Outcome Measures: We measured the angle of the bisection of each of the three facets with respect to the transverse plane, sagittal plane, and frontal plane for 162 calcanei. Results: The mean angulation of deviation from the transverse plane were: anterior facet 27.4°, middle facet 14.7°, and posterior facet 9.0°. Standard deviations were 7.3°, 6.1°, and 5.0° respectively. The mean angulation of deviation from the sagittal plane were: anterior facet 31.42°, middle facet 34.44°, and posterior facet 44.16°. Standard deviations were 11.88°, 7.95°, and 10.36° respectively. The mean angulation of deviation from the frontal plane were: anterior facet 58.58°, middle facet 55.56°, and posterior facet 45.84°. Standard deviations were 11.88°, 7.95°, and 10.36° respectively. Conclusions: The axis of the posterior cone shaped facet is directed toward the middle facet. The anterior facet sits 27°±7° from the transverse. [ABSTRACT FROM AUTHOR]

Background: Surgical interventions at the shoulder may alter function of the shoulder complex. Clinically, the outcome can be assessed by universal goniometry. Marker-based motion capture may not resemble these results due to differing angle definitions.Methods: The clinical inspection of bilateral arm abduction for assessing shoulder dysfunction is performed with a marker based 3D optical measurement method. An anatomical zero position of shoulder pose is proposed to determine absolute angles according to the Neutral-0-Method as used in orthopedic context. Static shoulder positions are documented simultaneously by 3D marker tracking and universal goniometry in 8 young and healthy volunteers. Repetitive bilateral arm abduction movements of at least 150° range of motion are monitored. Similarly a subject with gleno-humeral osteoarthritis is monitored for demonstrating the feasibility of the method and to illustrate possible shoulder dysfunction effects.Results: With mean differences of less than 2°, the proposed anatomical zero position results in good agreement between shoulder elevation/depression angles determined by 3D marker tracking and by universal goniometry in static positions. Lesser agreement is found for shoulder pro-/retraction with systematic deviations of up to 6°. In the bilateral arm abduction movements the volunteers perform a common and specific pattern in clavicula-thoracic and gleno-humeral motion with maximum shoulder angles of 32° elevation, 5° depression and 45° protraction, respectively, whereas retraction is hardly reached. Further, they all show relevant out of (frontal) plane motion with anteversion angles of 30° in overhead position (maximum abduction). With increasing arm anteversion the shoulder is increasingly retroverted, with a maximum of 20° retroversion. The subject with gleno-humeral osteoarthritis shows overall less shoulder abduction range of motion but with increased out-of-plane movement during abduction.Conclusions: The proposed anatomical zero definition for shoulder pose fills the missing link for determining absolute joint angles for shoulder elevation/depression and pro-/retraction. For elevation-/depression the accuracy suits clinical expectations very well with mean differences less than 2° and limits of agreement of 8.6° whereas for pro-/retraction the accuracy in individual cases may be inferior with limits of agreement of up to 24.6°. This has critically to be kept in mind when applying this concept to shoulder intervention studies. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the intrarater reliability for examining active range of motion (ROM) and isometric strength of the shoulder and elbow among asymptomatic female team handball athletes and a control group using a manual goniometer and hand-held dynamometry (HHD).Materials and Methods: 22 female team handball athletes (age: 21.0 ± 3.7 years) and 25 volunteers (13 female, 12 male, age: 21.9 ± 1.24 years) participated to determine bilateral ROM for shoulder rotation and elbow flexion/extension, as well as isometric shoulder rotation and elbow flexion/extension strength. Subjects were assessed on two separate test sessions with 7 days between sessions. Relative (intraclass correlation coefficients (ICC) and standard error of measurement (SEM) reliability were calculated.Results: Reliability for ROM and strength were good to excellent for both shoulders and groups (athletes: ICC = 0.94-0.97, SEM 1.07°-4.76 N, controls: ICC = 0.96-1.00, SEM = 0.00 N-4.48 N). Elbow measurements for both groups also showed good-to-excellent reliability (athletes: ICC = 0.79-0.97, SEM = 0.98°-5.94 N, controls: ICC = 0.87-1.00, SEM = 0.00 N-5.43 N).Conclusions: It is important to be able to reliably reproduce active ROM and isometric strength evaluations. Using a standardized testing position, goniometry and HHD are reliable instruments in the assessment of shoulder and elbow joint performance testing. We showed good-to-excellent reproducible results for male and female control subjects and female handball athletes, although the single parameters in ROM and strength were different for each group and between the shoulders and elbows. [ABSTRACT FROM AUTHOR]

Purpose: In unique clinical situations where C1-C2 anterior transarticular screw (ATS) fixation is not available or has failed, an anterior transarticular crossing screw (ATCS) with transcorporal pathway of the screws inside the contralateral promontory of C2 may enhance the stabilization and achieve atlantoaxial arthrodesis. The present study was to describe a novel technique of ATCS fixation for atlantoaxial joint instability and its applied anatomy, and compared it with ATS fixation method.Methods: Direct measurements using digital calipers and a goniometer were conducted on 30 pairs of dried human C1 and C2 vertebrae. The ATS and ATCS with screws (Φ 4.0 mm) were performed on 11 fresh cervical spine specimens. The screw lengths in the C1 and C2, and screw entry angles of the ATS and ATCS were measured, respectively. Cadaver specimens were dissected to observe the incidence of violation to the important structures surrounding the ATS and ATCS fixation technique.Results: There was enough osseous space for ATCS placement. The lateral and incline angle of the ATCS was 36.2° and 28.7°, respectively. Screw purchase in C2 of the ATCS (25.6 mm) was greater than that of the ATS (11.4 mm). The ATCS C1 purchase (14.8 mm) was similar to the ATS C1 purchase (14.9 mm). No violation to the vertebral artery groove, the spinal canal or the atlanto-occipital joint was observed after the ATCS placement.Conclusion: Anterior transarticular crossing screw is a feasible and viable option for atlantoaxial fixation in selected cases. This technique achieved remarkable longer screw purchase and could enhance the atlantoaxial stability. [ABSTRACT FROM AUTHOR]

Background: Evaluation of joint movements is essential to choose an appropriate rehabilitation protocol for a patient.Objective: The aim of this study is to suggest an alternative optical technique for measurement of joint angle which is convenient, inexpensive, and can be operated in real time.Methods: According to the principle of the triangulation method, position sensitive detector (PSD) converts reflected light signals into distance-related voltages. Various parameters were investigated to increase detection range and resolution of joint angle measurements.Results: The accuracy of the suggested optical sensor was verified by comparing with a commercial goniometer and 3D motion capture system.Conclusions: This method can be applied to monitor recovery progress for the patient in rehabilitation and sport science. [ABSTRACT FROM AUTHOR]

Introduction. Good measuring instruments are expected to be reliable, therefore this study determined the reliability of two instruments for measuring straight leg raising (SLR), which were the tape measure and universal goniometer. Material and Method. Two hundred (100 males and 100 females) undergraduate students participated in study. Their age range was between 19 and 30 years with a mean of 24.02±2.33 years. The participants were asked to wear unrestrictive clothing and the procedure explained to them. The skin of the participants were marked with a marker (the greater trochanter and the lateral condyle of the femur). In supine lying, the participants raised their right lower limb up and down until the onset of pelvic tilt was detected by the researcher. At the onset of pelvic tilt, the lower limb of the participants were held by the assistant and the measurement taken by the researcher, one after the other with the two instruments. This process was repeated two times and average value was recorded for each of the measurement procedure. The procedure was repeated on the subsequent measurement. Pearson product moment correlation coefficient (r) was used to determine the relationship between the first and subsequent measurement. Results. The test retest correlation coefficient (r=0.65; 0.66; 0.63) was obtained for goniometric measurements for all the participants, males and females respectively, whereas a corresponding lower test retest correlation coefficient (r=0.57; 0.60; 0.51) was obtained for tape measurements for all, males and females participants respectively. Conclusion. The two instruments were found to be reliable, with the goniometer having a higher value. Goniometer was more reliable than the tape measure and hence preferred for range of motion measurement. [ABSTRACT FROM AUTHOR]

Background: Measuring subtalar joint (STJ) motion is accompanied by complications due to the oblique STJ axis which results in triplanar pronation and supination.Objective: We developed a pronator and supinator testing apparatus whose axis was aligned with Inman's STJ axis. The purpose of this study was to assess day-to-day reliability of active STJ range of motion (ROM) measurements and to compare the results with those of a rearfoot goniometer.Methods: Active pronation, supination and total STJ ROM measurements were administered to 12 men (mean age: 23.8 years) and 12 women (mean age: 22.3 years) at two separate test sessions. Intraclass correlations (ICC), limits of agreement (LoA) and minimum detectable change (MDC) were calculated.Results: Except for pronation ROM in men, the STJ goniometer revealed substantial (ICC > 0.8) reliability in all conditions. Relative MDCs and LoAs were below 15% and 10%, respectively. Significantly higher total ROM (P< 0.05) was found for women compared to men when using the STJ goniometer. The rearfoot goniometer showed high reliability (ICCs > 0.7) but underestimated STJ ROM in average of 37%.Conclusions: Both goniometric methods showed high day-to-day reliability. However, when using the rearfoot goniometer, researchers have to consider whether the level of underestimation of STJ motion is acceptable in the context of the planned investigation. [ABSTRACT FROM AUTHOR]

Purpose - We assessed whether an intramedullary lengthening device would reduce the problems normally associated with the external fixation technique. We also wanted to determine whether it is a reliable construct for limb lengthening and deformity correction in the femur. Patients and methods - We conducted a matched-pair comparison of 30 femoral lengthenings, 15 with a motorized intramedullary nail (the nail group) and 15 lengthenings with an external ring fixator (the fixator group). The patients were matched based on age, sex, amount of lengthening, and the etiology of leg length discrepancy. Mean lengthening was 35 (25-55) mm in the nail group and 38 (15-75) mm in the fixator group. Outcome measures were: lengthening and alignment achieved, consolidation index, knee range of motion (ROM), and complications. Results - The pairs in this matched-pair study were similar in terms of age, sex, diagnosis, and amount of lengthening. The planned amount of lengthening was achieved in all patients in both groups and axis correction was considered sufficient. The mean radiographic consolidation index in the nail group, at 1.5 (0.9-3.0) months/cm, was better than the mean value for the fixator group (1.9 (0.9-3.4) months/cm) (p = 0.01). Knee ROM was better in the nail group during the lengthening, 6 weeks after lengthening was completed, and 6 months after lengthening was completed (p < 0.001). A larger number of complications were observed in the fixator group than in the nail group. Interpretation - A lengthening nail may be superior to external fixation in femoral lengthening, when the anatomical conditions and the complexity of the deformity allow the use of an intramedullary nail. [ABSTRACT FROM AUTHOR]

The current literature has been discussing the risks and benefits of joint hypermobility (JHM) for careers in ballet This study aimed to evaluate the prevalence of JHM and joint hypermobility syndrome (JHS) in a group of ballet teachers and students, looking both at aspects related to the flexibility required to dance, as at the risk of injuries when hypermobility is associated with other symptoms, in the case of JHS. We evaluated ballet teachers and ballet students, with age ranging from 18 to 40 years. All participants completed identification and sociodemographic questionnaires and underwent a physical examination. JHM was assessed using the Beighton score with goniometry. Symptoms of JHS were evaluated according to the Brighton criteria. Final sample consisted of 77 participants, being 44 ballet students and 33 ballet teachers. The prevalence of JHM in the sample as a whole was 58 %. Teachers and students had no significant differences regarding the prevalence of JHM ( p = 0.74) (OR 1.21; 95 % CI 0.48-3.07). However, the prevalence of JHS was significantly different ( p = 0.04) between students (16 %) and teachers (36 %). Teachers were three times more likely than student to have JHS (OR 3.02; 95 % CI 1.03-8.85). Teachers and students also presented differences in the frequency of specific items of Beighton score and Brighton criteria. These data provide elements to discuss the relationship between hypermobility, ballet technique and selection for dance, suggesting that dancers with JHS could find in ballet teaching an alternative to maintain professional activity with dance, while remaining protected from the higher risk of injury that professional dancers may be exposed to. [ABSTRACT FROM AUTHOR]

Background and Purpose The aim of the present study was to evaluate the immediate effects of therapeutic mobilization of the talocrural and subtalar joints on ankle mobility and postural control in elderly subjects. Methods Nineteen subjects (83.1 ± 6 years, 159 ± 1 cm; 56.1 ± 9.7 kg − mean ± standard deviation) participated in this study. The centre of pressure (COP) displacements along the anterior-posterior and medial-lateral axes was recorded in static and dynamic conditions on a force platform before and after therapeutic mobilization of the feet and ankles without blinding the subjects. Results In static conditions, the sway area is reduced contrarily to dynamic conditions where the sway area is increased. In the two experimental sessions, subjects showed comparable COP displacements and the total length of the oscillations. Results demonstrated a significant improvement immediately after mobilization for ankle range of motion in dorsal flexion (right +4.7°; left +3.2°) and plantar flexion (right 5.2°; left +4.2°). Conclusion These results suggested that postural control is improved in static conditions and decreased in dynamic conditions. Therapeutic mobilization of feet and ankles in the elderly provides an immediate improvement in joint range of movement in dorsal and plantar flexion. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and Purpose. Patellofemoral pain (PFP) is associated with a wide range of local and global physical factors possibly contributing to pain and thus requires detailed assessment and individualized treatment. Yet, no cohort study was found that assessed the value of individualized physiotherapy, probably because this approach lends itself to clinical practice but not to scientific research. Most studies focus on a 'knee' or 'hip' treatment approach irrespective of individual global differences in lower limb alignment, movement patterns and muscle tightness. Therefore, this study aimed to determine the effectiveness of supplementing local treatment of PFP with individualized treatment targeting global contributing factors. Secondarily it aimed to subgroup the patients according to variations in lower limb alignment/laxity, movement patterns, biarticular muscle tightness and joint degeneration. Method. Forty-one patients (60 knees) with PFP who had followed a programme of local quadriceps strengthening, quadriceps stretching and taping for one fortnight were prescribed an individualized programme based on assessment. This global assessment included lower limb postural alignment, movement patterns, muscle tightness and range of motion. Another fortnights treatment was prescribed accordingly and included specific, individualized postural and movement retraining, stretching and functional weight-bearing, strengthening exercises. Seven outcome measures, namely four pain measures, isokinetic quadriceps strength, quadriceps length and eccentric knee control, assessed improvement. Results. All outcome measures showed further significant improvement following individualized treatment ( p < 0.03). Patients fell into four broad physical subgroups: hypermobility (often with malalignment), hypomobility (with three of four tight muscle groups), faulty movement patterns (mostly dynamic knee valgus) and patellofemoral osteoarthritis. Conclusions. Individualized treatment supplementing local standard physiotherapy for PFP leads to further significant improvement over 2 weeks. This study highlights the importance of assessing patients globally in order to optimize treatment and ongoing improvement. Recognition of different subgroups may guide treatment that should include both local and deficit-targeted global treatment. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and Purpose. Familial dysautonomia (FD) is a rare genetic autosomal recessive disease that impairs vital functions and causes neural and motor deficiency. These motor deficits often are characterized by static and dynamic instability and an ataxic gait. As a result, people with FD are at risk for significant physical impairment and falls and pose unique challenges for delivering rehabilitation exercise. Consequently, there is a need for challenging ways to safely and feasibly deliver active exercise rehabilitation to these individuals. Case Description . This case report describes 3 people with FD (ages 11, 12, and 22 years) with gait and stability' problems who attended rehabilitation exercises augmented by the use of an iPhone application specifically developed for the program. Outcomes . The Berg Balance Scale and the Four Square Step Test were conducted prior to training, after training, and after 2 months of follow-up without training. Two patients showed improvements on both measures at the posttest, which were maintained throughout follow-up testing. Discussion. Although greater experience is needed to more fully evaluate the efficiency of the iPhone application used in this program for people with FD, the results of these initial cases are encouraging. Systematically and prospectively tracking motor abilities and other functional outcomes during rehabilitation of individuals with FD who use the suggested application in balance training is recommended in order to provide greater evidence in this area. [ABSTRACT FROM AUTHOR]

Objective: Delayed-onset muscle soreness (DOMS) often occurs after unaccustomed eccentric exercise and reduces exercise performance. We aimed to study the preventive effects of saffron and indomethacin on the biochemical and functional indicators of DOMS after 1-session eccentric exercise. Design: A 10-day, randomized, double-blind, placebo-controlled, pretest–posttest design. Setting: Controlled research laboratory. Participants: Thirty-nine nonactive male university students randomly divided into saffron (n = 12), indomethacin (n = 12), and control (n = 15) groups. Interventions: Saffron group received 1 capsule containing dried saffron powder (n = 12, 300 mg/d), indomethacin group received 75 mg indomethacin (n = 12, 25 mg thrice a day), and control group (n = 15) received placebo capsules, 1 week before and 3 days after eccentric exercise. Ten days before and 24, 48, and 72 hours after muscle soreness protocol, the maximum isometric and isotonic forces, plasma creatine kinase (CK), plasma lactate dehydrogenase (LDH), perceived pain, knee range of movement, and thigh circumference were measured. Muscle soreness protocol was performed with a weight load equal to 80% of the maximum isotonic force in 4 sessions with 20 repetitions and 3-minute rest in between. Main Outcome Measures: This study shows that 10-day supplementation with 300 mg saffron significantly decreased the CK and LDH concentrations (P < 0.0001). In the saffron group, there was no decline in maximum isometric and isotonic forces after eccentric exercise, but a significant decline in the isometric force was observed in the control group (P < 0.0001). No pain was reported in the saffron group, whereas the indomethacin group experienced pain before 72 hours (P < 0.001). Conclusions: Results obtained from the current novel research indicate a strong preventive effect of 10-day supplementation with saffron on the DOMS. Clinical Relevance: The saffron can be used to prevent DOMS and alleviate the DOMS symptoms [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to (1) examine riding habits of injured cyclists, (2) identify factors related to seeking medical treatment, (3) investigate performance of recreational road cyclists compared with established norms regarding strength and flexibility measures, and (4) propose cycling-specific injury risk factors. Design: Observational and prospective study. Setting: Cycling store and bicycle distribution company. Participants: Sixty-three experienced road cyclists. Assessment of Risk Factors: Initial data collection included a questionnaire. A 2-week training diary and 8 weekly follow-up injury questionnaires were also collected. Main Outcome Measures: Training habits and injury history, bike fit, flexibility, and isometric, dynamic, and plyometric strength measures. Results: Participants were likely to have an injury at baseline, and chronic pain was common. Cyclists trained for an equal quantity of time irrespective of experiencing pain. Injury severity in terms of pain level and participant age were factors in seeking medical care. Our participants performed poorly on our testing protocol compared with available norms. Flexibility, strength, and bike fit measures did not predict injury. Previous injury predicted prospective injury. The knee and lumbar region were most frequently injured. Conclusions: Cycling is a sport in which injury risk and prevention need to be further studied. Cyclists are frequently injured but continue to participate in cycling at volumes equal to their healthy peers. Clinical Relevance: This study outlines a clinically reproducible cyclist assessment and discusses behaviors common to the cycling patient. [ABSTRACT FROM AUTHOR]

Background: Voluntary posterior instability of the shoulder is a rare condition in which the patient is able to cause a subluxation by voluntary muscle activation. A shoulder rehabilitation program aimed to correct abnormal muscle patterns and restore correct scapular motion may provide good results and improve the quality of life of these patients. Methods: Fifteen subjects (six males, nine females; mean age 19 years) underwent physical examination and clinical tests [Disability of the Arm, Shoulder and Hand (DASH) score, Shoulder Pain and Disability Index (SPADI), and modified Rowe score] and compiled the patient global assessment (PGA). Articular or rotator cuff lesions were excluded by X-rays and MRI. The rehabilitation program included three phases: (1) assessment and correction of abnormal muscle patterns, (2) restoration of correct scapular motion, and (3) strengthening of scapular and posterior glenohumeral muscles. Follow-up was at 3, 6, 12, and 24 months. Results: DASH and SPADI scores improved significantly at 3 ( p < 0.01), 6 ( p < 0.009), 12 ( p < 0.001), and 24 months ( p < 0.001). The Rowe score was fair at 3 months and good at 6, 12, and 24 months. Active flexion, abduction, and external rotation increased at all follow-up points ( p < 0.01), whereas internal rotation remained unchanged ( p > 0.05). PGA values were high. Compliance was good without serious adverse events reported during the treatment. A correlation was found between age and DASH changes (Spearman's ρ −0.56; p = 0.0455). Conclusions: Our findings stress the value of a rehabilitation program that teaches subjects with voluntary instability how to correct abnormal muscle patterns to restore scapular motion, and the importance of adopting home rehabilitation exercises as a part of the normal lifestyle. [ABSTRACT FROM AUTHOR]

Objectives: While studies have looked into the effects of Maitland mobilization on symptom relief, to date, no work has specifically looked at the effects of Mulligan mobilization. The objective of this work was to compare the effectiveness of Maitland and Mulligan's mobilization and exercises on pain response, range of motion (ROM) and functional ability in patients with mechanical neck pain. Methods: A total sample of 60 subjects (21-45 years of age) with complaints of insidious onset of mechanical pain that has lasted for less than 12 weeks and reduced ROM were randomly assigned to: group I - Maitland mobilization and exercises; group - II Mulligan mobilization and exercises; and group-III exercises only, and assessed for dependent variables by a blinded examiner. Results: Post measurement readings revealed statistical significance with time ( p < 0.00) and no significance between groups ( p > 0.05) indicating no group is superior to another after treatment and at follow-up. The effect sizes between the treatment groups were small. Conclusion: Our results showed that manual therapy interventions were no better than supervised exercises in reducing pain, improving ROM and neck disability. [ABSTRACT FROM AUTHOR]

Background/Purpose: The squat is a fundamental movement of many athletic and daily activities. Methods to clinically assess the squat maneuver range from simple observation to the use of sophisticated equipment. The purpose of this study was to examine the reliability of Coach's Eye (TechSmith Corp), a 2-dimensional (2D) motion analysis mobile device application (app), for assessing maximal sagittal plane hip, knee, and ankle motion during a functional movement screen deep squat, and to compare range of motion values generated by it to those from a Vicon (Vicon Motion Systems Ltd) 3-dimensional (3D) motion analysis system. Methods: Twenty-six healthy subjects performed three functional movement screen deep squats recorded simultaneously by both the app (on an iPad [Apple Inc]) and the 3D motion analysis system. Joint angle data were calculated with Vicon Nexus software (Vicon Motion Systems Ltd). The app video was analyzed frame by frame to determine, and freeze on the screen, the deepest position of the squat. With a capacitive stylus reference lines were then drawn on the iPad screen to determine joint angles. Procedures were repeated with approximately 48 hours between sessions. Results: Test-retest intrarater reliability (ICC3,1) for the app at the hip, knee, and ankle was 0.98, 0.98, and 0.79, respectively. Minimum detectable change was hip 6°, knee 6°, and ankle 7°. Hip joint angles measured with the 2D app exceeded measurements obtained with the 3D motion analysis system by approximately 40°. Differences at the knee and ankle were of lower magnitude, with mean differences of 5° and 3°, respectively. Bland-Altman analysis demonstrated a systematic bias in the hip range-of-motion measurement. No such bias was demonstrated at the knee or ankle. Conclusions: The 2D app demonstrated excellent reliability and appeared to be a responsive means to assess for clinical change, with minimum detectable change values ranging from 6° to 7°. These results also suggest that the 2D app may be used as an alternative to a sophisticated 3D motion analysis system for assessing sagittal plane knee and ankle motion; however, it does not appear to be a comparable alternative for assessing hip motion. [ABSTRACT FROM AUTHOR]

Background: Pitchers may be at greater risk of injury in comparison to other overhead throwing athletes due to the repetition of the pitching motion. It has been reported that approximately 30% of all baseball injuries occur in the lower body. This may be related to limited hip mobility, which can compromise pitching biomechanics while placing excessive stress on the trunk and upper quarter. Hip motion and strength measurements have been reported in professional baseball pitchers but have not been reported in collegiate pitchers. Purpose: The purpose of this study was to report preliminary findings for passive hip motion and isometric hip muscle strength in collegiate pitchers and compare them to previously published values for professional level pitchers. Study Design: Cross sectional study Methods: Twenty-nine collegiate baseball pitchers (age = 20.0 + 1.4 years, height = 1.88 + 0.06 m; weight = 89.3 + 10.7 kg; body mass index = 25.3 + 2.5 kg/m2) were recruited. Subjects were assessed for hip internal rotation (IR) and external rotation (ER) passive motion, hip anteversion or retroversion, gluteus maximus, gluteus medius, hip internal rotator, hip external rotator strength, and lumbo-pelvic control with the prone active hip rotation test as described by Sahrmann. Statistical analysis included calculation of subject demographics (means and SD) and use of a two-tailed t-test (p >0.05). Results: Fifty-two percent of the right-handed and 50% of the left-handed pitchers demonstrated poor lumbo-pelvic motor control with an inability to stabilize during active hip IR and ER even though isolated strength deficits were not detected at a significant level. There were no significant differences in hip passive motion or gluteus medius strength between right and left-handed pitchers. Differences did exist between collegiate data and previously published values for professional pitchers for IR motion measured in prone and gluteus maximus strength. Hip retroversion was present in 55% of the pitchers primarily in both limbs with four of the pitchers presenting with retroversion singularly in either the stride or trail limb where the ER rotation motion was greater than the IR. Conclusion: Assessing mobility and muscle strength of the lower quarter in isolation can be misleading and may not be adequate to ensure the potential for optimal pitching performance. These findings suggest that lumbo-pelvic control in relation to the lower extremities should be assessed as one functional unit. This is the first study to explore hip motion, strength, and lumbo-pelvic control during active hip rotation in collegiate baseball pitchers. [ABSTRACT FROM AUTHOR]

This study evaluates the effects of training and detraining on ankle proprioception in terms of kinesthesia in adult women. Sixty participants were randomly assigned to three groups. Tai Chi and Brisk Walking Groups went through a 16-week training period followed by an eight-week detraining period. The ankle plantar-flexion, dorsal-flexion, inversion, and eversion kinesthesia were measured every four weeks. The ankle kinesthesia in plantar/dorsal flexion of both exercise groups decreased, but the Tai Chi Group decreased more and sooner than the Brisk Walking Group. The training effects of Tai Chi exercise were retained but diminished during the detraining. The training effects of Brisk Walking exercise were not retained. The kinesthesia of ankle inversion and eversion remained unchanged after training. The results suggest that Tai Chi exercise is more effective in training ankle proprioception in plantar and dorsal flexion and in retaining the training effects compared with Brisk Walking exercise. [ABSTRACT FROM PUBLISHER]

Background and Purpose. Muscle tension dysphonia (MTD), a common voice disorder that is not commonly referred for physical therapy intervention, is characterized by excessive muscle recruitment, resulting in incorrect vibratory patterns of vocal folds and an alteration in voice production. This case series was conducted to determine whether physical therapy including manual therapy, exercise, and stress management education would be beneficial to this population by reducing excess muscle tension. Case Description. Nine patients with MTD completed a minimum of 9 sessions of the intervention. Patient-reported outcomes of pain, function, and quality of life were assessed at baseline and the conclusion of treatment. The outcome measures were the numeric rating scale (NRS), Patient-Specific Functional Scale (PSFS), and Voice Handicap Index (VHI). Cervical and jaw range of motion also were assessed at baseline and postintervention using standard goniometric measurements. Outcomes. Eight of the patients had no pain after treatment. All 9 of the patients demonstrated an improvement in PSFS score, with 7 patients exceeding a clinically meaningful improvement at the conclusion of the intervention. Three of the patients also had a clinically meaningful change in VHI scores. All 9 of the patients demonstrated improvement in cervical flexion and lateral flexion and jaw opening, whereas 8 patients improved in cervical extension and rotation postintervention. Discussion. The findings suggest that physical therapists can feasibly implement an intervention to improve outcomes in patients with MTD. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the intervention. A clinical implication is the expansion of physical therapy to include referrals from voice centers for the treatment of MTD. [ABSTRACT FROM AUTHOR]