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
Background:To determine the effectiveness of resistive range of motion exercises in improving muscle strength and functional abilities in Duchenne muscular dystrophy.The study was also aimed to determine if resistive ...Background:To determine the effectiveness of resistive range of motion exercises in improving muscle strength and functional abilities in Duchenne muscular dystrophy.The study was also aimed to determine if resistive range of motion exercises can slow down the progression of the disease.Methods:A seven-year-old male child was diagnosed with Duchenne muscle dystrophy presented to outpatient physiotherapy clinic.The patient was presented with difficulty in stair climbing,sitting up from the floor,fatigue,and muscle weakness specifically weakness in the proximal limb muscles.The progressive resistive range of motion training was implemented for four years to improve muscle strength and functional abilities.The medical research council grading scale,north ambulatory assessment scale,and creatine kinase were used to evaluate muscle strength,functional abilities,and creatine kinase levels.Results:The muscular strength and functional abilities did not improve after four years of exercise training.The creatine kinase levels were decreased over the period of four years.Conclusion:Resistive range of motion exercises are helpful in maintaining the muscular strength and functional abilities in Duchenne muscular dystrophy.展开更多
Objective:This study evaluates the reliability of smartphone compass software in measuring the cervical range of motion in healthy people.Methods:We selected 40 healthy intern college students from Tianjin Hospital fr...Objective:This study evaluates the reliability of smartphone compass software in measuring the cervical range of motion in healthy people.Methods:We selected 40 healthy intern college students from Tianjin Hospital from June to August 2022 to participate in this study.Two physiotherapists used a smartphone(iPhone 11256 Gb(model A2223))compass software to measure six directions of motion of the cervical spine in 40 subjects in a total of 3 rounds each.The intraclass correlation coefficient was used to compare the reliability intra-group,and the Pearson correlation coefficient was also used to compare the correlation between groups,with P<0.05 being statistically significant.Results:The intraclass correlation coefficient showed good reliability(>0.5)in cervical range of motion(CROM),especially in cervical flexion and right rotation(>0.9).In the correlation comparison between the two groups,the Spearman comparison was used,and the six directions of the cervical spine were significantly correlated(P<0.05).Conclusion:The built-in compass software in smartphones has good reliability in measuring CROM in healthy people.展开更多
Objective： To observe the tested results of the segmental range of motion （ROM） of lumbar spine by charge couple device （CCD）-based system for 3-dimensional real-time positioning （CCD system）, and to analyze it...Objective： To observe the tested results of the segmental range of motion （ROM） of lumbar spine by charge couple device （CCD）-based system for 3-dimensional real-time positioning （CCD system）, and to analyze its clinical significance. Methods： Seven patients with lumbar joint dysfunction and 8 healthy subjects were tested twice by the CCD-based system with an interval of 10 min. Results： The ROM of the patients was obviously lesser than that of the healthy subjects. The measuring data of segmental ROM of lumbar spine by CCD system is correlated significantly to the same data checked later on the same subjects in every direction of the movements. The differences between two checks are usually less than 1 degree. Conclusion： Specially designed CCD based system for 3-dimensional real-time positioning could objectively reflect the segmental ROM of lumbar spine. The system would be of great clinical significance in the assessment of the biomechanical dysfunction of lumbar spine and the effect of the treatment applied.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
Background: Multiple level anterior cervical discectomy and fusion (ACDF) is indicated for those who suffer from multilevel stenosis or compression of the spinal canal. It was reported that this intervention would unf...Background: Multiple level anterior cervical discectomy and fusion (ACDF) is indicated for those who suffer from multilevel stenosis or compression of the spinal canal. It was reported that this intervention would unfortunately lead to a loss of normal cervical range of motion (CROM). Although, fewer studies have demonstrated the exact impact of the procedure on CROM. In our study, short and midterm postoperative CROM was described. Methods: Ninety patients who underwent ACDF were followed up postoperatively for at least 3 months. Active CROM was measured in all patients preoperatively and in postoperative follow-ups by cervical spine X-rays in lateral dynamic view using Cobb’s angle method. Results: Unfortunately, postoperative CROM was significantly diminished. At the short-term (3 months) follow-up there was a great limitation in CROM. While an obvious increase in CROM at the midterm (6 months) follow-up was observed in flexion especially. The reduction in global ROM (calculated as preoperative global ROM – 6 months postoperative ROM) was 4.1 and the reduction rate (calculated as reduction ROM divided by preoperative ROM) was 9.5%. The recovery ROM (calculated as 6 months postoperative ROM – 1 month postoperative ROM) was 8.2. The recovery rate (calculated as recovery ROM divided by 1 month postoperative ROM) was 26.5%. Conclusion: Active CROM following multiple level ACDF was obviously diminished. The most affected motion after surgery was flexion. It was noticed that at the short-term follow-up CROM would be more limited while after further follow up CROM was obviously improved even in neck flexion motion.展开更多
To study the influence of head-neck ratio and implant position on the range of motion (ROM) after total hip arthroplasty (THA).Methods In this study the author established a three-dimensional computerized model of hip...To study the influence of head-neck ratio and implant position on the range of motion (ROM) after total hip arthroplasty (THA).Methods In this study the author established a three-dimensional computerized model of hip joint and tested the range of motion of three different head-neck ratio after total hip arthroplasty.Results Range of motion after total hip arthroplasty depended on design parameters such as head-neck ratio,but also on the implantation parameters such as the cup’s inclination and antevertion,the stem’s antevertion and their combination of each other.Optimal range of motion required compliant position of total hip components.The range of motion increased with the enlarging of head-hnck ratio.Conclusion Higher head-neck ratio leads to optimal range of motion and decreased the prevalence of prosthetic impingement within compliant,well-defined combination of cup’s inclination,cup’s antevertion and stem’s antevertion depending on the intended ROM.Domestic magnesium-silicon jade total hip prosthesis has too low head-neck ratio to result in enough range of motion that fulfilled daily living after total hip arthroplasty.14 refs,4 figs,3 tabs.展开更多
Total knee arthroplasty is highly successful,in part due to range of motion(RoM)recovery.This is typically estimated goniometrically/visually by physical therapists(PTs)in the clinic,which is imprecise.Accordingly,a v...Total knee arthroplasty is highly successful,in part due to range of motion(RoM)recovery.This is typically estimated goniometrically/visually by physical therapists(PTs)in the clinic,which is imprecise.Accordingly,a validated inertial measurement unit(IMU)method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting.The study's objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs,dividing data into PT/non-PT portions of each day,and comparing PT/non-PT metrics.We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings.10 patients(3 M,69±13 years)completed informed consent documents following ethics board approval.A validated IMU method captured long duration(8–12 h/day,~50 days)knee RoM pre-/post-op.Post-op metrics were subdivided(PT versus non-PT).Clinical RoM and patient reported outcome measures were also captured.Compliance and clinical disruption were evaluated.ANOVA compared post-op PT and non-PT means and change scores.Maximum flexion during PT was less than outside PT.PT stance/swing RoM and activity level were greater than outside PT.No temporal variable differences were found PT versus non-PT.IMU RoM measurements capture richer information than clinical measures.Maximum PT flexion was likely less than non-PT due to the exercises completed(i.e.high passive RoM vs.low RoM gait).PT gait flexion likely exceed non-PT because of‘white coat effects’wherein patients are closely monitored clinically.This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance.展开更多
Background:Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues.Vitamin E is an antioxidant with potential anti-fibroblastic effect.The aim of this study was to establish a...Background:Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues.Vitamin E is an antioxidant with potential anti-fibroblastic effect.The aim of this study was to establish an arthrofibrosis rat model after joint replacement and assess the effects of vitamin E supplementation on joint fibrosis.Methods:We simulated knee replacement in 16 male Sprague–Dawley rats.We immobilized the surgical leg with a suture in full flexion.The control groups were killed at 2 and 12 weeks(n=5 per group),and the test group was supplemented daily with vitamin E(0.2 mg/mL)in their drinking water for 12 weeks(n=6).We performed histological staining to investigate the presence and severity of arthrofibrosis.Immunofluorescent staining andα2-macroglobulin(α2M)enzyme-linked immunosorbent assay(ELISA)were used to assess local and systemic inflammation.Static weight bearing(total internal reflection)and range of motion(ROM)were collected for functional assessment.Results:The ROM and weight-bearing symmetry decreased after the procedure and recovered slowly with still significant deficit at the end of the study for both groups.Histological analysis confirmed fibrosis in both lateral and posterior periarticular tissue.Vitamin E supplementation showed a moderate anti-inflammatory effect on the local and systemic levels.The vitamin E group exhibited significant improvement in ROM and weight-bearing symmetry at day 84 compared to the control group.Conclusions:This model is viable for simulating arthrofibrosis after joint replacement.Vitamin E may benefit postsurgical arthrofibrosis,and further studies are needed for dosing requirements.展开更多
Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The applicati...Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The application of evidence-based guidelines to clinical practice can help healthcare professionals to provide good quality care to patients and, in turn, produce better patient outcomes. The purpose of the present paper is to describe the development process of an evidenced-based guideline. Challenges in the implementation of evidence-based practice are identi.ed and strategies for tackling them discussed.展开更多
BACKGROUND There is a lack of studies on the effects of enhanced recovery after surgery(ERAS)with multidisciplinary collaboration on the nursing outcomes of total knee arthroplasty(TKA).AIM To explore the effect of ER...BACKGROUND There is a lack of studies on the effects of enhanced recovery after surgery(ERAS)with multidisciplinary collaboration on the nursing outcomes of total knee arthroplasty(TKA).AIM To explore the effect of ERAS with multidisciplinary collaboration on nursing outcomes after TKA.METHODS We retrospectively analyzed the clinical data of 80 patients who underwent TKA at a tertiary hospital between January 2021 and December 2022.The patients were divided into two groups according to the nursing mode:the ERAS group(n=40)received ERAS with multidisciplinary collaboration,and the conventional group(n=40)received routine nursing.The following indicators were compared between the two groups:length of hospital stay,hospitalization cost,intraoperative blood loss,hemoglobin level 24 h after surgery,visual analog scale(VAS)score for pain,range of motion(ROM)of the knee joint,Hospital for Special Surgery(HSS)knee score,and postoperative complications.RESULTS The ERAS group had a significantly shorter length of hospital stay,lower hospitalization cost,less intraoperative blood loss,higher hemoglobin level 24 h after surgery,lower VAS score for pain,higher knee joint ROM,and higher HSS knee score than the conventional group(all P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).CONCLUSION Multidisciplinary collaboration with ERAS can reduce blood loss,shorten hospital stay,and improve knee function in patients undergoing TKA.展开更多
BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone...BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first phalanx.AIM To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical results.METHODS From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study.The technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic control.Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo follow-up.American Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were recorded.In addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were evaluated.Radiological parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was assessed.Student t-test and Fisher exact test were used to assess statistical analysis.RESULTS From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of follow-up was found in LSTR N group.Complications were rare in both groups.CONCLUSION LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.展开更多
Background:Acute improvement in range of motion(ROM)is a widely reported effect of stretching and foam rolling,which is commonly explained by changes in pain threshold and/or musculotendinous stiffness.Interestingly,t...Background:Acute improvement in range of motion(ROM)is a widely reported effect of stretching and foam rolling,which is commonly explained by changes in pain threshold and/or musculotendinous stiffness.Interestingly,these effects were also reported in response to various other active and passive interventions that induce responses such as enhanced muscle temperature.Therefore,we hypothesized that acute ROM enhancements could be induced by a wide variety of interventions other than stretching or foam rolling that promote an increase in muscle temperature.Methods:After a systematic search in PubMed,Web of Science,and SPORTDiscus databases,38 studies comparing the effects of stretching and foam rolling with several other interventions on ROM and passive properties were included.These studies had 1134 participants in total,and the data analysis resulted in 140 effect sizes(ESs).ES calculations were performed using robust variance estimation model with R-package.Results:Study quality of the included studies was classified as fair(PEDro score=4.58)with low to moderate certainty of evidence.Results showed no significant differences in ROM(ES=0.01,p=0.88),stiffness(ES=0.09,p=0.67),or passive peak torque(ES=-0.30,p=0.14)between stretching or foam rolling and the other identified activities.Funnel plots revealed no publication bias.Conclusion:Based on current literature,our results challenge the established view on stretching and foam rolling as a recommended component of warm-up programs.The lack of significant difference between interventions suggests there is no need to emphasize stretching or foam rolling to induce acute ROM,passive peak torque increases,or stiffness reductions.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 Hands are one of the most common burn sites in children.Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion(ROM),motility,and fine motor activit...BACKGROUND Hands are one of the most common burn sites in children.Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion(ROM),motility,and fine motor activities.Rehabilitation can improve the function of hands.But the optimal time of rehabilitation intervention is still unclear.Therefore,this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention.AIM To investigate the effects of early rehabilitation management of paediatric burnt hands.METHODS A total of 52 children with burnt hands were allocated into the early intervention group(≤1 mo from onset)and a late intervention group(>1 mo from onset)between January 2016 and December 2017.The children received the same rehabilitation programme including skin care,scar massage,passive ROM exercises,active ROM exercises,compression therapy,orthotic devices wearing and game or music therapy.Rehabilitation assessments were performed before and after the rehabilitation treatment.RESULTS In the early intervention group,the ROM of the hands was significantly improved after rehabilitation(P=0.001).But in the late group the effect was not significant statistically(P=0.142).In the early group,38.5%of the patients showed significant improvement,while in the late group,69.2%of the patients showed no significant improvement.The time from onset to posttraumatic rehabilitation(P=0.0007)and length of hospital stay(P=0.003)were negatively correlated with the hand function improvement.The length of rehabilitation stay was positively correlated with the hand function improvement(P=0.005).CONCLUSION These findings suggest that early rehabilitation might show better results in terms of ROM.展开更多
BACKGROUND Gastrointestinal stromal tumors(GISTs)are rare primary neoplasms of the gastrointestinal tract,accounting for 1%to 2%of all gastrointestinal neoplasms worldwide.GISTs are frequently discovered incidentally ...BACKGROUND Gastrointestinal stromal tumors(GISTs)are rare primary neoplasms of the gastrointestinal tract,accounting for 1%to 2%of all gastrointestinal neoplasms worldwide.GISTs are frequently discovered incidentally during workup for other diagnosis or intestinal obstruction,as they can present with few or no symptoms.Simultaneously,GISTs confer a high degree of malignant transformation,with a progression in about 10%to 30%of cases.CASE SUMMARY A 63-year-old healthy female presented to our institution with complaints of right knee pain and limited passive and active motion in the setting of a previous right total knee arthroplasty(TKA).One year after TKA,the patient was incidentally diagnosed with a GIST,which was successfully removed.After removal,the patient continued to have limited range of motion of the right knee and subsequently underwent revision TKA.Intraoperatively significant fibrotic adhesions were found encapsulating the femoral and tibial components.The patient’s pain improved postoperatively,however,she continued to have decreased range of motion with difficulty ambulating.CONCLUSION We propose that this case may demonstrate a proinflammatory milieu arising from a GIST,which had a direct influence on the outcome of recent total knee arthroplasty.This proposed mechanism between neoplastic cytokinetic activity and adhesion formation could have implications on preoperative and postoperative orthopedic management of total knee arthroplasty.展开更多
The objective of this paper is to quantify the local stabilities of the neck and upper extremities （right/left shoulders and right/left elbows）, and investigate differences between linear and nonlinear measurements ...The objective of this paper is to quantify the local stabilities of the neck and upper extremities （right/left shoulders and right/left elbows）, and investigate differences between linear and nonlinear measurements of the associated joint motions and differences in the local stability between the upper and lower extremities. This attempt involves the calculation of a nonlinear parameter, Lyapunov Exponent （LE）, and a linear parameter, Range of Motion （ROM）, during treadmill walking in conj unction with a large population of healthy subjects. Joint motions of subjects were captured using a three-dimensional motion-capture system. Then mathematical chaos theory and the Rosenstein algorithm were employed to calculate LE of joints as the extent of logarithmic divergence between the neighboring state-space trajectories of flexion-extension angles. LEs computed over twenty males and twenty females were 0.037~0.023 for the neck, 0.043＋0.021 for the right shoulder, 0.045i0.030 for the left shoulder, 0.032i0.021 for the right elbow, and 0.034~0.026 for the left elbow. Although statistically significant difference in the ROM was observed between all pairs of the neck and upper extremity joints, differences in the LE between all pairs of the joints as well as between males and females were not statistically significant. Between the upper and lower extremities, LEs of the neck, shoulder, and elbow were significantly smaller than those of the hip （-0.064） and the knee （-0,062）. These results indicate that a statistical difference in the local stability between the upper extremity joints is not significant. However, the different result between the ROM and LE gives a strong rationale for applying both linear and nonlinear tools together to the evaluation of joint movement. The LEs of the joints calculated from a large population of healthy subjects could provide normative values for the associated joints and can be used to evaluate the recovery progress of patients with joint related diseases.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
BACKGROUND Dynamic cervical implant(DCI)stabilization has been reported to have satisfactory clinical and radiological results with short-and mid-term follow-up in the treatment of cervical degenerative disc disease.H...BACKGROUND Dynamic cervical implant(DCI)stabilization has been reported to have satisfactory clinical and radiological results with short-and mid-term follow-up in the treatment of cervical degenerative disc disease.However,few reports about the clinical and radiological outcome with more than 5-year follow-up exist.AIM To investigate the long-term clinical and radiological results of DCI arthroplasty.METHODS A total of 40 patients who received DCI arthroplasty were consecutively reviewed from May 2010 to August 2015.Visual analogue scale(VAS),neck disability index(NDI)score,Japanese Orthopaedic Association(JOA)score,and SF-36 items were used to assess neural function rehabilitation.Static and dynamic radiographs and 3-dimentional computed tomography were used to evaluate the radiological outcomes.RESULTS The scores of neck/arm VAS,NDI,JOA,and 8-dimensions of SF-36 were significantly improved at the 1-mo follow-up(P<0.05)and maintained until the last follow-up(P<0.05).The range of motion(ROM)of C2-C7,functional spinal unit(FSU),upper/lower adjacent level,C2-C7 lateral bending,and FSU lateral bending decreased at the 1-mo follow-up(P<0.05),whereas they increased to the preoperative level at the later follow-up intervals(P>0.05),except the ROM of FSU lateral bending(P<0.05).The C2-C7 alignment and FSU angle kept more lordotic at the last follow-up(P<0.05).The intervertebral height increased significantly at the 1-mo follow-up(P<0.05)and decreased at later follow-ups(P>0.05).At the last follow-up,12(26.1%)segments developed heterotopic ossification.CONCLUSION DCI arthroplasty is a safe and effective non-fusion technique to treat cervical degenerative disc disease in long-term follow-up.展开更多
As the elderly population continues to grow, the number of patients with low back pain is gradually increasing. Among them, Lumbar Degenerative Diseases (LDD) is one of the major contributors to low back pain. Biomech...As the elderly population continues to grow, the number of patients with low back pain is gradually increasing. Among them, Lumbar Degenerative Diseases (LDD) is one of the major contributors to low back pain. Biomechanical in vivo studies of the lumbar spine are mainly performed by implants or imaging data to record the real-time changes of form and stress on the intervertebral disc during motion. However, the current developments are slow due to the technological and ethical limitations. In vitro experiments include animal experiments and cadaver experiments, which are difficult to operate or differ greatly from normal human structures, and the results still need to be verified repeatedly to test their accuracy. As for finite element method, it is relatively low cost and can repeat the experimental results. Therefore, we believe that finite element analysis plays an extremely important role in biomechanical research, especially in analyzing the relationship between different surgical models and the degeneration caused by different mechanics.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Background:To determine the effectiveness of resistive range of motion exercises in improving muscle strength and functional abilities in Duchenne muscular dystrophy.The study was also aimed to determine if resistive range of motion exercises can slow down the progression of the disease.Methods:A seven-year-old male child was diagnosed with Duchenne muscle dystrophy presented to outpatient physiotherapy clinic.The patient was presented with difficulty in stair climbing,sitting up from the floor,fatigue,and muscle weakness specifically weakness in the proximal limb muscles.The progressive resistive range of motion training was implemented for four years to improve muscle strength and functional abilities.The medical research council grading scale,north ambulatory assessment scale,and creatine kinase were used to evaluate muscle strength,functional abilities,and creatine kinase levels.Results:The muscular strength and functional abilities did not improve after four years of exercise training.The creatine kinase levels were decreased over the period of four years.Conclusion:Resistive range of motion exercises are helpful in maintaining the muscular strength and functional abilities in Duchenne muscular dystrophy.
文摘Objective:This study evaluates the reliability of smartphone compass software in measuring the cervical range of motion in healthy people.Methods:We selected 40 healthy intern college students from Tianjin Hospital from June to August 2022 to participate in this study.Two physiotherapists used a smartphone(iPhone 11256 Gb(model A2223))compass software to measure six directions of motion of the cervical spine in 40 subjects in a total of 3 rounds each.The intraclass correlation coefficient was used to compare the reliability intra-group,and the Pearson correlation coefficient was also used to compare the correlation between groups,with P<0.05 being statistically significant.Results:The intraclass correlation coefficient showed good reliability(>0.5)in cervical range of motion(CROM),especially in cervical flexion and right rotation(>0.9).In the correlation comparison between the two groups,the Spearman comparison was used,and the six directions of the cervical spine were significantly correlated(P<0.05).Conclusion:The built-in compass software in smartphones has good reliability in measuring CROM in healthy people.
文摘Objective： To observe the tested results of the segmental range of motion （ROM） of lumbar spine by charge couple device （CCD）-based system for 3-dimensional real-time positioning （CCD system）, and to analyze its clinical significance. Methods： Seven patients with lumbar joint dysfunction and 8 healthy subjects were tested twice by the CCD-based system with an interval of 10 min. Results： The ROM of the patients was obviously lesser than that of the healthy subjects. The measuring data of segmental ROM of lumbar spine by CCD system is correlated significantly to the same data checked later on the same subjects in every direction of the movements. The differences between two checks are usually less than 1 degree. Conclusion： Specially designed CCD based system for 3-dimensional real-time positioning could objectively reflect the segmental ROM of lumbar spine. The system would be of great clinical significance in the assessment of the biomechanical dysfunction of lumbar spine and the effect of the treatment applied.
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Background: Multiple level anterior cervical discectomy and fusion (ACDF) is indicated for those who suffer from multilevel stenosis or compression of the spinal canal. It was reported that this intervention would unfortunately lead to a loss of normal cervical range of motion (CROM). Although, fewer studies have demonstrated the exact impact of the procedure on CROM. In our study, short and midterm postoperative CROM was described. Methods: Ninety patients who underwent ACDF were followed up postoperatively for at least 3 months. Active CROM was measured in all patients preoperatively and in postoperative follow-ups by cervical spine X-rays in lateral dynamic view using Cobb’s angle method. Results: Unfortunately, postoperative CROM was significantly diminished. At the short-term (3 months) follow-up there was a great limitation in CROM. While an obvious increase in CROM at the midterm (6 months) follow-up was observed in flexion especially. The reduction in global ROM (calculated as preoperative global ROM – 6 months postoperative ROM) was 4.1 and the reduction rate (calculated as reduction ROM divided by preoperative ROM) was 9.5%. The recovery ROM (calculated as 6 months postoperative ROM – 1 month postoperative ROM) was 8.2. The recovery rate (calculated as recovery ROM divided by 1 month postoperative ROM) was 26.5%. Conclusion: Active CROM following multiple level ACDF was obviously diminished. The most affected motion after surgery was flexion. It was noticed that at the short-term follow-up CROM would be more limited while after further follow up CROM was obviously improved even in neck flexion motion.
文摘To study the influence of head-neck ratio and implant position on the range of motion (ROM) after total hip arthroplasty (THA).Methods In this study the author established a three-dimensional computerized model of hip joint and tested the range of motion of three different head-neck ratio after total hip arthroplasty.Results Range of motion after total hip arthroplasty depended on design parameters such as head-neck ratio,but also on the implantation parameters such as the cup’s inclination and antevertion,the stem’s antevertion and their combination of each other.Optimal range of motion required compliant position of total hip components.The range of motion increased with the enlarging of head-hnck ratio.Conclusion Higher head-neck ratio leads to optimal range of motion and decreased the prevalence of prosthetic impingement within compliant,well-defined combination of cup’s inclination,cup’s antevertion and stem’s antevertion depending on the intended ROM.Domestic magnesium-silicon jade total hip prosthesis has too low head-neck ratio to result in enough range of motion that fulfilled daily living after total hip arthroplasty.14 refs,4 figs,3 tabs.
基金This was work supported by the National Center for Advancing Translational Sciences of the National Institutes of Health[UL1TR001086].
文摘Total knee arthroplasty is highly successful,in part due to range of motion(RoM)recovery.This is typically estimated goniometrically/visually by physical therapists(PTs)in the clinic,which is imprecise.Accordingly,a validated inertial measurement unit(IMU)method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting.The study's objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs,dividing data into PT/non-PT portions of each day,and comparing PT/non-PT metrics.We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings.10 patients(3 M,69±13 years)completed informed consent documents following ethics board approval.A validated IMU method captured long duration(8–12 h/day,~50 days)knee RoM pre-/post-op.Post-op metrics were subdivided(PT versus non-PT).Clinical RoM and patient reported outcome measures were also captured.Compliance and clinical disruption were evaluated.ANOVA compared post-op PT and non-PT means and change scores.Maximum flexion during PT was less than outside PT.PT stance/swing RoM and activity level were greater than outside PT.No temporal variable differences were found PT versus non-PT.IMU RoM measurements capture richer information than clinical measures.Maximum PT flexion was likely less than non-PT due to the exercises completed(i.e.high passive RoM vs.low RoM gait).PT gait flexion likely exceed non-PT because of‘white coat effects’wherein patients are closely monitored clinically.This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance.
基金supported in part by the Ruth Jackson Orthopedic Society and the Harris Orthopedic Laboratoryapproved by the Institutional Care and Use Committee of Massachusetts General Hospital(2020N000081)。
文摘Background:Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues.Vitamin E is an antioxidant with potential anti-fibroblastic effect.The aim of this study was to establish an arthrofibrosis rat model after joint replacement and assess the effects of vitamin E supplementation on joint fibrosis.Methods:We simulated knee replacement in 16 male Sprague–Dawley rats.We immobilized the surgical leg with a suture in full flexion.The control groups were killed at 2 and 12 weeks(n=5 per group),and the test group was supplemented daily with vitamin E(0.2 mg/mL)in their drinking water for 12 weeks(n=6).We performed histological staining to investigate the presence and severity of arthrofibrosis.Immunofluorescent staining andα2-macroglobulin(α2M)enzyme-linked immunosorbent assay(ELISA)were used to assess local and systemic inflammation.Static weight bearing(total internal reflection)and range of motion(ROM)were collected for functional assessment.Results:The ROM and weight-bearing symmetry decreased after the procedure and recovered slowly with still significant deficit at the end of the study for both groups.Histological analysis confirmed fibrosis in both lateral and posterior periarticular tissue.Vitamin E supplementation showed a moderate anti-inflammatory effect on the local and systemic levels.The vitamin E group exhibited significant improvement in ROM and weight-bearing symmetry at day 84 compared to the control group.Conclusions:This model is viable for simulating arthrofibrosis after joint replacement.Vitamin E may benefit postsurgical arthrofibrosis,and further studies are needed for dosing requirements.
文摘Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The application of evidence-based guidelines to clinical practice can help healthcare professionals to provide good quality care to patients and, in turn, produce better patient outcomes. The purpose of the present paper is to describe the development process of an evidenced-based guideline. Challenges in the implementation of evidence-based practice are identi.ed and strategies for tackling them discussed.
文摘BACKGROUND There is a lack of studies on the effects of enhanced recovery after surgery(ERAS)with multidisciplinary collaboration on the nursing outcomes of total knee arthroplasty(TKA).AIM To explore the effect of ERAS with multidisciplinary collaboration on nursing outcomes after TKA.METHODS We retrospectively analyzed the clinical data of 80 patients who underwent TKA at a tertiary hospital between January 2021 and December 2022.The patients were divided into two groups according to the nursing mode:the ERAS group(n=40)received ERAS with multidisciplinary collaboration,and the conventional group(n=40)received routine nursing.The following indicators were compared between the two groups:length of hospital stay,hospitalization cost,intraoperative blood loss,hemoglobin level 24 h after surgery,visual analog scale(VAS)score for pain,range of motion(ROM)of the knee joint,Hospital for Special Surgery(HSS)knee score,and postoperative complications.RESULTS The ERAS group had a significantly shorter length of hospital stay,lower hospitalization cost,less intraoperative blood loss,higher hemoglobin level 24 h after surgery,lower VAS score for pain,higher knee joint ROM,and higher HSS knee score than the conventional group(all P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).CONCLUSION Multidisciplinary collaboration with ERAS can reduce blood loss,shorten hospital stay,and improve knee function in patients undergoing TKA.
文摘BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first phalanx.AIM To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical results.METHODS From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study.The technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic control.Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo follow-up.American Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were recorded.In addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were evaluated.Radiological parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was assessed.Student t-test and Fisher exact test were used to assess statistical analysis.RESULTS From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of follow-up was found in LSTR N group.Complications were rare in both groups.CONCLUSION LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.
文摘Background:Acute improvement in range of motion(ROM)is a widely reported effect of stretching and foam rolling,which is commonly explained by changes in pain threshold and/or musculotendinous stiffness.Interestingly,these effects were also reported in response to various other active and passive interventions that induce responses such as enhanced muscle temperature.Therefore,we hypothesized that acute ROM enhancements could be induced by a wide variety of interventions other than stretching or foam rolling that promote an increase in muscle temperature.Methods:After a systematic search in PubMed,Web of Science,and SPORTDiscus databases,38 studies comparing the effects of stretching and foam rolling with several other interventions on ROM and passive properties were included.These studies had 1134 participants in total,and the data analysis resulted in 140 effect sizes(ESs).ES calculations were performed using robust variance estimation model with R-package.Results:Study quality of the included studies was classified as fair(PEDro score=4.58)with low to moderate certainty of evidence.Results showed no significant differences in ROM(ES=0.01,p=0.88),stiffness(ES=0.09,p=0.67),or passive peak torque(ES=-0.30,p=0.14)between stretching or foam rolling and the other identified activities.Funnel plots revealed no publication bias.Conclusion:Based on current literature,our results challenge the established view on stretching and foam rolling as a recommended component of warm-up programs.The lack of significant difference between interventions suggests there is no need to emphasize stretching or foam rolling to induce acute ROM,passive peak torque increases,or stiffness reductions.
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.
基金by the State Key Laboratory of Trauma,Burn and Combined Injury,No.SKL11201802Chongqing Basic Research and Frontier Exploration Project,No.cstc2017jcyjAX0242.
文摘BACKGROUND Hands are one of the most common burn sites in children.Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion(ROM),motility,and fine motor activities.Rehabilitation can improve the function of hands.But the optimal time of rehabilitation intervention is still unclear.Therefore,this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention.AIM To investigate the effects of early rehabilitation management of paediatric burnt hands.METHODS A total of 52 children with burnt hands were allocated into the early intervention group(≤1 mo from onset)and a late intervention group(>1 mo from onset)between January 2016 and December 2017.The children received the same rehabilitation programme including skin care,scar massage,passive ROM exercises,active ROM exercises,compression therapy,orthotic devices wearing and game or music therapy.Rehabilitation assessments were performed before and after the rehabilitation treatment.RESULTS In the early intervention group,the ROM of the hands was significantly improved after rehabilitation(P=0.001).But in the late group the effect was not significant statistically(P=0.142).In the early group,38.5%of the patients showed significant improvement,while in the late group,69.2%of the patients showed no significant improvement.The time from onset to posttraumatic rehabilitation(P=0.0007)and length of hospital stay(P=0.003)were negatively correlated with the hand function improvement.The length of rehabilitation stay was positively correlated with the hand function improvement(P=0.005).CONCLUSION These findings suggest that early rehabilitation might show better results in terms of ROM.
文摘BACKGROUND Gastrointestinal stromal tumors(GISTs)are rare primary neoplasms of the gastrointestinal tract,accounting for 1%to 2%of all gastrointestinal neoplasms worldwide.GISTs are frequently discovered incidentally during workup for other diagnosis or intestinal obstruction,as they can present with few or no symptoms.Simultaneously,GISTs confer a high degree of malignant transformation,with a progression in about 10%to 30%of cases.CASE SUMMARY A 63-year-old healthy female presented to our institution with complaints of right knee pain and limited passive and active motion in the setting of a previous right total knee arthroplasty(TKA).One year after TKA,the patient was incidentally diagnosed with a GIST,which was successfully removed.After removal,the patient continued to have limited range of motion of the right knee and subsequently underwent revision TKA.Intraoperatively significant fibrotic adhesions were found encapsulating the femoral and tibial components.The patient’s pain improved postoperatively,however,she continued to have decreased range of motion with difficulty ambulating.CONCLUSION We propose that this case may demonstrate a proinflammatory milieu arising from a GIST,which had a direct influence on the outcome of recent total knee arthroplasty.This proposed mechanism between neoplastic cytokinetic activity and adhesion formation could have implications on preoperative and postoperative orthopedic management of total knee arthroplasty.
文摘The objective of this paper is to quantify the local stabilities of the neck and upper extremities （right/left shoulders and right/left elbows）, and investigate differences between linear and nonlinear measurements of the associated joint motions and differences in the local stability between the upper and lower extremities. This attempt involves the calculation of a nonlinear parameter, Lyapunov Exponent （LE）, and a linear parameter, Range of Motion （ROM）, during treadmill walking in conj unction with a large population of healthy subjects. Joint motions of subjects were captured using a three-dimensional motion-capture system. Then mathematical chaos theory and the Rosenstein algorithm were employed to calculate LE of joints as the extent of logarithmic divergence between the neighboring state-space trajectories of flexion-extension angles. LEs computed over twenty males and twenty females were 0.037~0.023 for the neck, 0.043＋0.021 for the right shoulder, 0.045i0.030 for the left shoulder, 0.032i0.021 for the right elbow, and 0.034~0.026 for the left elbow. Although statistically significant difference in the ROM was observed between all pairs of the neck and upper extremity joints, differences in the LE between all pairs of the joints as well as between males and females were not statistically significant. Between the upper and lower extremities, LEs of the neck, shoulder, and elbow were significantly smaller than those of the hip （-0.064） and the knee （-0,062）. These results indicate that a statistical difference in the local stability between the upper extremity joints is not significant. However, the different result between the ROM and LE gives a strong rationale for applying both linear and nonlinear tools together to the evaluation of joint movement. The LEs of the joints calculated from a large population of healthy subjects could provide normative values for the associated joints and can be used to evaluate the recovery progress of patients with joint related diseases.
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BACKGROUND Dynamic cervical implant(DCI)stabilization has been reported to have satisfactory clinical and radiological results with short-and mid-term follow-up in the treatment of cervical degenerative disc disease.However,few reports about the clinical and radiological outcome with more than 5-year follow-up exist.AIM To investigate the long-term clinical and radiological results of DCI arthroplasty.METHODS A total of 40 patients who received DCI arthroplasty were consecutively reviewed from May 2010 to August 2015.Visual analogue scale(VAS),neck disability index(NDI)score,Japanese Orthopaedic Association(JOA)score,and SF-36 items were used to assess neural function rehabilitation.Static and dynamic radiographs and 3-dimentional computed tomography were used to evaluate the radiological outcomes.RESULTS The scores of neck/arm VAS,NDI,JOA,and 8-dimensions of SF-36 were significantly improved at the 1-mo follow-up(P<0.05)and maintained until the last follow-up(P<0.05).The range of motion(ROM)of C2-C7,functional spinal unit(FSU),upper/lower adjacent level,C2-C7 lateral bending,and FSU lateral bending decreased at the 1-mo follow-up(P<0.05),whereas they increased to the preoperative level at the later follow-up intervals(P>0.05),except the ROM of FSU lateral bending(P<0.05).The C2-C7 alignment and FSU angle kept more lordotic at the last follow-up(P<0.05).The intervertebral height increased significantly at the 1-mo follow-up(P<0.05)and decreased at later follow-ups(P>0.05).At the last follow-up,12(26.1%)segments developed heterotopic ossification.CONCLUSION DCI arthroplasty is a safe and effective non-fusion technique to treat cervical degenerative disc disease in long-term follow-up.
文摘As the elderly population continues to grow, the number of patients with low back pain is gradually increasing. Among them, Lumbar Degenerative Diseases (LDD) is one of the major contributors to low back pain. Biomechanical in vivo studies of the lumbar spine are mainly performed by implants or imaging data to record the real-time changes of form and stress on the intervertebral disc during motion. However, the current developments are slow due to the technological and ethical limitations. In vitro experiments include animal experiments and cadaver experiments, which are difficult to operate or differ greatly from normal human structures, and the results still need to be verified repeatedly to test their accuracy. As for finite element method, it is relatively low cost and can repeat the experimental results. Therefore, we believe that finite element analysis plays an extremely important role in biomechanical research, especially in analyzing the relationship between different surgical models and the degeneration caused by different mechanics.
