Optimising the Validity of Shoulder Range of Motion Evaluation: A Comparative Study

During the assessment process diachronically conceived in the initial, dynamic, and final stages, data recording is often performed by instrumental measurement using the goniometer. In Romania, the logistics equipment - hardware and software - has a very low or even absent incidence in the conceptual and applicative design of kinetic rehabilitation programmes. Some disadvantages of universal goniometry are revealed by relatively accurate measurements, given that the testing instrument may provide erroneous data when the specific rules are not followed. Moreover, the tester’s interpretation of angular values may vary; therefore, in order to objectify and validate the specific assessment and evaluation, we propose a precise angular motion measurement device called Kinesimeter, assisted by specific Labview software designed at the Human Movement Science Discipline of “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureş. Our purpose was to compare the results and interpret the differences arising from the use of two specific assessment methods for the shoulder range of motion. Thus, the values recorded by two physiotherapists using the manual goniometer were compared with the values recorded with the Kinesimeter. In order to validate the results, we calculated statistical parameters such as correlation and significance. We strongly believe that the proposed hardware and software device for measuring, controlling, and analysing shoulder movements can become a modern performing tool needed by each rehabilitation institution, having a dual role - investigative and monitoring of a rehabilitation programme - both extremely important, additional to current measurements with the goniometer.</em

Associations between paraclinical parameters, symptoms and quality of life in patients with acromegaly: a cross sectional study

Abstract Introduction Acromegaly is a rare chronic endocrine disorder that can lead to significant quality of life (QoL) impairment and persistent symptomatology in both biochemically uncontrolled as well as in cured or controlled patients. We aimed to conduct an observational cross-sectional study investigating the associations between biochemical disease control, associated comorbidities, and symptoms severity on QoL in a cohort of acromegalic patients. Methods Thirty-one patients with acromegaly were enrolled in our study. AcroQoL and PASQ (Pain assessed acromegaly symptoms questionnaire) questionnaires were applied to all patients. Information about disease status, associated comorbidities, and other relevant clinical and paraclinical data were gathered. Results Patients with uncontrolled acromegaly presented worse QoL and symptoms scores than controlled patients, but the difference was not statistically significant (AcroQoL 57.22 vs 64.04, p > 0.05; PASQ 12 vs 16.47, p > 0.05). Worse symptoms were significantly associated with impaired QoL (overall symptoms score on PASQ was negatively correlated with AcroQoL total score, r = − 0.61, p < 0.05). Cardiovascular complications were associated with lower QoL scores, but not with worse symptoms (AcroQoL total score in patients with- versus patients without cardiovascular complications: 54.89 vs 70.14, p < 0.05). Conclusions Achieving biochemical control of acromegaly might not be enough to reverse the QoL impairment and improve symptomatology in acromegalic patients. While symptoms severity and the presence of cardiovascular complications seem to play an important role in reducing patients QoL, the roles of disease control, diabetes, and pituitary insufficiency are less clear

Successful Pregnancy in a Patient with Long-Standing Acromegaly – a Case Report

Introduction: Acromegaly is a rare endocrine disorder of the growth hormone (GH)-insulin-like growth factor 1 (IGF1) metabolism that can affect women of fertile age. Although uncommon, pregnancies in acromegalic women can occur, with data regarding the management of these cases being very limited, mostly consisting of case reports

Effects of Adding Aquatic-to-Land-Based Physiotherapy Programs for Shoulder Joint Position Sense Rehabilitation

There is limited evidence regarding the effects of aquatic-based physiotherapy on shoulder proprioception following post-traumatic injury to the joint. The main aim of this study was to investigate the effects of additional aquatic-based rehabilitation to a land-based physiotherapy program on shoulder joint position sense (JPS) rehabilitation. Forty-four individuals (mean age 44.50 &plusmn; 10.11) who had suffered a post-traumatic shoulder injury less than five months previously were pseudo-randomly allocated equally into a control group (9 females, 13 males) and experimental group (6 females, 16 males). Both groups received individualized standard land-based physiotherapy on average for 50 min per session, with five sessions per week for four consecutive weeks. The experimental group received an additional 30 min of personalized aquatic-based therapy during each session. Shoulder JPS was assessed by flexion (60&deg;), extension (25&deg;), abduction (60&deg;), internal rotation (35&deg;) and external rotation (35&deg;) positions prior, halfway through, and after the intervention. Shoulder JPS improved significantly for all positions for both the control group (p &lt; 0.03) and the experimental group (p &lt; 0.01). No significant differences between the control group and the experimental group were found for change in shoulder JPS over time. Our results indicate that shoulder JPS can be significantly improved among individuals with post-traumatic injury to the joint through four weeks of personalized physiotherapy. The addition of aquatic-based exercises to standard land-based therapy did not, however, show significant benefits, and thus cannot be recommended for the improvement of shoulder JPS based on our findings

Effects of a Novel Proprioceptive Rehabilitation Device on Shoulder Joint Position Sense, Pain and Function

Background and Objectives: Shoulder disorders are associated with pain, restricted range of motion and muscular strength, moderate disability and diminished proprioception. This study aimed to compare the effectiveness of an innovative technology-supported and a classical therapist-based proprioceptive training program in addition to conventional physiotherapy, on joint position sense (JPS), pain and function, in individuals with different musculoskeletal shoulder disorders, such as rotator cuff tear, subacromial impingement syndrome and superior labrum anterior and posterior tear. The innovative element of the proprioceptive training programme consists of the use of the Kinesimeter, a device created for both training and assessing shoulder JPS. Materials and Methods: The shoulder JPS test and the DASH outcome questionnaire were applied to fifty-five individuals (28 females, 27 males, mean age 56.31 &plusmn; 6.75), divided into three groups: 17 in the conventional physiotherapy group (control group); 19 in the conventional physiotherapy + classical proprioceptive training program group (CPT group); and 19 in the conventional physiotherapy + innovative proprioceptive training program group (KPT group). Assessments were performed before and after a four-week rehabilitation program, with five physiotherapy sessions per week. Results: When baseline and post-intervention results were compared, the value of the shoulder JPS and DASH outcome questionnaire improved significantly for the KPT and CPT groups (all p &lt; 0.001). Both KPT and CPT groups showed statistically significant improvements in JPS, pain and function, compared to the control group which received no proprioceptive training (all p &lt; 0.05). However, the KPT group showed no significant benefits compared to the CPT group. Conclusions: Our findings indicate that using the Kinesimeter device as a novel, innovative proprioceptive training tool has similar effects as the classical proprioceptive training programs among individuals with different non-operated musculoskeletal shoulder disorders such as: rotator cuff tear, subacromial impingement syndrome, and superior labrum anterior and posterior tear

Residents’ Perception of Destination Quality: Key Factors for Sustainable Rural Development

Tourism represents a viable alternative for economic activities in rural areas, and improves the living standards of the communities. The aim of the paper is to assess residents&rsquo; perceptions towards tourism destination quality in the North-West Development Region of Romania using the following items: natural attractions: cultural and social attractions; accommodation; food; availability of transportation to destination area; quality of information and communication; hospitality of host community; feeling of security and safety. A survey was conducted to collect the data and a total of 433 questionnaires were validated and analyzed. Descriptive and inferential statistics (Principal component analysis, ANOVA, Scheffe multiple range test) were used to analyze the data. Results show that there are statistically significant differences in residents&rsquo; perceptions between counties. Two of the components of destination quality (general infrastructure and tourism potential) are affected by the gender of residents, while the level of education has no significant effect. A weak and indirect correlation was found between the age of residents and their perception towards a quality destination. This study makes two contributions to the existing literature. First, a questionnaire was developed based on the QUALITEST tool adapted to the realities of the research area. Second, we analyzed the perception of residents towards a quality destination in relation to their socio-demographic characteristics and county of residence. Understanding the implications of tourism development from the residents&rsquo; point of view helps to increase knowledge about the factors affecting the long-term, sustainable success of tourism destinations