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Introduction To investigate the test–retest and inter-rater reliability of a new protocol using the back range of motion instrument (BROM II) to measure the lumbar range of motion (LROM). Methods Five raters and twenty healthy subjects participated in this study. Before the measurement, all raters and all subjects were asked to watch a 4-minute video clip demonstrating the rating method. The raters and the subjects were then asked to practice the testing protocol until they thoroughly understood it. The subjects were asked to move the lumbar spine in six directions, with consistent verbal instruction. The raters measured the subjects’ LROM twice and were blinded to the data. The intraclass correlation coefficients were used to estimate the test–retest and inter-rater reliability of the LROM. Results The results showed that the intra-rater reliability [ICC(3,1)] was good-to-excellent, ranging from 0.82 to 0.98, except for the LROM in the right rotation, which was moderate-to-good, ranging from 0.74 to 0.97. The inter-rater reliability [ICC(2,1)] was good-to-excellent, ranging from 0.78 to 0.87. Conclusions The intra- and inter-rater reliability of this protocol in measuring LROM obtained by the BROM II were reliable and suitable for both teaching and research.

Objective The aims of this study were to assess the psychological, functional, and physical differences between patients with femoroacetabular impingement (FAI) syndrome and individuals who were asymptomatic (controls) to analyze clinical differences among 4 subtypes of FAI (cam type, cam type with labral tear, pincer type, and pincer type with labral tear), to calculate the correlations among the variables described, and to identify risk factors contributing to the hip function variance. Methods A case–control study was conducted at a hospital rehabilitation unit with a cohort of individuals who were asymptomatic (controls) and a cohort of patients with FAI. Sociodemographic characteristics, pain intensity, psychological health status, hip range of motion (RoM), hip isometric strength, and hip function were assessed. Results A total of 69 controls and 69 patients with FAI were analyzed. Although sociodemographic characteristics were comparable between samples, poorer hip RoM, strength, and psychological health were found for the cases. FAI subtypes showed no significant pain intensity, psychological health, or RoM differences (except for hip adduction), but hip strength differed among FAI subtypes. Multiple significant correlations between psychological health, pain intensity, RoM, strength, and hip function were found. The variance values of the International Hip Outcome Tool, Hip Outcome Score (HOS) for daily living activities, and HOS for sports activities were partially explained (47.6%, 36.0%, and 21.6%, respectively) on the basis of kinesiophobia, hip strength, self-efficacy, and anxiety. Conclusion Patients with FAI showed poorer psychological health, hip RoM, and strength than individuals who were asymptomatic and had similar sociodemographic characteristics. FAI subtype influenced the patients' clinical presentations. Hip strength, kinesiophobia, anxiety, and self-efficacy should be targeted for improving hip function, as they have been demonstrated to be important contributors to hip disability. Impact This study demonstrated that pain catastrophizing, hip strength, and hip adduction differed among FAI subtypes. However, hip function and pain intensity were comparable between FAI subtypes. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is a highly common musculoskeletal condition and the leading cause of work absenteeism. This project aims to develop a medical test to help healthcare professionals decide on and assign physical treatment for patients with nonspecific LBP. The design uses machine learning (ML) models based on the classification of motion capture (MoCap) data obtained from the range of motion (ROM) exercises among healthy and clinically diagnosed patients with LBP from Imbabura–Ecuador. The following seven ML algorithms were tested for evaluation and comparison: logistic regression, decision tree, random forest, support vector machine (SVM), k-nearest neighbor (KNN), multilayer perceptron (MLP), and gradient boosting algorithms. All ML techniques obtained an accuracy above 80%, and three models (SVM, random forest, and MLP) obtained an accuracy of >90%. SVM was found to be the best-performing algorithm. This article aims to improve the applicability of inertial MoCap in healthcare by making use of precise spatiotemporal measurements with a data-driven treatment approach to improve the quality of life of people with chronic LBP. [ABSTRACT FROM AUTHOR]

Introduction: "Periarthritis" and "adhesive capsulitis" have been used synonymously with frozen shoulder. The condition known as "frozen shoulder," which has an unknown cause, is characterized by a delayed, spontaneous restoration of all shoulder joint movements to some extent or entirely over several months to a year. Various treatment methods have been employed to manage periarthritis shoulder, with varying outcomes. The Aim: To evaluate the functional outcomes and pain relief of periarthritis shoulder treated with intra-articular steroid injection and manipulation under anesthesia. Material and Methods: A prospective study was conducted on adults with periarthritis shoulder admitted, evaluated, and followed up on 30 periarthritis shoulder cases using intra-articular steroid injection and manipulation over three months. Results: In our study, most of the patients were females and elderly, with diabetics being more prone to periarthritis of the shoulder. The range of movements improved, and pain was relieved in all 30 patients. Excellent results were found in 26 cases (86.6%) by DASH Score criteria. Conclusion: Intra-articular steroid injection and manipulation of the shoulder in periarthritis shoulder with follow-up for 12 weeks resulted in the study finding a significant improvement in the range of shoulder movement, pain, and function in patients with shoulder periarthritis. Keywords: Periarthritis shoulder; intra-articular steroid injection; Range of movement.

Purpose: At our centre, we developed and implemented a video-based post-operative physiotherapy program for patients undergoing total knee arthroplasty (TKA). Our aims were to analyse and compare the outcomes of this program to in-person physiotherapy. Methods: We reviewed the outcomes of 112 patients and captured range-of-motion (ROM) measurements and pain scores (P4 questionnaire). We compared the outcomes to a cohort of 175 patients undergoing in-person therapy. Comparative analysis was performed using a two-tailed Student's t-test. Results: There was no significant difference between the two groups in age, sex, or initial post-operative knee ROM. On discharge from virtual physiotherapy, mean flexion was 122.6° (SD 7.6). There was no significant difference in improvement in knee flexion between the virtual and in-person groups (mean 30.6° vs 34.0°, p = 0.07). There was no significant difference in the proportion of patients achieving ≥ 120° of flexion (85.0% virtual vs 91.3% in-person, p = 0.11) or those achieving an extension deficit of ≤ 5° (96.0% vs 98.3%, p = 0.25). There was no difference in the number of PT visits to discharge (10.5 vs 11.1, p = 0.14) or final pain scores (12.4 vs 11.9, p = 0.61). Conclusion: Improvements in knee ROM measures are comparable between virtual and in-person physiotherapy with both groups achieving a good functional range. These findings have implications for the virtual delivery of healthcare, especially among remote populations and patients with mobility limitations. [ABSTRACT FROM AUTHOR]

The International Paralympic Committee has been promoting the development of evidence‐based classification to reduce the subjectivity in current decision‐making systems. The current study aimed to evaluate the validity of the impairment and performance tests for para‐alpine sit skiing classification, and whether cluster analysis of the measures would produce a valid classification structure. Thirty‐eight para‐alpine sit skiers with different disabilities completed seven tests. During these tests, isometric trunk strength, trunk muscle excitation, trunk range of movement (ROM), and simulated skiing performance (board tilt angle) were assessed. Correlations between the measures and the board tilt angle were calculated. To group athletes, K‐means cluster analysis was performed according to how much the impairment measures affected the board tilting. There were significant correlations between all measures and the maximal board tilt angle (r = 0.35–0.81, p < 0.05). The cluster analysis revealed that the introduction of ROM and muscle excitation was an effective supplement to strength measures in improving the classification accuracy (53%–79%). It produced four clusters with strong structures (mean silhouette coefficient = 0.81) and large and significant inter‐cluster differences in most measures and performance between clusters (p < 0.05). The cluster analysis produced classes comprising athletes with similar degrees of activity limitation. All tests reported can help establish a more transparent classification system for para‐alpine sit skiers. This study also provides a reference for evidence‐based classification systems in other Para sports. [ABSTRACT FROM AUTHOR]

Introduction. To investigate the test-retest and inter-rater reliability of a new protocol using the back range of motion instrument (BROM II) to measure the lumbar range of motion (LROM). Methods. Five raters and twenty healthy subjects participated in this study. Before the measurement, all raters and all subjects were asked to watch a 4-minute video clip demonstrating the rating method. The raters and the subjects were then asked to practice the testing protocol until they thoroughly understood it. The subjects were asked to move the lumbar spine in six directions, with consistent verbal instruction. The raters measured the subjects' LROM twice and were blinded to the data. The intraclass correlation coefficients were used to estimate the test-retest and inter-rater reliability of the LROM. Results. The results showed that the intra-rater reliability [ICC(3,1)] was good-to-excellent, ranging from 0.82 to 0.98, except for the LROM in the right rotation, which was moderate-to-good, ranging from 0.74 to 0.97. The inter-rater reliability [ICC(2,1)] was good-to-excellent, ranging from 0.78 to 0.87. Conclusion. The intra- and inter-rater reliability of this protocol in measuring LROM obtained by the BROM II were reliable and suitable for both teaching and research. [ABSTRACT FROM AUTHOR]

Capacitive and resistive electric transfer (TECAR) has emerged as a pain-free and non-invasive treatment modality, gaining popularity over the last two decades for addressing various acute and chronic painful conditions. Athletes often encounter anterior cruciate ligament (ACL) injuries. While successful reconstruction is achieved in 90% - 95% of cases, comprehensive rehabilitation is crucial for maximizing recovery and restoring athletes to their pre-injury levels. Aim: The study aimed to investigate the direct relationship between pain intensity, knee joint range of movement and functional disability of the lower limb using TECAR therapy in athletes after ACL reconstruction. Materials and methods: This cross-sectional study was conduced as a part of a randomized controlled trial involving 122 athletes (both male and female). Following a detailed analysis and comparison of the experimental group (EG, n = 61) and the control group (CG, n = 61), we focused on further examining the results of the EG patients and on determining whether there was any relationship between the measured variables and the functional recovery of the joint. EG subjects received TECAR therapy as a supplement to the rehabilitation program for ACL injury and subsequent surgery. The study monitored pain dynamics (Visual Analogue Scale - VAS), joint edema (in centimeters), range of movement (goniometry), flexor and extensor strength (Manual Muscle Testing - MMT) and Lower Extremity Functional Scale (LEFS). Assessment were conducted before and after the therapeutic course (comprising 20 procedures lasting 40 - 50 min each). The data were analyzed using SPSS version 26.0. Results: The Spearman's rho coefficient results for VAS, MMT, range of movement and LEFS varied. The strength of correlation between variables was generally weak but statistically significant (p < 0.05, 95% CI; 2-tailed) except for VAS and knee range of movement (ROM) of flexion (p > 0.05, 95% CI). Conclusions: Intragroup analysis revealed statistically significant differences compared to pretreatment in terms of pain, knee-ROM, muscular strength and functional disability (Wilcoxon test p < 0.05, 95% CI). For athletes after ACL reconstruction, TECAR therapy, when used in conjunction with conventional physical therapy, demonstrated a weak correlation between knee-ROM, LEFS and muscular strength. [ABSTRACT FROM AUTHOR]

To investigate the effects of providing rigid wrist-hand orthoses plus usual multidisciplinary care, on reducing hand impairments in children with cerebral palsy. A pragmatic, multicentre, assessor-blinded randomised controlled trial aimed to enrol 194 children aged 5–15 years, with wrist flexor Modified Ashworth Scale score ≥1. Randomisation with concealed allocation was stratified by study site and passive wrist range. The treatment group received a rigid wrist-hand orthosis, to wear ≥6 h per night for 3 years. Analysis included repeated measures mixed-effects linear regression models, using intention-to-treat principles. The trial stopped early due to insufficient recruitment: 74 children, across all Manual Ability Classification System levels, were randomised (n = 38 orthosis group; n = 36 control). Mean age was 10.2 (SD 3.1) years (orthosis group) and 9.1 (SD 2.8) years (control). Data showed some evidence that rigid wrist-hand orthosis impacted passive wrist extension with fingers extended in the first year [mean difference between-groups at 6 months: 13.15° (95%CI: 0.81–25.48°, p = 0.04); 12 months: 20.94° (95%CI: 8.20–33.69°, p = 0.001)]. Beyond 18 months, participant numbers were insufficient for conclusive findings. The study provided detailed data about short- and long-term effects of the wrist-hand orthosis and highlighted challenges in conducting large randomised controlled trials with this population. Trial Registration: Australia and New Zealand Clinical Trials Registry: U1111-1164-0572 There may be incremental benefit, for children with cerebral palsy, at 6 and 12 months on passive wrist range from wearing a rigid wrist-hand orthosis designed according to this protocol. The rigid-wrist-hand orthosis evaluated in this study, which allowed for some tailoring for individual children's presentations, differed in design from past recommendations for "resting hand" positioning. Longitudinal follow up of children with cerebral palsy prescribed a rigid wrist-hand orthosis is essential to monitor any benefit. Minor adverse events were commonly experienced when wearing the orthosis and should be discussed prior to prescription of a rigid wrist-hand orthosis. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore if specific hip and knee range-of-movement (ROM) tests can predict a risk factor for hamstring strain (HS) injury in male and female soccer players. Methods: One hundred amateur soccer players (56 men and 44 women) performed six tests to determine hip and knee ROM: straight leg raise test (SLR), modified Thomas test (TT), hip internal and external rotation (ER), hip abduction and adduction, Nachlas test and Ridge test. A logistic regression analysis was carried out to create a predictive model for HS injuries. Results: The percentage of HS injury was 20.45% and 30.35%, for female and male players. The logistic regression showed a significant model for both genders on the logit of suffering an HS injury with active-SLR and TT variables for females (R2CS = 0.491; R2N = 0.771) and active SLR and ER variables for males (R2CS = 0.623; R2N = 0.882). The predictive models correctly classify 95.5% and 94.6% of cases presenting good sensitivity (77.8% and 88.2%) and full (100%) and high (97.4%) specificity respectively. Furthermore, female players showed a greater ROM than males (p ≤ 0.01). Conclusion: Both female and male soccer players that suffered a HS injury had lower ROM in SLR, NT and RT and higher ROM in the TT that non-injured players. The tests that most likely predict HS injury are SLR and TT in females and SLR and ER in males. Thus, it is suggested to including specific exercises in amateur soccer players training programs to improve hip and knee ROM for injury prevention. [ABSTRACT FROM AUTHOR]

Background: Platelet concentrate has become an increasingly popular alternative source of growth factors for several types of dental and surgical procedures. It improves healing and stimulates cell proliferation, matrix remodeling, and angiogenesis. The injectable platelet-rich fibrin (i-PRF) has various advantages over platelet-rich plasma (PRP). The aim of our study was to evaluate the efficacy of intra-articular injections of i-PRF versus PRP in the management of temporomandibular disorders (TDMs). Method: The prospective randomized study involved 14 patients (N = 28 joints) of internal derangement between the age groups of 20 to 50 years divided randomly into two groups with seven patients (N = 14 joints) in each group. For all the patients, arthrocentesis was carried out in the first sitting followed by intra-articular injections of PRP and i-PRF in group I and group II, respectively, at 1-month interval for 6 months. A single surgeon has performed the procedure. All patients were assessed clinically for pain, maximal mouth opening (MMO), lateral movement, protrusive movement, and joint sounds and radiographically for disc position and joint effusion (JE). Results: Pain reduction, MMO, lateral movement, protrusive movement, and joint sounds were significant in both groups with more significance in group II. Disc position had improved toward normal in both groups and showed significant changes in both groups at the 9-month follow-up with better results in group II. Conclusion: PRP and i-PRF injections are regarded as simple and safe methods with potential beneficial effects and are cost-effective. In this preliminary study, i-PRF has been found to be scoring better in terms of efficacy over PRP across all set parameters. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the efficacy of an active exercise physiotherapy programme versus an exercise for well-being programme improving muscle strength, range of movement, respiratory capacity and quality of life of women with fibromyalgia. A randomized, assessor-blind, controlled trial was conducted. A total of 141 women diagnosed with fibromyalgia were randomized to a physiotherapy exercise group (n = 47), an exercise for well-being group (n = 47) and a control group (n = 47). The study lasted 4 weeks and the experimental groups received 45 min sessions performed twice a week on alternate days. The primary outcome measures were range of movement and muscle strength. The secondary outcome measures were respiratory capacity and quality of life. The results showed statistically significant improvements in the exercise for well-being and physiotherapy groups vs. the control group at week 5 in relation to joint range of movement (p = 0.004), muscle strength (p = 0.003) and quality of life (p = 0.002). The changes found in all the spirometry parameters seem to be associated to some of the changes in joint range of movement and muscle strength as well as quality of life. Physiotherapy and exercise for well-being improved upper limb and lower limb range of movement and the muscle strength of women with fibromyalgia. [ABSTRACT FROM AUTHOR]

Coaches within the same sport often have varying methods to achieve performance outcomes, and, therefore, it is crucial to understand their performance model to maximise the impact of strength and conditioning (S&C) support. Having a deliberate approach for understanding the demands of a sport from a sports coach's lens and aligning S&C support to the coaches' performance model rather than utilising a generic needs analysis to guide S&C support is vital to provide impactful S&C support. The multi-disciplinary team (MDT) may also play a pivotal role in providing insight into various aspects of performance beyond a generic needs analysis. It is to the S&C coaches' advantage to utilise the expertise of the MDT. Finally, the S&C coach must develop a technical framework that consists of avenues of impact or objectives for S&C support and demonstrates how biomotor qualities developed within the S&C programme may support determinants of performance and technical models for key sporting actions, in line with the coaches' performance principles. The current paper aims to utilise the authors' experience of working with the head coach of two national rowing performance programmes over the last three Olympic cycles, with specific reference to the preparation for the 2020 Tokyo Olympic games to articulate a philosophical approach for aligning S&C support to a coach's performance model. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is a highly common musculoskeletal condition and the leading cause of work absenteeism. This project aims to develop a medical test to help healthcare professionals decide on and assign physical treatment for patients with nonspecific LBP. The design uses machine learning (ML) models based on the classification of motion capture (MoCap) data obtained from the range of motion (ROM) exercises among healthy and clinically diagnosed patients with LBP from Imbabura–Ecuador. The following seven ML algorithms were tested for evaluation and comparison: logistic regression, decision tree, random forest, support vector machine (SVM), k-nearest neighbor (KNN), multilayer perceptron (MLP), and gradient boosting algorithms. All ML techniques obtained an accuracy above 80%, and three models (SVM, random forest, and MLP) obtained an accuracy of >90%. SVM was found to be the best-performing algorithm. This article aims to improve the applicability of inertial MoCap in healthcare by making use of precise spatiotemporal measurements with a data-driven treatment approach to improve the quality of life of people with chronic LBP.

Objective: Elbow flexion contractures are common complications of neonatal brachial plexus palsy, but evidence on how to treat these contractures is weak. This study compared the treatment of elbow flexion contractures using a dynamic orthosis or serial circular casting. Methods: A randomized controlled trial was conducted with one-year follow-up. Children with an elbow flexion contracture of ≥30° were treated with either a night-worn dynamic orthosis for one year or serial casting for four weeks followed by night splinting. For pragmatic reasons, some participants were included in an open part of this study, this group was also analyzed separately. Degree of contracture and goal attainment scaling was evaluated at baseline and after 8, 20 and 54 weeks. Results: 55 patients were analyzed in this trial, 32 of whom were randomized to treatment. At one-year follow-up of the randomized group, both dynamic splinting (median −8.5°, interquartile range [IQR] −13.5, −5) and serial casting (median −11.0°, IQR −16, −5) resulted in significant reduction of contracture (P < 0. 001). The reduction was significantly greater with serial casting in the first 20 weeks, but not at one-year follow-up (P = 0.683). In the entire cohort, the individual functional goals had been reached in 24 out of 32 cases (80%) of dynamic splinting and 18 out of 23 cases (82%) of serial casting, respectively. Conclusion: The dynamic night orthosis is comparable to serial casting for treating elbow flexion contractures in children with brachial plexus birth injury. We recommend selecting one of these treatment modalities in close consultation with parents and patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to review the tests used to measure flexibility in gymnastic disciplines. The search was conducted on PubMed, WOS, Scopus, Sport Discus and Google Scholar databases, and included studies in English and Spanish that assessed flexibility in gymnasts and were published between January 2005 and March 2020. Twenty-seven manuscripts were selected, rhythmic and women’s artistic gymnastics being the most frequently studied disciplines. Flexibility was most commonly assessed in the hip and shoulder joints. Within the wide variety of tests performed, the most commonly used ones were the split, shoulder flexibility, bridge and sit-and-reach tests. Linear measurements were usually used, followed by the angular ones. In conclusion, in spite of flexibility being a determining capacity in gymnastic disciplines, several studies did not provide information on the validity of their results. Further studies including validated tests applied to larger samples and using longitudinal approaches are needed, with the aim to confirm test predictive validity and to allow for greater generalisation.

Manipulating resistance training variables is crucial to plan the induced stimuli correctly. When reporting the exercise variables in resistance training protocols, sports scientists and practitioners often refer to the load lifted and the total number of repetitions. The present conceptual review explores all within-exercise variables that may influence the strength and hypertrophic gains, and the changes in muscle architecture. Together with the (1) load and (2) the number of repetitions, (3) performing repetitions to failure or not to failure, (4) the displacement of the load or the range of movement (full or partial), (5) the portion of the partial movement to identify the muscle length at which the exercise is performed, (6) the total time under tension, the duration of each phase and the position of the two isometric phases, (7) whether the concentric, eccentric or concentric-eccentric phase is performed, (8) the use of internal or external focus and (9) the inter-set rest may all have repercussions on the adaptations induced by each resistance exercise. Manipulating one or more variable allows to increase, equalize or decrease the stimuli related to each exercise. Sports scientists and practitioners are invited to list all aforementioned variables for each exercise when reporting resistance training protocols. [ABSTRACT FROM AUTHOR]

Background: Water-polo is the water sport with the highest incidence of injuries, with shoulder pain being the most common one. The understanding of risk factors and guidance on preventive measures is essential in this sport discipline. The aim of this study was to determine the effects of a specific 6-week training plan on range of motion (ROM) and joint strength levels in a group of professional water-polo players. Methods: Quasi-experimental study with a sample of 28 participants (age: 20.1 ± 2.5 years; height: 176.9 ± 6.2 cm; body mass: 74.6 ± 8.1 kg). Three study groups, which consisted of one control group and two experimental groups, were established. Two repeated measurements, pre and post intervention, were performed. During these measurements, ROM of the glenohumeral joint was analyzed both in external (ER) and internal (IR) rotation, as well as the maximal isometric strength. Conclusions: The application of a training program improved glenohumeral joint ROM. ER and IR evolve differently in both shoulders. ER improved only in the throwing arm only in the group undergoing intervention but for the non-dominant side, improvements were observed in both ER and IR, regardless of whether or not they had followed the intervention plan. No improvements were observed in either the isometric strength or contralateral asymmetries. [ABSTRACT FROM AUTHOR]

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Abstract Background This study was to evaluate and compare the biomechanical features of multilevel lateral lumbar interbody fusion (LLIF) with or without supplemental instrumentations. Methods Six human lumbar specimens were tested under multidirectional nondestructive moments (7.5 N·m), with a 6 degree-of-freedom spine simulator. The overall and intervertebral range of motion (ROM) were measured optoelectronically. Each specimen was tested under the following conditions at L2–5 levels: intact; stand-alone; cage supplemented with lateral plate (LP); cage supplemented with unilateral or bilateral pedicle screw/rod (UPS or BPS). Results Compared with intact condition, the overall and intersegmental ROM were significantly reduced after multilevel stand-alone LLIF. The ROM was further reduced after using LP instrumentation. In flexion-extension (FE) and axial rotation (AR), pedicle screw/rod demonstrated greater overall ROM reduction compared to LP (P

Aims: This systematic review examines the available evidence on the use of medical stretching devices to treat knee arthrofibrosis, it suggests a focus for future studies addressing limitations in current research and identifies gaps in the published literature to facilitate future works. Materials and methods: Articles were identified using the Cochrane Library, MEDLINE, PubMed and SCOPUS databases. Articles from peer reviewed journals investigating the effectiveness of medical stretching devices to increase range of movement when treating arthrofibrosis of the knee were included. Results: A total of 13 studies (558 participants) met the inclusion criteria with the devices falling into the following categories; CPM, load control or displacement control stretching devices. A statistically significant increase in range of movement was demonstrated in CPM, load-control and displacement-control studies (p ​

(1) Objective: to analyze current active noninvasive measurement systems of the thoracic range of movements of the spine. (2) Methods: A systematic review and meta-analysis were performed that included observational or clinical trial studies published in English or Spanish, whose subjects were healthy human males or females ≥18 years of age with reported measurements of thoracic range of motion measured with an active system in either flexion, extension, lateral bending, or axial rotation. All studies that passed the screening had a low risk of bias and good methodological results, according to the PEDro and MINORS scales. The mean values and 95% confidence interval of the reported measures were calculated for different types of device groups. To calculate the differences between the type of device measures, studies were pooled for different types of device groups using Review Manager software. (3) Results: 48 studies were included in the review; all had scores higher than 7.5 over 10 on the PEDro and MINORs methodological rating scales, collecting a total of 2365 healthy subjects, 1053 males and 1312 females; they were 39.24 ± 20.64 years old and had 24.44 ± 3.81 kg/m2 body mass indexes on average. We summarized and analyzed a total of 11,892 measurements: 1298 of flexoextension, 1394 of flexion, 1021 of extension, 491 of side-to-side lateral flexion, 637 of right lateral flexion, 607 of left lateral flexion, 2170 of side-to-side rotation, 2152 of right rotation and 2122 of left rotation. (4) Conclusions: All collected and analyzed measurements of physiological movements of the dorsal spine had very disparate results from each other, the cause of the reason for such analysis is that the measurement protocols of the different types of measurement tools used in these measurements are different and cause measurement biases. To solve this, it is proposed to establish a standardized measurement protocol for all tools. [ABSTRACT FROM AUTHOR]

Background: Outcome reporting following flexor tendon repair has historically concentrated on range of movement. Recently, there has been an increase in the use of patient-reported outcome measures (PROMs). At present, there is no agreed set of outcomes to report following flexor tendon repair. The aim of this study is to review outcome reporting practices after flexor tendon repair in zones 1 and 2. Methods: A search of Ovid MEDLINE, Ovid EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) between 1 January 1980 and 31 December 2019 was performed to identify the studies that reported outcomes following the repair of flexor tendons in zones 1 and 2. Study characteristics and data with regard to the reporting of eight outcome domains was extracted: functional outcome (quantitative), functional outcome (subjective), activities of daily living (ADL), satisfaction/quality of life, post-treatment recovery, resources, aesthetics and safety. Results: A total of 94 out of 4,118 articles identified were included in the review. All studies reported range of motion using 17 different methods of measurement. Eleven studies defined measurement methods incorrectly or unclearly. Only 16 studies reported PROMs, with only one reporting data on assessment of quality of life. Eighteen studies reported time away from employment. Minimal data on resource utilisation and aesthetics were included. Conclusion: This review highlights wide heterogeneity and paucity of data reporting clinical outcomes of flexor tendon surgery. The development of a core outcome set that would ensure essential outcomes are correctly defined, measured and reported is required. Level of Evidence: Level IV (Prognostic) [ABSTRACT FROM AUTHOR]

Introduction: Osteoarthritis (OA) of the knee is a debilitating old age disease causing pain and restriction in movement. Proximal Fibular Osteotomy (PFO) can be a novel surgical technique which may provide an increase in the joint space and balance the load bearing of the knee joint. The present study was conducted to determine the outcomes of this surgical technique in patients with OA of the knee. The findings may motivate many practicing orthopaedicians to undertake this surgical technique and thereby, impart better quality of life to such patients. Aim: To assess the outcome in terms of medial joint space, lateral joint space, tibiofemoral angle and range of movement of medial compartment decompression by fibular osteotomy in medial compartment knee OA. Materials and Methods: This retrospective study was conducted in the Postgraduate Department of Orthopaedics, Government Medical College, Jammu, India, from November 2018 to October 2019, on 30 adult patients (both genders) aged 40-60 years who had moderate to severe symptomatic medial compartment knee OA. Patients who had rheumatoid arthritis, post-traumatic arthritis, congenital lower extremities defects, infections in joints, presence of ligament/meniscus injury, and those with abnormality in the lateral compartment were excluded. Preoperatively and postoperatively, medial joint space, lateral joint space, tibiofemoral angle and range of movement were assessed and compared. The p-value <0.05 was taken as statistically significant. Results: A total of 30 patients were enrolled in the study, 18 (60%) were males, and 12 (40%) were females. Compared to preoperative values, postoperatively there was a significant increase in medial joint space (1.3±0.7 vs 5.2±0.9 mm, p-value <0.01), significant decrease in lateral joint space (6.9±0.3 mm vs 5.7±0.2 mm, p-value <0.01), significant decrease in tibiofemoral angle (180.7±1.02 vs 178.13±0.97, p-value <0.01) and significant increase in range of movement (135.36±1.06 degrees vs 137.6±1.02 degrees postoperatively, p-value <0.01). The median duration of follow-up for the patients were six months. Conclusion: Proximal fibular osteotomy can be suitably applied in the clinical practice for OA of the knee joint and it can give prolonged beneficial outcomes for the patients. [ABSTRACT FROM AUTHOR]

This study aimed to examine the progression of large joint involvement from early to established RA in terms of range of movement (ROM) and time to joint surgery, according to the presence of rheumatoid factor (RF). We used a historical longitudinal cohort of early RA patients. Patients were deemed RF negative if all repeated assessments were negative. The rate of progression from normal to any loss of range of movement (ROM) from years 3 to 14 were modelled using generalized estimating equations, for elbows, wrists, hips, knees and ankle, adjusting for confounders. Time to joint surgery was analysed using multivariable Cox models. A total of 1458 patients were included (66% female, mean age 55 years) and 74% were RF-positive. The prevalence of any loss of ROM, from year 3 through to 14 was highest in the wrist followed by ankle, knee, elbow and hip. Odds of loss of ROM increased over time in all joint regions assessed, at around 7–13% per year from year 3 to 14. Time to surgery was similar according to RF-status for the wrist and ankle, but RF-positive cases had a lower hazard of surgery at the elbow (HR 0.37, 0.15–0.90), hip (HR 0.69, 0.48–0.99) and after 10 years at the knee (HR 0.41, 0.25–0.68). Large joints become progressively involved in RA, most frequently affecting the wrist followed by ankle, which is overlooked in composite disease activity indices. RF-negative and positive cases progressed similarly. Treat-to-target approaches should be followed irrespective of RF status. [ABSTRACT FROM AUTHOR]

Introduction: Osteoarthritis (OA) of the knee is a debilitating old age disease causing pain and restriction in movement. Proximal Fibular Osteotomy (PFO) can be a novel surgical technique which may provide an increase in the joint space and balance the load bearing of the knee joint. The present study was conducted to determine the outcomes of this surgical technique in patients with OA of the knee. The findings may motivate many practicing orthopaedicians to undertake this surgical technique and thereby, impart better quality of life to such patients. Aim: To assess the outcome in terms of medial joint space, lateral joint space, tibiofemoral angle and range of movement of medial compartment decompression by fibular osteotomy in medial compartment knee OA. Materials and Methods: This retrospective study was conducted in the Postgraduate Department of Orthopaedics, Government Medical College, Jammu, India, from November 2018 to October 2019, on 30 adult patients (both genders) aged 40-60 years who had moderate to severe symptomatic medial compartment knee OA. Patients who had rheumatoid arthritis, post-traumatic arthritis, congenital lower extremities defects, infections in joints, presence of ligament/meniscus injury, and those with abnormality in the lateral compartment were excluded. Preoperatively and postoperatively, medial joint space, lateral joint space, tibiofemoral angle and range of movement were assessed and compared. The p-value

The aim of this study was to review the tests used to measure flexibility in gymnastic disciplines. The search was conducted on PubMed, WOS, Scopus, Sport Discus and Google Scholar databases, and included studies in English and Spanish that assessed flexibility in gymnasts and were published between January 2005 and March 2020. Twenty-seven manuscripts were selected, rhythmic and women's artistic gymnastics being the most frequently studied disciplines. Flexibility was most commonly assessed in the hip and shoulder joints. Within the wide variety of tests performed, the most commonly used ones were the split, shoulder flexibility, bridge and sit-and-reach tests. Linear measurements were usually used, followed by the angular ones. In conclusion, in spite of flexibility being a determining capacity in gymnastic disciplines, several studies did not provide information on the validity of their results. Further studies including validated tests applied to larger samples and using longitudinal approaches are needed, with the aim to confirm test predictive validity and to allow for greater generalisation. [ABSTRACT FROM AUTHOR]

Introduction: Trunk function assessment is considered a key factor for the development of evidence-based classification process in wheelchair athletes. Thus, the aim of this study was to determine the intra-session reliability of two kinematic analysis tools (2D video analysis measure and an inclinometer mobile application) that could be used by classifiers to detect trunk range of movement (ROM) impairment in wheelchair athletes. Material and methods: Sixteen wheelchair athletes and six non-disabled participants (CG) were recruited for this study. Wheelchair athletes were dividing according to the origin of their eligible physical impairment in a neurological impairment group (ANI, n=7) and an impaired muscle power group (IMP, n=9). ROM was assessed in sagittal and coronal plane movements. Results: High-excellent relative intra-session reliability scores were found for trunk ROM measures for all participants (0.87 < ICC < 0.99). Significantly lower ROM values were observed in wheelchair athletes compared to CG, with the exception of the trunk flexion tilt movement measured by the 2D video analysis in the IMP group and the trunk extension tilt movement measured by the inclinometer app in the ANI group. Conclusion: 2D video analysis showed good intra-session reliability in the assessment of trunk ROM, while high intra-subject variability was observed when using the inclinometer app. The proposed tools may help classifiers to detect trunk ROM impairment at different levels in wheelchair athletes with different health conditions being the inclinometer app more interesting to detect lower back trunk impairment.

Background: Nowadays, there is a lack of consensus and high controversy about the most effective range of motion (ROM) to minimize the risk of injury and maximize the resistance training adaptations. Objective: To conduct a systematic review and meta‐analysis of the scientific evidence examining the effects of full and partial ROM resistance training interventions on neuromuscular, functional, and structural adaptations. Methods: The original protocol (CRD42020160976) was prospectively registered in the PROSPERO database. Medline, Scopus, and Web of Science databases were searched to identify relevant articles from the earliest record up to and including March 2021. The RoB 2 and GRADE tools were used to judge the level of bias and quality of evidence. Meta‐analyses were performed using robust variance estimation with small‐sample corrections. Results: Sixteen studies were finally included in the systematic review and meta‐analyses. Full ROM training produced significantly greater adaptations than partial ROM on muscle strength (ES = 0.56, p = 0.004) and lower‐limb hypertrophy (ES = 0.88, p = 0.027). Furthermore, although not statistically significant, changes in functional performance were maximized by the full ROM training (ES = 0.44, p = 0.186). Finally, no significant superiority of either ROM was found to produce changes in muscle thickness, pennation angle, and fascicle length (ES = 0.28, p = 0.226). Conclusion: Full ROM resistance training is more effective than partial ROM to maximize muscle strength and lower‐limb muscle hypertrophy. Likewise, functional performance appears to be favored by the use of full ROM exercises. On the contrary, there are no large differences between the full and partial ROM interventions to generate changes in muscle architecture. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective comparison of the surgical outcome after cervical laminoplasty for cervical spondylotic myelopathy (CSM) using a modified K-line based on lordosis in neck extension as a predictor: in K-line Back CSM (KB group), the K-line crosses the ventral edge of any of the spinous processes, whereas in K-line Front CSM (KF group), the K-line does not.Objective: To investigate the neurological and radiological outcomes 5 years after surgery and the contact between the spinal cord and posterior elements after laminoplasty for CSM using the modified K-line.Summary Of Background Data: No indicators on a lateral radiograph can predict the neurological outcome after laminoplasty for CSM.Methods: Patients with CSM were divided into KB (n = 20) and KF groups (n = 13). We compared the postoperative Japanese Orthopedic Association (JOA) score, recovery rate, grip-and-release and foot-tapping test results, alignment, and contact between the spinal cord and posterior elements between the two groups.Results: The postoperative JOA score and its recovery rate were significantly lower in the KB group (12.4 points and 34.1%, respectively) than in the KF group (14.1 points and 59.0%, respectively) at final follow-up (P = 0.0415 and 0.0458). The grip-and-release and foot-tapping test results improved significantly in the KF group but not in the KB group. In the KB group, a larger lordotic angle in extension at 1 year postoperatively continued until final follow-up. The rate of recovery of the JOA score in patients with contacts at both C4/5 and C5/6 and any contact in the KB group (-1.5% and 31.9%, respectively) were lower (P = 0.0013 and 0.0534, respectively) than those in the KF group (58.6% and 60.7%, respectively).Conclusion: The K-line Back predicts a poor neurological outcome after laminoplasty for CSM. Decompression with fusion may be recommended for these patients.Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

The present study aims to create a patient-specific hand model to simulate the passive rehabilitation on the index finger, quantifying the flexor digitorum profundus (FDP) tendon excursion and the stress experienced during simulated flexion. The computational model used in this analysis was created from an unknown patient dataset available in the Embodi3d online library. The segmentation, three-dimensional reconstruction, and modeling of the structures involved were performed using Materialise Mimics and Rhino3D. The FDP tendon excursion and stress values present in the model were calculated in the ANSYS environment. Based on the finite-element simulation, the FDP tendon presents an excursion of 10.1 mm during passive postoperative flexion. The highest-stress values were observed between the pulleys-FDP tendon contact surfaces. In particular, the pulley A1 exhibited the máximum principal stress of the model with a 58.7 MPa. The pulley A3 showed the same stress distribution pattern that A1 Pulley, but with the lowest values. The FDP Tendon excursión obtained is consistent with the results reported in the literature, which vary from 8 to 11 mm. The stress values found in the model explain the importance of the pulley mechanism keeping the FDP tendon attached to the finger bone during the range of motion experienced. The silico model proposed may potentially be used in the assessment of new medical device proposals in the field of hand reconstructive surgery.

The present study aims to create a patient-specific hand model to simulate the passive rehabilitation on the index finger, quantifying the flexor digitorum profundus (FDP) tendon excursion and the stress experienced during simulated flexion. The computational model used in this analysis was created from an unknown patient dataset available in the Embodi3d online library. The segmentation, three-dimensional reconstruction, and modeling of the structures involved were performed using Materialise Mimics and Rhino3D. The FDP tendon excursion and stress values present in the model were calculated in the ANSYS environment. Based on the finite-element simulation, the FDP tendon presents an excursion of 10.1 mm during passive postoperative flexion. The highest-stress values were observed between the pulleys-FDP tendon contact surfaces. In particular, the pulley A1 exhibited the maximum principal stress of the model with a 58.7 MPa. The pulley A3 showed the same stress distribution pattern that A1 Pulley, but with the lowest values. The FDP Tendon excursion obtained is consistent with the results reported in the literature, which vary from 8 to 11 mm. The stress values found in the model explain the importance of the pulley mechanism keeping the FDP tendon attached to the finger bone during the range of motion experienced. The silico model proposed may potentially be used in the assessment of new medical device proposals in the field of hand reconstructive surgery. [ABSTRACT FROM AUTHOR]

Trunk function assessment is considered a key factor for the development of evidencebased classification process in wheelchair athletes. Thus, the aim of this study was to determine the intra-session reliability of two kinematic analysis tools (2D video analysis measure and an inclinometer mobile application) that could be used by classifiers to detect trunk range of movement (ROM) impairment in wheelchair athletes. Sixteen wheelchair athletes and six nondisabled participants (CG) were recruited for this study. Wheelchair athletes were dividing according to the origin of their eligible physical impairment in a neurological impairment group (ANI, n=7) and an impaired muscle power group (IMP, n=9). ROM was assessed in sagittal and coronal plane movements. High-excellent relative intra-session reliability scores were found for trunk ROM measures for all participants (0.87 < ICC < 0.99). Significantly lower ROM values were observed in wheelchair athletes compared to CG, with the exception of the trunk flexion tilt movement measured by the 2D video analysis in the IMP group and the trunk extension tilt movement measured by the inclinometer app in the ANI group. 2D video analysis showed good intra-session reliability in the assessment of trunk ROM, while high intra-subject variability was observed when using the inclinometer app. The proposed tools may help classifiers to detect trunk ROM impairment at different levels in wheelchair athletes with different health conditions being the inclinometer app more interesting to detect lower back trunk impairment. [ABSTRACT FROM AUTHOR]

The objective of the present study was to analyze the differences in muscle flexibility profile according to sex in elite futsal players. A total of 22 players (12 men, 10 women) were assessed using the basic version of the ROM-SPORT protocol following the recommendations established by the American Medical Association. A descriptive analysis of the values of the ten movements evaluated was performed. A t-test for independent samples was applied to observe the existence of significant differences between sexes. Statistical analysis found significant differences in the range of motion (ROM) of the internal rotation of the hip, the ROM of the external rotation of the hip, the ROM of the hip abduction, the ROM of abduction of the hip with it flexed, in the ROM of the hip extension and in the ROM of the knee flexion. Elite male futsal players have higher flexibility values than female players of the same sport and competitive level in the adductor, ilio-psoas and quadriceps muscles. By contrast, female futsal players have higher values in the rotator muscles of the hip.

Abstract Background Patients with non-operated traumatic primary anterior shoulder dislocation (PASD) are assumed to have less shoulder impairment than patients with recurrent anterior shoulder dislocations (RASD). This may impact treatment decision strategy. The aim was to study whether patients with non-operated traumatic PASD have less shoulder impairment than those with RASD. Methods In a cross-sectional study baseline data from patients with PASD and RASD in a randomised controlled trial of non-operative shoulder exercise treatment were used. Shoulder function was self-reported (Western Ontario Shoulder Instability (WOSI), Tampa Scale of Kinesiophobia (TSK), General Health (EQ-5D-VAS), Numeric Pain Rating Scale (NPRS)), and measured (Constant-Murley shoulder Score (CMS total), CMS - Range of Motion (CMS-ROM, CMS – strength, proprioception, clinical tests). Results In total, 56 patients (34 (28 men) with PASD and 22 (21 men) with RASD) (mean age 26 years) participated. WOSI total was 1064 and 1048, and TSK above 37 (indicating high re-injury fear) was present in 33 (97%) and 21 (96%) of the groups with PASD and RASD, with no group difference. CMS total (66.4 and 70.4), CMS-ROM (28.7 and 31.5), CMS-strength (injured shoulder: 7.6 kg and 9.1 kg), proprioception and clinical tests were the same. Furthermore, 26 (76%) with PASD and 13 (59%) with RASD reported not to have received non-operative shoulder treatment. Conclusions Non-operated patients with PASD and self-reported shoulder trouble three-six weeks after initial injury do not have less shoulder impairment (self-reportedly or objectively measured) than non-operated patients RASD and self-reported shoulder trouble three-six weeks after their latest shoulder dislocation event.

Background: Water-polo is the water sport with the highest incidence of injuries, with shoulder pain being the most common one. The understanding of risk factors and guidance on preventive measures is essential in this sport discipline. The aim of this study was to determine the effects of a specific 6-week training plan on range of motion (ROM) and joint strength levels in a group of professional water-polo players. Methods: Quasi-experimental study with a sample of 28 participants (age: 20.1 ± 2.5 years; height: 176.9 ± 6.2 cm; body mass: 74.6 ± 8.1 kg). Three study groups, which consisted of one control group and two experimental groups, were established. Two repeated measurements, pre and post intervention, were performed. During these measurements, ROM of the glenohumeral joint was analyzed both in external (ER) and internal (IR) rotation, as well as the maximal isometric strength. Conclusions: The application of a training program improved glenohumeral joint ROM. ER and IR evolve differently in both shoulders. ER improved only in the throwing arm only in the group undergoing intervention but for the non-dominant side, improvements were observed in both ER and IR, regardless of whether or not they had followed the intervention plan. No improvements were observed in either the isometric strength or contralateral asymmetries.

Background: This study was to evaluate and compare the biomechanical features of multilevel lateral lumbar interbody fusion (LLIF) with or without supplemental instrumentations.Methods: Six human lumbar specimens were tested under multidirectional nondestructive moments (7.5 N·m), with a 6 degree-of-freedom spine simulator. The overall and intervertebral range of motion (ROM) were measured optoelectronically. Each specimen was tested under the following conditions at L2-5 levels: intact; stand-alone; cage supplemented with lateral plate (LP); cage supplemented with unilateral or bilateral pedicle screw/rod (UPS or BPS).Results: Compared with intact condition, the overall and intersegmental ROM were significantly reduced after multilevel stand-alone LLIF. The ROM was further reduced after using LP instrumentation. In flexion-extension (FE) and axial rotation (AR), pedicle screw/rod demonstrated greater overall ROM reduction compared to LP (P < 0.01), and bilateral greater than unilateral (P < 0.01). In lateral bending (LB), BPS demonstrated greater overall ROM reduction compared to UPS and LP (P < 0.01), however, UPS and LP showed similar reduction (P = 0.245). Intervertebral ROM reductions showed similar trend as the overall ones after using different types of instrumentation. However, at L2/3 (P = 0.57) and L3/4 (P = 0.097) levels, the intervertebral ROM reductions in AR were similar between UPS and LP.Conclusions: The overall and intervertebral stability increased significantly after multilevel LLIF with or without supplemental instrumentation. BPS provided the greatest stability, followed by UPS and LP. However, in clinical practice, less invasive adjunctive fixation methods including UPS and LP may provide sufficient biomechanical stability for multilevel LLIF. [ABSTRACT FROM AUTHOR]

Despite signs of facial nerve recovery within a few months following face transplantation, speech deficits persist for years. Behavioral speech modifications (e.g., slower-than-normal speaking rate and increased loudness) have shown promising potential to enhance speech intelligibility in populations with dysarthric speech. However, such evidence-based practice approach is lacking in clinical management of speech in individuals with facial transplantation. Because facial transplantation involves complex craniofacial reconstruction and facial nerve coaptation, it is unknown to what extent individuals with face transplant are capable of adapting their motor system to task-specific articulatory demands. The purpose of this study was to identify the underlying articulatory mechanisms employed by individuals with face transplantation in response to speech modification cues at early and late stages of neuromotor recovery. In addition, we aimed to identify speech modifications that conferred improved speech clarity. Participants were seven individuals who underwent full or partial facial vascularized composite allografts that included lips and muscles of facial animation and were in early (~2 months) or late (~42 months) stages of recovery. Participants produced repetitions of the sentence “Buy Bobby a puppy” in normal, fast, loud, and slow speech modifications. Articulatory movement traces were recorded using a 3D optical motion capture system. Kinematic measures of average speed (mm/s) and range of movement (mm3) were extracted from the lower lip (± jaw) marker. Two speech language pathologists rated speech clarity for each speaker using a visual analog scale (VAS) approach. Results demonstrated that facial motor capacity increased from early to late stages of recovery. While individuals in the early group exhibited restricted capabilities to adjust their motor system based on the articulatory demands of each speech modification, individuals in the late group demonstrated faster speed and larger-than-normal range of movement for loud speech, and slower speed and larger-than-normal range of movement for slow speech. In addition, subjects in both groups showed overreliance on jaw rather than lip articulatory function across all speech modifications, perhaps as a compensatory strategy to optimize articulatory stability and maximize speech function. Finally, improved speech clarity was associated with loud speech in both stages of recovery.

(1) Objective: to analyze current active noninvasive measurement systems of the thoracic range of movements of the spine. (2) Methods: A systematic review and meta-analysis were performed that included observational or clinical trial studies published in English or Spanish, whose subjects were healthy human males or females ≥18 years of age with reported measurements of thoracic range of motion measured with an active system in either flexion, extension, lateral bending, or axial rotation. All studies that passed the screening had a low risk of bias and good methodological results, according to the PEDro and MINORS scales. The mean values and 95% confidence interval of the reported measures were calculated for different types of device groups. To calculate the differences between the type of device measures, studies were pooled for different types of device groups using Review Manager software. (3) Results: 48 studies were included in the review; all had scores higher than 7.5 over 10 on the PEDro and MINORs methodological rating scales, collecting a total of 2365 healthy subjects, 1053 males and 1312 females; they were 39.24 ± 20.64 years old and had 24.44 ± 3.81 kg/m2 body mass indexes on average. We summarized and analyzed a total of 11,892 measurements: 1298 of flexoextension, 1394 of flexion, 1021 of extension, 491 of side-to-side lateral flexion, 637 of right lateral flexion, 607 of left lateral flexion, 2170 of side-to-side rotation, 2152 of right rotation and 2122 of left rotation. (4) Conclusions: All collected and analyzed measurements of physiological movements of the dorsal spine had very disparate results from each other, the cause of the reason for such analysis is that the measurement protocols of the different types of measurement tools used in these measurements are different and cause measurement biases. To solve this, it is proposed to establish a standardized measurement protocol for all tools.

Despite signs of facial nerve recovery within a few months following face transplantation, speech deficits persist for years. Behavioral speech modifications (e.g., slower-than-normal speaking rate and increased loudness) have shown promising potential to enhance speech intelligibility in populations with dysarthric speech. However, such evidence-based practice approach is lacking in clinical management of speech in individuals with facial transplantation. Because facial transplantation involves complex craniofacial reconstruction and facial nerve coaptation, it is unknown to what extent individuals with face transplant are capable of adapting their motor system to task-specific articulatory demands. The purpose of this study was to identify the underlying articulatory mechanisms employed by individuals with face transplantation in response to speech modification cues at early and late stages of neuromotor recovery. In addition, we aimed to identify speech modifications that conferred improved speech clarity. Participants were seven individuals who underwent full or partial facial vascularized composite allografts that included lips and muscles of facial animation and were in early (~2 months) or late (~42 months) stages of recovery. Participants produced repetitions of the sentence "Buy Bobby a puppy" in normal, fast, loud, and slow speech modifications. Articulatory movement traces were recorded using a 3D optical motion capture system. Kinematic measures of average speed (mm/s) and range of movement (mm3) were extracted from the lower lip (± jaw) marker. Two speech language pathologists rated speech clarity for each speaker using a visual analog scale (VAS) approach. Results demonstrated that facial motor capacity increased from early to late stages of recovery. While individuals in the early group exhibited restricted capabilities to adjust their motor system based on the articulatory demands of each speech modification, individuals in the late group demonstrated faster speed and larger-than-normal range of movement for loud speech, and slower speed and larger-than-normal range of movement for slow speech. In addition, subjects in both groups showed overreliance on jaw rather than lip articulatory function across all speech modifications, perhaps as a compensatory strategy to optimize articulatory stability and maximize speech function. Finally, improved speech clarity was associated with loud speech in both stages of recovery. [ABSTRACT FROM AUTHOR]

Introduction: traffic accidents cause 50 million injuries per year in the world, being 'cervical whiplash' one of the most common. This disorder affect structures such as upper limb nerve trunks, leading to changes in neural mechanosensitivity. Objective: to assess impairment mechanosensitivity of median, ulnar and radial nerves in subjects with whiplash associated disorder, compared to healthy asymptomatic subjects. Material and method: cross-sectional comparative study of cross association, with a total of 20 participants (10 symptomatic). A single experimental session was scheduled for each subject, where a researcher performed the upper limb neurodynamic tests, and another measured the ROM of the last parameter of each test with goniometry and the PPT of each nerve trunk with algometry. Results: the results of the mean ROM were: 106.82 ± 11.46 for the median, 57.94 ± 8.99 for the ulnar and 45.16 ± 11.08 for the radial, for the cases; while for the control group it was: 115.55 ± 10, 59.83 ± 7.36 and 70.64 ± 21.99, respectively. Regarding the UDP, the mean of the results was: 2.05 ± 0.52 of the median, 1.98 ± 0.68 of the ulnar and 2.08 ± 0.74 of the radial for the group of cases; while for the control group it was: 2.38 ± 0.67, 3.43 ± 0.83 and 3.55 ± 1.15 respectively. The study showed statistically significant differences for the shoulder ROM (p = 0.004), as well as for the UDP of the ulnar (p <0.001) and radial (p = 0.003). Conclusion: subjects with whiplash show less range of shoulder mobility, as well as greater sensitivity of the ulnar and radial nerves. [ABSTRACT FROM AUTHOR]

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Purpose: To demonstrate the validity and reliability of a smartphone app to measure ROM after stroke. Materials and methods: Twenty-one stroke survivors with a diagnosis of stroke that affected the motor cortex or subcortical motor pathways and were hospital inpatients at one of two metropolitan hospitals were recruited. A within-session test-retest design was used to compare ROM measurements taken using the GetMyROM app for iPhone to those taken by a digital inclinometer. Torque-controlled passive elbow and wrist extension were collected and statistical analysis of concurrent validity and test-retest reliability performed. Results: GetMyROM app was valid when compared to the digital inclinometer for measuring passive ROM of the elbow (r =.98, p =.0001, ICC = 0.97) and wrist (r =.97, p =.0001, ICC = 0.96) in individuals with acute stroke. Both the GetMyROM app and inclinometer demonstrated excellent test-retest reliability: ICC values are 0.84 to 0.93, and standard error of measurement between 6° to 10°. Conclusion: The GetMyROM app may be implemented in a clinical setting similar to that where the study was conducted, enabling rehabilitation physicians and therapists to use a smartphone to take precise measurements of ROM in daily clinical practice. Approximately half of all stroke survivors experience reduced passive upper limb range of movement. Accurate measurement of passive upper limb range of movement using validated assessments and/or instruments is paramount. This study demonstrates that the GetMyROM app is valid and reliable compared to the gold standard comparison (digital inclinometer), and is therefore appropriate to use in clinical settings to take precise measurements. [ABSTRACT FROM AUTHOR]

BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJECTIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p < 0.001), decreased intensity of dizziness (p < 0.001) and intensity of pain (p < 0.001). Functional capacity also improved after the intervention (p < 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness. [ABSTRACT FROM AUTHOR]

Background: Shoulder injuries in cricket are often undetected and untreated. Objectives: To determine whether there are associations between shoulder internal and external rotation range of movement (ROM), throwing arc (TA) ROM, glenohumeral internal rotation deficit (GIRD), external rotation gain (ERG), pectoralis minor muscle length and the incidence of shoulder injury during the first 3 months of a cricket season amongst provincial and club cricketers. Method: Male, actively participating, provincial and club cricketers were included in this prospective longitudinal cohort study. The independent variables included shoulder pain, which did not limit participation in cricket training and matches; shoulder external and internal rotation (ROM, TA ROM, GIRD and ERG) and pectoralis minor muscle length. Time-loss dominant shoulder injury was recorded for 3 months. Results: Nine of the 32 participants sustained dominant shoulder injuries. Initial non-time-loss shoulder pain during baseline testing was associated with time-loss in-season shoulder injury (p = 0.007). Statistically significant side-to-side differences were found for all of the independent variables (internal rotation ROM, TA ROM and pectoralis minor muscle length distance), with the exception of external rotation ROM, amongst the uninjured players. Conclusion: Non-time-loss-defined shoulder pain in actively participating cricketers seems to be a precursor to time-loss shoulder injury. Asymmetries in ROM and pectoralis minor muscle length in uninjured cricketers may have a protective role to play in the case of shoulder injury. Clinical implications: The presence of shoulder pain and asymmetries in ROM should be investigated during the pre-season screening procedures, and early intervention should be implemented where appropriate.