Assessing the cervical range of motion in infants with positional plagiocephaly

Purpose: To determine if infants with positional plagiocephaly have limitations of active and passive cervical range of motion measured with simple and reliable methods. Methods: The examiners assessed bilateral active and passive cervical rotations and passive cervical lateral flexion. Cervical assessment was performed twice by 2 different physicians to assess intertester reliability. To assess intratester reliability the first investigator performed a second examination 48 hours after the first one. Results: One-hundred nine subjects were analyzed; 70.7% of the sample had head positional preference on the right, while 29.3% had head positional preference on the left (x2 35.52, P <0.001). Cervical rotations and lateral flexion showed reliable levels of agreement for intra and intertester reliability. Conclusions: The most limited range of motion in infants with positional plagiocephaly was cervical active rotation which affected more than 90% of patients. Passive cervical rotations and lateral flexion were limited in more than 60% of patient

Comment on “early efficacy of intra-articular HYADD® 4 (Hymovis®) injections for symptomatic knee osteoarthritis”

We read with great interest the study by Priano titled“Early efficacy of intra-articular HYADD® 4 (Hymovis®) injections for symptomatic knee osteoarthritis.” 1 The author would like to explore the efficacy of intra-articular HYADD 4 (Hymovis) injections for symptomatic knee osteoarthritis. Results from this study are very interesting and promising from a clinical aspect; however, we believe that studying patient’sclinical status with visual analog scale and Western Ontario and McMaster Universities Arthritis Index scale should be supported by biomechanical information. From this point of view, to have more data that could influence the clinical practice, it is important to note the possible action that intraarticular injections of different kinds of hyaluronic acid could have on walking biomechanics using an objective measurement tool as gait analysis. In our opinion, the work by Priano1 is promising because it investigates the efficacy of a new formulation of hyaluronic acid. Nowadays, many hyaluronic acid formulations are approved for clinical use in Europe and the United States. Furthermore, hyaluronic acid injections’ efficacy has been demonstrated also in hip osteoarthritis. 2 However, even if these formulations differ in their chemical– physical properties, joint space half-life, rheological properties, and clinical efficacy, there are few studies that investigate hyaluronic acid’s possible action from a biomechanical point of view. 3,4 From this point of view, we believe that osteoarthritis management and rehabilitation should be prescribed after an objective analysis of functional walking alterations using gait analysis instrumentations. The use of gait analysis should be desirable during diagnosis and follow-up. In fact, it is capable to identify different walking patterns in patient with osteoarthritis of the lower limbs, whereas the radiology can evaluate the status of the joint’s structures

Kinematic analysis of reaching movements of the upper limb after total or reverse shoulder arthroplasty

Studies have analyzed three-dimensional complex motion of the shoulder in healthy subjects or patients undergoing total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA). No study to date has assessed the reaching movements in patients with TSA or RSA. Twelve patients with TSA (Group A) and 12 with RSA (Group B) underwent kinematic analysis of reaching movements directed at four targets. The results were compared to those of 12 healthy subjects (Group C). The assessed parameters were hand-to-target distance, target-approaching velocity, humeral-elevation angular velocity, normalized jerk (indicating motion fluidity), elbow extension and humeral elevation angles. Mean Constant score increased by 38 points in Group A and 47 in Group B after surgery. In three of the tasks, there were no significant differences between healthy subjects and patients in the study groups. Mean target-approaching velocity and humeral-elevation angular velocity were significantly greater in the control group than in study groups and, overall, greater in Group A than Group B. Movement fluidity was significantly greater in the controls, with patients in Group B showing greater fluidity than those in Group A. Reaching movements in the study groups were comparable, in three of the tasks, to those in the control group. However, the latter performed significantly better with regard to target-approaching velocity, humeral-elevation angular velocity and movement fluidity, which are the most representative characteristics of reaching motion. These differences, that may be related to deterioration of shoulder proprioception after prosthetic implant, might possibly be decreased with appropriate rehabilitation

Assessment Capacity of the Armeo® Power: Cross-Sectional Study

The use of robotics in rehabilitating motor functions has increased exponentially in recent decades. One of the most used robotic tools is undoubtedly the Armeo® Power, which has proved to have excellent qualities as a rehabilitation tool. However, none of these studies has investigated the ability of Armeo® Power to assess the upper limb by correlating the data resulting from the software with patient-reported outcome measures (PROMs). The present study aims to evaluate the variability between the standardized PROMs, Stroke Upper Limb Capacity Scale (SULCS), Fugl–Meyer upper limb assessment (FMA-UL), and the Armeo® Power measurements. To evaluate the correlation between SULCS and FMA-UL and the strength and joint assessments obtained with the Armeo® Power, Pearson’s correlation coefficient was used. A total of 102 stroke survivors were included in this cross-sectional study, and all participants finished the study. The results showed many statistically significant correlations between PROM items and Armeo® Power data. In conclusion, from this study, it can be stated that Armeo® Power, based on the analysis of the data collected, can be an objective evaluation tool, which can be combined with the operator-employee traditional evaluation techniques, especially when compared to a patient-reported outcome measures (PROMs)

Outbreak of unusualSalmonella entericaserovar Typhimurium monophasic variant 1,4 [5],12:i:-, Italy, June 2013 to September 2014

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Long-term efficacy of a short period of taping followed by an exercise program in a cohort of patients with patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) is a common source of anterior knee pain. While treatment for PFPS may be successful in the short term, long-term results are less promising. The purpose of this study was to record long-term pain and functionality outcomes following rehabilitation in patients affected by PFPS. A prospective cohort study of 44 patients with a diagnosis of PFPS and an activation imbalance between the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles were enrolled. Patients underwent patellar taping (2 weeks) followed by a rehabilitation program lasting until the end of the third month. Primary outcome measures were pain and the functional level of the patellofemoral joint. Secondary outcome measures were surface electromyographic (sEMG) onset timing of the VMO/VL during seated knee extension and squat and isometric knee extensor muscle strength. Significant differences in all the outcome measures were observed between the affected and unaffected sides before treatment. The pain score significantly decreased both posttreatment (Delta=-4.7; 95% CI=-5.4 to -3.9) and at the 12-month follow-up (Delta=-5.5; 95% CI=-6.1 to -4.8), while the functional level significantly increased both posttreatment (Delta=24; 95% CI=18.3 to 30.2) and at the 12-month follow-up (Delta=26; 95% CI=21.4 to 30.6). Post-treatment, 35/44 patients (79.5%) and 31/44 patients (70.5%) achieved normal sEMG onset timing of the VMO and VL in the seated knee extension exercise and in the squat exercise, respectively. A short period of patellar taping followed by an exercise program results in long-lasting pain control in PFPS associated with muscular dysfunction

Clinical definition of sarcopenia

Sarcopenia is a condition characterized by loss of skeletal muscle mass and function. Although it is primarily a disease of the elderly, its development may be associated with conditions that are not exclusively seen in older persons. Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength and it is strictly correlated with physical disability, poor quality of life and death. Risk factors for sarcopenia include age, gender and level of physical activity. In conditions such as malignancy, rheumatoid arthritis and aging, lean body mass is lost while fat mass may be preserved or even increased. The loss in muscle mass may be associated with increased body fat so that despite normal weight there is marked weakness, this is a condition called sarcopenic obesity. There is an important correlation between inactivity and losses of muscle mass and strength, this suggests that physical activity should be a protective factor for the prevention but also the management of sarcopenia. Furthermore one of the first step to be taken for a person with sarcopenia or clinical frailty is to ensure that the sarcopenic patient is receiving correct and sufficient nutrition. Sarcopenia has a greater effect on survival. It should be important to prevent or postpone as much as possible the onset of this condition, to enhance survival and to reduce the demand for long-term care. Interventions for sarcopenia need to be developed with most attention on exercise and nutritional interventions

Kinematic and kinetic features of normal level walking in patellofemoral pain syndrome: More than a sagittal plane alteration

Patients with patellofemoral pain syndrome (PFPS) often report discomfort and pain during walking. To date, most of the studies conducted to determine gait alterations in PFPS patients have focused on sagittal plane alterations. Physiological and biomechanical factors, however, suggest that frontal and transverse plane alterations may be involved in PFPS. We therefore decided to conduct a kinematic and kinetic evaluation on all three planes in 9 PFPS subjects and 9 healthy sex- and age-matched controls. General gait characteristics were similar in patients and controls, with the exception of swing velocity, which was lower in PFPS patients. Patients also displayed an increased knee abductor and external rotator moments in loading response, and reduced knee extensor moment both in loading response and in terminal stance. We speculate that these findings may be linked both to a pain-avoiding gait pattern and to alterations in the timing of activation of different components of the quadriceps muscle, which is typical of PFPS. The relevance for clinicians is this gait pattern may represent a biomechanical risk factor for future knee osteoarthritis. We therefore recommend that treatments aimed at PFPS should also attempt to restore a correct walking pattern. (C) 2010 Elsevier Ltd. All rights reserved