Background: The shape of the capitellum has been traditionally described in anatomy books as part of a sphere. Alteration in the capitellar morphology following pathologies such as fractures, osteochondrosis, and dege...Background: The shape of the capitellum has been traditionally described in anatomy books as part of a sphere. Alteration in the capitellar morphology following pathologies such as fractures, osteochondrosis, and degenerative arthritis has been associated with less optimum functional results. Aim: To define the relationship between the sphericity of the capitellar morphology as measured on trauma series plain radiographs and the elbow range of motion. Methods: 40 patients were included in the study. All patients recruited from the upper limb clinics presented with non-elbow joint-related complaints. The elbow range of motion was measured using a standardized technique. Digital anteroposterior and lateral radiographs of patients’ elbows were used to measure capitellar circularity using the ImageJ processing program and circularity calculation equation. Correlation analyses were conducted between the degree of capitellar sphericity and elbow range of motion. Results: The results of measurements from the anteroposterior radiographs showed a positive correlation between increased circularity and an increase in the range of flexion, pronation, and supination. The range of extension decreased with the increased circularity of the capitellum. This trend was repeated with measures of lateral radiographs but was statistically not significant. Conclusion: Native capitellar circularity has an impact on the elbow range of motion. This should be put into consideration when dealing with pathologies that affect capitellar morphology.展开更多
The purpose of this study is to investigate a new method for measuring shoulder range of motion (ROM) in an orthopedic practice utilizing a smartphone application to improve accuracy from physical exam typically used ...The purpose of this study is to investigate a new method for measuring shoulder range of motion (ROM) in an orthopedic practice utilizing a smartphone application to improve accuracy from physical exam typically used in research. Our aim is to evaluate the application, Physio2Go (P2G), which uses a virtual goniometer, assessing validity by comparing its measurements to those taken by a universal goniometer (UG). Two observers of varying clinical experience, a research assistant and research fellow, compared measurements. Statistically, we used the intra-class correlation coefficient (ICC), standard error of measurement (SEM), and the Pearson correlation coefficient (PCC). Following validation we tested P2G in symptomatic postoperative shoulder patients measuring forward flexion (FF) and external rotation (ER). We compared P2G measurements to visual estimation (VE) done by a fellowship trained orthopedic surgeon. Statistically we used ICC, Bland- Altman plots with 95% limits of agreement (LOA), and scatter plots. We examined the impact of the application using Welch’s t-test comparing pre-to-postoperative ROM improvements using the values obtained by P2G and VE. We found high intra-rater reliability of P2G for both observers, substantial correlation between UG and P2G measurements, highly correlated inter-observer reliability for UG and P2G, and statistically significant PCC values (p < 0.05). As expected, ROM measurements of symptomatic patients comparing P2G and VE measurements demonstrated lower correlation. Bland-Altman plots demonstrated wide confidence intervals;scatterplots and histograms confirmed low agreement among measurement methods. Clinical application demonstrated varying statistical significance depending on whether measurements were done by P2G or VE. Our study found that P2G provided superior reliability compared to the customary physical exam routinely used for orthopedic research. The value of using this application instead of a UG is the ease of use and the ability for any member of the healthcare team, regardless of clinical experience to be able to produce reliable and valid measurements.展开更多
Purpose: Belt electrode skeletal muscle electrical stimulation (B-SES) can stimulate large portions of muscles including deep sites without localisation of the stimulation area. The purpose of this study is to investi...Purpose: Belt electrode skeletal muscle electrical stimulation (B-SES) can stimulate large portions of muscles including deep sites without localisation of the stimulation area. The purpose of this study is to investigate both immediate treatment effects of B-SES and long-term treatment effects of B-SES with passive exercise on range of motion (ROM) and muscle tone of lower extremities in bedridden elderly patients. Methods: Outcome measures before and after B-SES treatment alone (4 Hz, 20 min, both lower extremities) were examined for the immediate effect. Outcome measures were: ROM and Modified Ashworth scale (MAS) of hip flexion and adduction;knee flexion and extension;and knee joint distance at position of flexion abduction in hip (distance of knee). A randomized crossover trial was conducted to examine the long-term effect of adding B-SES to passive exercise on ROM and MAS. Results and Discussion: The immediate effect study had 18 patients. ROM and MAS of 4 joint angles in 2 joints and distance of knee significantly improved after B-SES treatment. The long-term effect study had 11 patients. Friedman test revealed ROM and MAS of 4 joint angles in 2 joints and distance of knee significantly improved during B-SES intervention but not control intervention. B-SES in addition to passive stretch has a more statistically significant effect on contracture and spasticity in large portions of the lower extremities of bedridden elderly patients than passive stretching alone. Conclusions: We consider B-SES a useful tool to improve the ROM in lower extremities of bedridden patients.展开更多
The aim of this study was to characterize the obesity effect on children knee and hip joint range of motion. A randomized controlled trial was performed with goniometry evaluation for hip flexion, extension, abduction...The aim of this study was to characterize the obesity effect on children knee and hip joint range of motion. A randomized controlled trial was performed with goniometry evaluation for hip flexion, extension, abduction, adduction, external and internal rotation, and knee flexion in fifty male children (20 obese and 30 non obese), with age ranging from 6 to 12 years old. The obesity effect was found to be non-uniform across the joint range of motion. In the obesity group, a statistically significant reduction in the range of motion of hip flexion and adduction, and knee flexion was observed;and also an increase in external rotation in the hip was observed. Conclusion: Obese and overweight children present alterations in hip and knee joints mobility when compared to eutrophic children. The obesity/overweight associated with factors previously described in the literature, such as joint overload, postural deviation and sedentariness may influence the musculoskeletal development and, consequently, the motor function.展开更多
Post-stroke spasticity is associated with restriction in the range of motion of the shoulder.Reducing muscular dystrophy may help relieve muscular dysfunction in patients with post-stroke shoulder spasticity.Dry needl...Post-stroke spasticity is associated with restriction in the range of motion of the shoulder.Reducing muscular dystrophy may help relieve muscular dysfunction in patients with post-stroke shoulder spasticity.Dry needle therapy is a method of needling the trigger points using a syringe needle without the use of a drug.Dry needle therapy is commonly used for pain at the shoulder,neck,waist,and back.In this case study,a 62-year-old male patient affected with cerebral hemorrhage of the right frontal lobe had received rehabilitative treatment for 12 years.However,he still experienced shoulder spasticity.The patient received daily dry needling at the trigger points of infraspinatus,teres minor,posterior deltoid,and pectoralis major on 9 days.After the first and ninth treatment,the Modified Ashworth Scale and the passive range of motion of the shoulder was used to assess the effect of the treatment.The spasticity and range of motion of the shoulder showed obvious improvement.These results indicate that dry needling at the myofascial trigger points can effectively treat chronic poststroke shoulder spasticity.展开更多
BACKGROUND Frozen shoulder(FS)is a familiar disorder.Diabetics with FS have more severe symptoms and a worse prognosis.Thus,this study investigated the influence of enhancing dynamic scapular recognition on shoulder d...BACKGROUND Frozen shoulder(FS)is a familiar disorder.Diabetics with FS have more severe symptoms and a worse prognosis.Thus,this study investigated the influence of enhancing dynamic scapular recognition on shoulder disability and pain in diabetics with FS.CASE SUMMARY A Forty-five years-old male person with diabetes mellitus and a unilateral FS(stage II)for at least 3 mo with shoulder pain and limitation in both passive and active ranges of motion(ROMs)of the glenohumeral joint of≥25%in 2 directions participated in this study.This person received dynamic scapular recognition exercise was applied to a diabetic person with a unilateral FS(stage II).The main outcome measures were upward rotation of the scapula,shoulder pain and disability index,and shoulder range of motion of flexion,abduction,and external rotation.The dynamic scapular exercise was performed for 15 min/session and 3 sessions/wk lasted for 4 wk.After 4 wk of intervention,there were improvements between pre-treatment and post-treatment in shoulder pain,shoulder pain and disability index,shoulder ROM,and upward rotation of the scapula.CONCLUSION This case report suggested that enhancing dynamic scapular recognition may improve shoulder pain and disability;upward rotation of the scapula;and shoulder ROM of shoulder abduction,flexion,and external rotation after 4 wk.展开更多
The purpose of the study was designed to clarify the modern trends of physical therapy in treatment of temporomandibular joint dysfunctions in Parkinsonian patients, which in this respect included the degree of pain, ...The purpose of the study was designed to clarify the modern trends of physical therapy in treatment of temporomandibular joint dysfunctions in Parkinsonian patients, which in this respect included the degree of pain, the muscles power of both masseter and pterygoid, the range of TMJ motion, the angle of mouth opening and their effects on electromyography study in both sexes. Subjects: Thirty males and females were the same degree of disabilities according to modified Hoehn and Yahr scales (grade 3) of Parkinsonian patients, and their age ranged from 50 - 77 years old and their weight ranged from 60 - 88 kg. They were randomly divided into two equal groups (G1 and G2). G1 (control) consisted of 15 patients of both sexes and was treated by exercises therapy program and G2 (experimental) consisted of 15 Parkinsonian patients of both sexes and was treated by the same exercises therapy program and low level pulsed electromagnetic therapy. Vital signs such as blood pressure, body temperature, pulse rate and respiratory rate were measured before and after the treatment sessions. Assessments: Visual analogue scale was used to measure degree of pain. Tensiometer was used to measure the muscle power of masseter and pterygoid, the digital goniometer was used to investigate the range of TMJ movement. Moreover, standard electromyography test (EMG) was used to measure the compound muscle action potentials. Statistically the results for all groups were analyzed by t-test to compare the differences between the two groups. The statistical package of social sciences (SPSS, version 10) was used for data processing using the P-value 0.05 as a level of significance. Results showed that there were significant improvements in all variables in G2 only. However, there was a little improvement but not significant in both G1. Therefore, it could be concluded that the use of low level pulsed electro-magnetic therapy combined with exercises program was the good method to control pain of TMJ, increase of muscle power and the range of their movements together with determination of electro-myography. Our results opened a new link to manage the TMJ dysfunctions in Parkinsonian patients via the use of low level pulsed electromagnetic therapy combined with exercises program.展开更多
Joint range of motion (ROM) is very important in daily activities, sport and in clinical diagnosis. Many factors have been reported to influence joint ROM. Musculoskeletal adaptation and some special side effects due ...Joint range of motion (ROM) is very important in daily activities, sport and in clinical diagnosis. Many factors have been reported to influence joint ROM. Musculoskeletal adaptation and some special side effects due to his or her physical demands and movement patterns in professional athletes are very important subjects in sport sciences. The present study is a comparison of shoulder joint ROM in elite athlete and non-athlete groups and its relationship to their age, post and years of their tournament play. The subjects in this study included 106 men with mean age (23.65 ±3.45) and mean years of tournament play (5.60 ±2.23). The groups of subjects included 26 handball players, 25 volleyball players, 25 soccer players and 30 non-athletes. Data were collected through questionnaires and inspection, and subjects’ ROM was measured by “Leighton flex- ometer” (r = 0.90 – 0.99) in external rotation and abduction of shoulder joint in dominant and non-domi- nant hands. Data were analyzed by correlation coefficient, t – test, ANOVA and post hock Schaffe test. The results showed that an increase in age and years of tournament play reduced the shoulder ROM of subjects (p ≤ 0.05). There were significant differences in shoulder ROM among athletic groups. Additionally, there are significant differences between dominant and non-dominant hands (p ≤ 0.05). It can be concluded that more specific stretching exercises and warm-up for shoulder in all athletes and especially in older and experienced players should be performed by coaches. The results also emphasized routine screening, corrective exercise programs and a design of preventing strategies by athletic trainers and coaches.展开更多
文摘Background: The shape of the capitellum has been traditionally described in anatomy books as part of a sphere. Alteration in the capitellar morphology following pathologies such as fractures, osteochondrosis, and degenerative arthritis has been associated with less optimum functional results. Aim: To define the relationship between the sphericity of the capitellar morphology as measured on trauma series plain radiographs and the elbow range of motion. Methods: 40 patients were included in the study. All patients recruited from the upper limb clinics presented with non-elbow joint-related complaints. The elbow range of motion was measured using a standardized technique. Digital anteroposterior and lateral radiographs of patients’ elbows were used to measure capitellar circularity using the ImageJ processing program and circularity calculation equation. Correlation analyses were conducted between the degree of capitellar sphericity and elbow range of motion. Results: The results of measurements from the anteroposterior radiographs showed a positive correlation between increased circularity and an increase in the range of flexion, pronation, and supination. The range of extension decreased with the increased circularity of the capitellum. This trend was repeated with measures of lateral radiographs but was statistically not significant. Conclusion: Native capitellar circularity has an impact on the elbow range of motion. This should be put into consideration when dealing with pathologies that affect capitellar morphology.
文摘The purpose of this study is to investigate a new method for measuring shoulder range of motion (ROM) in an orthopedic practice utilizing a smartphone application to improve accuracy from physical exam typically used in research. Our aim is to evaluate the application, Physio2Go (P2G), which uses a virtual goniometer, assessing validity by comparing its measurements to those taken by a universal goniometer (UG). Two observers of varying clinical experience, a research assistant and research fellow, compared measurements. Statistically, we used the intra-class correlation coefficient (ICC), standard error of measurement (SEM), and the Pearson correlation coefficient (PCC). Following validation we tested P2G in symptomatic postoperative shoulder patients measuring forward flexion (FF) and external rotation (ER). We compared P2G measurements to visual estimation (VE) done by a fellowship trained orthopedic surgeon. Statistically we used ICC, Bland- Altman plots with 95% limits of agreement (LOA), and scatter plots. We examined the impact of the application using Welch’s t-test comparing pre-to-postoperative ROM improvements using the values obtained by P2G and VE. We found high intra-rater reliability of P2G for both observers, substantial correlation between UG and P2G measurements, highly correlated inter-observer reliability for UG and P2G, and statistically significant PCC values (p < 0.05). As expected, ROM measurements of symptomatic patients comparing P2G and VE measurements demonstrated lower correlation. Bland-Altman plots demonstrated wide confidence intervals;scatterplots and histograms confirmed low agreement among measurement methods. Clinical application demonstrated varying statistical significance depending on whether measurements were done by P2G or VE. Our study found that P2G provided superior reliability compared to the customary physical exam routinely used for orthopedic research. The value of using this application instead of a UG is the ease of use and the ability for any member of the healthcare team, regardless of clinical experience to be able to produce reliable and valid measurements.
文摘Purpose: Belt electrode skeletal muscle electrical stimulation (B-SES) can stimulate large portions of muscles including deep sites without localisation of the stimulation area. The purpose of this study is to investigate both immediate treatment effects of B-SES and long-term treatment effects of B-SES with passive exercise on range of motion (ROM) and muscle tone of lower extremities in bedridden elderly patients. Methods: Outcome measures before and after B-SES treatment alone (4 Hz, 20 min, both lower extremities) were examined for the immediate effect. Outcome measures were: ROM and Modified Ashworth scale (MAS) of hip flexion and adduction;knee flexion and extension;and knee joint distance at position of flexion abduction in hip (distance of knee). A randomized crossover trial was conducted to examine the long-term effect of adding B-SES to passive exercise on ROM and MAS. Results and Discussion: The immediate effect study had 18 patients. ROM and MAS of 4 joint angles in 2 joints and distance of knee significantly improved after B-SES treatment. The long-term effect study had 11 patients. Friedman test revealed ROM and MAS of 4 joint angles in 2 joints and distance of knee significantly improved during B-SES intervention but not control intervention. B-SES in addition to passive stretch has a more statistically significant effect on contracture and spasticity in large portions of the lower extremities of bedridden elderly patients than passive stretching alone. Conclusions: We consider B-SES a useful tool to improve the ROM in lower extremities of bedridden patients.
文摘The aim of this study was to characterize the obesity effect on children knee and hip joint range of motion. A randomized controlled trial was performed with goniometry evaluation for hip flexion, extension, abduction, adduction, external and internal rotation, and knee flexion in fifty male children (20 obese and 30 non obese), with age ranging from 6 to 12 years old. The obesity effect was found to be non-uniform across the joint range of motion. In the obesity group, a statistically significant reduction in the range of motion of hip flexion and adduction, and knee flexion was observed;and also an increase in external rotation in the hip was observed. Conclusion: Obese and overweight children present alterations in hip and knee joints mobility when compared to eutrophic children. The obesity/overweight associated with factors previously described in the literature, such as joint overload, postural deviation and sedentariness may influence the musculoskeletal development and, consequently, the motor function.
文摘Post-stroke spasticity is associated with restriction in the range of motion of the shoulder.Reducing muscular dystrophy may help relieve muscular dysfunction in patients with post-stroke shoulder spasticity.Dry needle therapy is a method of needling the trigger points using a syringe needle without the use of a drug.Dry needle therapy is commonly used for pain at the shoulder,neck,waist,and back.In this case study,a 62-year-old male patient affected with cerebral hemorrhage of the right frontal lobe had received rehabilitative treatment for 12 years.However,he still experienced shoulder spasticity.The patient received daily dry needling at the trigger points of infraspinatus,teres minor,posterior deltoid,and pectoralis major on 9 days.After the first and ninth treatment,the Modified Ashworth Scale and the passive range of motion of the shoulder was used to assess the effect of the treatment.The spasticity and range of motion of the shoulder showed obvious improvement.These results indicate that dry needling at the myofascial trigger points can effectively treat chronic poststroke shoulder spasticity.
文摘BACKGROUND Frozen shoulder(FS)is a familiar disorder.Diabetics with FS have more severe symptoms and a worse prognosis.Thus,this study investigated the influence of enhancing dynamic scapular recognition on shoulder disability and pain in diabetics with FS.CASE SUMMARY A Forty-five years-old male person with diabetes mellitus and a unilateral FS(stage II)for at least 3 mo with shoulder pain and limitation in both passive and active ranges of motion(ROMs)of the glenohumeral joint of≥25%in 2 directions participated in this study.This person received dynamic scapular recognition exercise was applied to a diabetic person with a unilateral FS(stage II).The main outcome measures were upward rotation of the scapula,shoulder pain and disability index,and shoulder range of motion of flexion,abduction,and external rotation.The dynamic scapular exercise was performed for 15 min/session and 3 sessions/wk lasted for 4 wk.After 4 wk of intervention,there were improvements between pre-treatment and post-treatment in shoulder pain,shoulder pain and disability index,shoulder ROM,and upward rotation of the scapula.CONCLUSION This case report suggested that enhancing dynamic scapular recognition may improve shoulder pain and disability;upward rotation of the scapula;and shoulder ROM of shoulder abduction,flexion,and external rotation after 4 wk.
文摘The purpose of the study was designed to clarify the modern trends of physical therapy in treatment of temporomandibular joint dysfunctions in Parkinsonian patients, which in this respect included the degree of pain, the muscles power of both masseter and pterygoid, the range of TMJ motion, the angle of mouth opening and their effects on electromyography study in both sexes. Subjects: Thirty males and females were the same degree of disabilities according to modified Hoehn and Yahr scales (grade 3) of Parkinsonian patients, and their age ranged from 50 - 77 years old and their weight ranged from 60 - 88 kg. They were randomly divided into two equal groups (G1 and G2). G1 (control) consisted of 15 patients of both sexes and was treated by exercises therapy program and G2 (experimental) consisted of 15 Parkinsonian patients of both sexes and was treated by the same exercises therapy program and low level pulsed electromagnetic therapy. Vital signs such as blood pressure, body temperature, pulse rate and respiratory rate were measured before and after the treatment sessions. Assessments: Visual analogue scale was used to measure degree of pain. Tensiometer was used to measure the muscle power of masseter and pterygoid, the digital goniometer was used to investigate the range of TMJ movement. Moreover, standard electromyography test (EMG) was used to measure the compound muscle action potentials. Statistically the results for all groups were analyzed by t-test to compare the differences between the two groups. The statistical package of social sciences (SPSS, version 10) was used for data processing using the P-value 0.05 as a level of significance. Results showed that there were significant improvements in all variables in G2 only. However, there was a little improvement but not significant in both G1. Therefore, it could be concluded that the use of low level pulsed electro-magnetic therapy combined with exercises program was the good method to control pain of TMJ, increase of muscle power and the range of their movements together with determination of electro-myography. Our results opened a new link to manage the TMJ dysfunctions in Parkinsonian patients via the use of low level pulsed electromagnetic therapy combined with exercises program.
文摘Joint range of motion (ROM) is very important in daily activities, sport and in clinical diagnosis. Many factors have been reported to influence joint ROM. Musculoskeletal adaptation and some special side effects due to his or her physical demands and movement patterns in professional athletes are very important subjects in sport sciences. The present study is a comparison of shoulder joint ROM in elite athlete and non-athlete groups and its relationship to their age, post and years of their tournament play. The subjects in this study included 106 men with mean age (23.65 ±3.45) and mean years of tournament play (5.60 ±2.23). The groups of subjects included 26 handball players, 25 volleyball players, 25 soccer players and 30 non-athletes. Data were collected through questionnaires and inspection, and subjects’ ROM was measured by “Leighton flex- ometer” (r = 0.90 – 0.99) in external rotation and abduction of shoulder joint in dominant and non-domi- nant hands. Data were analyzed by correlation coefficient, t – test, ANOVA and post hock Schaffe test. The results showed that an increase in age and years of tournament play reduced the shoulder ROM of subjects (p ≤ 0.05). There were significant differences in shoulder ROM among athletic groups. Additionally, there are significant differences between dominant and non-dominant hands (p ≤ 0.05). It can be concluded that more specific stretching exercises and warm-up for shoulder in all athletes and especially in older and experienced players should be performed by coaches. The results also emphasized routine screening, corrective exercise programs and a design of preventing strategies by athletic trainers and coaches.
