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Bhagwatkar SS, Harjpal P, Ankar P. A Case Report of Sjögren's Syndrome and Rheumatoid Arthritis: The Role of Physiotherapy in Enhancing Quality of Life. Cureus 2024; 16:e55411. [PMID: 38567231 PMCID: PMC10985055 DOI: 10.7759/cureus.55411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease with profound effects on joints and extra-articular organs. This case report explores the complex treatment approach for a 54-year-old female patient who is dealing with the dual diagnosis of RA and Sjogren's syndrome (SS). RA primarily involves joint inflammation and morning stiffness leading to significant disability, while SS, another autoimmune condition, manifests with autoantibodies and lymphocytic infiltration affecting exocrine glands. The patient presented with joint and low back pain, alongside reduced mobility, portraying a complex clinical picture. Physiotherapy played a crucial role in addressing the diverse symptoms exhibited by the patient. Treatment involved Mulligan mobilization targeting sacroiliac joint dysfunction, laser therapy for pain relief, and tailored exercises focusing on joint mobility and muscle strength. Progress was monitored using the Rheumatoid Arthritis Disease Activity Index (RADAI-5) and overall quality of life assessments. Significant improvements were observed post-rehabilitation including reduced pain levels, increased joint range of motion, increased muscle strength, and enhanced sacroiliac mobility. These positive outcomes highlight the efficacy of physiotherapy in managing autoimmune rheumatic disorders. Collaboration between healthcare professionals particularly rheumatologists and physiotherapists is essential for comprehensive patient care. This case emphasizes the importance of adopting a holistic approach to managing autoimmune disorders. Physiotherapy emerges as a pivotal component in alleviating symptoms and enhancing physical function underscoring its integration into the multidisciplinary care framework for individuals facing the challenges of autoimmune rheumatic disorders.
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Affiliation(s)
- Sawari S Bhagwatkar
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pallavi Harjpal
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prajyot Ankar
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Yamamoto N, Arino A, Kawakami J, Aizawa T, Itoi E. When and how much does the muscle strength recover after arthroscopic superior capsular reconstruction? J Shoulder Elbow Surg 2024; 33:306-311. [PMID: 37473907 DOI: 10.1016/j.jse.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Recently, arthroscopic superior capsular reconstruction (SCR) has been performed for irreparable large to massive rotator cuff tears and excellent clinical results have been reported. Although the muscle strength is reported to recover, it has not yet been clarified when and how much it recovers. The purpose of this study was to determine the recovery pattern of muscle strength after SCR. METHODS We retrospectively reviewed 35 patients (mean age, 65 years) who met the following inclusion criteria: (1) patients with large to massive irreparable tears of the rotator cuff including the supraspinatus and infraspinatus tendons; (2) those with severe muscle atrophy and fatty change; (3) those who underwent assessment of muscle quality and strength by magnetic resonance imaging and dynamometry at 6 months, 1 year, and 2 years; (4) those with a minimum follow-up period of 2 years; and (5) those without severe osteoarthritis. The isometric muscle strength of scaption (ie, scapular-plane elevation), internal rotation, and external rotation in adduction was measured twice for each motion by a dynamometer. RESULTS Relative to the muscle strength on the uninvolved side, the involved side showed 61% ± 21% in scaption, 63% ± 20% in external rotation, and 103% ± 29% in internal rotation at 2 years after surgery. Whereas no significant differences were observed between the 1-year and 2-year follow-up assessments, a significant difference in muscle strength of scaption was found between 6 months and 1 year (P = .0174). Graft retear was seen in 5 cases (14%). There was a trend that the muscle strength of scaption and external rotation in the no-retear group was greater than that in the retear group despite no significant difference (P = .0717 and P = .0824, respectively). CONCLUSION The recovery of the muscle strength after SCR was observed until 1 year after surgery, and the muscle strength of scaption and external rotation returned to 60% of that on the uninvolved side at 2 years.
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Affiliation(s)
- Nobuyuki Yamamoto
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
| | - Atsushi Arino
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Jun Kawakami
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Toshimi Aizawa
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan
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Naz F, Hussain D, Ali H, Raza Q, Siddique F. Effectiveness of functional electrical stimulation machine in managing neurological diseases - A retrospective study. Pak J Med Sci 2024; 40:S53-S57. [PMID: 38328644 PMCID: PMC10844914 DOI: 10.12669/pjms.40.2(icon).8966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/18/2023] [Accepted: 11/16/2023] [Indexed: 02/09/2024] Open
Abstract
Background & Objective Cerebrovascular Accident (CVA) or stroke, Spinal Cord injury can lead to neurological diseases resulting in major loss in motor function causing hemiplegia or tetraplegia. In 2019, according to The Global Burden of Diseases (GBD) CVA/Stroke is the second leading cause of death and the third leading cause of death and disability combined, globally. Its prevalence vary drastically among South Asian countries. The objective of this study was to determine the effectiveness of Functional Electrical Stimulation (FES) machine on neurologically impaired patients at the Physical Therapy department at IHHN, Karachi, Pakistan. Method In this retrospective study data was extracted from August 2016 to February 2022 on patients with neurological symptoms i.e. hemiplegia or paraplegia with muscle power of two or less on Manual Muscle Testing (MMT). The parameters for evaluating patients progress pre and post treatment were MMT results and their mobility status. The number of sessions ranged between 40 to 100 sessions of Functional Electrical Stimulation (FES) provided on alternate days according to the patient's need. Result Data of 51 patients who had completed their treatment were extracted and analyzed. The mean age of patients who completed treatment was 49.62 ± 17.26 years. Out of 51(100%), 30 (58.8%) were male and 21 (41.2%) were female. Pre- and post-treatment median (IQR) showed remarkable improvement in MMT of upper limb muscle (from 1.0 to 4.0) and lower limb muscle (from 2.0 to 4.0). Conclusion FES cycling is an effective treatment for patients with neurological impairments, as it resulted in improvement in both upper and lower limb muscle strength, along with mobility status.
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Affiliation(s)
- Farah Naz
- Farah Naz, Department of Physical Therapy, Indus Hospital and Health Network, Karachi, Pakistan
| | - Danish Hussain
- Danish Hussain, Department of Physical Therapy, Indus Hospital and Health Network, Karachi, Pakistan
| | - Hussain Ali
- Hussain Ali, Department of Physical Therapy, Indus Hospital and Health Network, Karachi, Pakistan
| | - Qasim Raza
- Qasim Raza, Department of Physical Therapy, Indus Hospital and Health Network, Karachi, Pakistan
| | - Farrukh Siddique
- Farrukh Siddique, Department of Physical Therapy, Indus Hospital and Health Network, Karachi, Pakistan
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Cho SY, Myong Y, Park S, Cho M, Kim S. A portable articulated dynamometer for ankle dorsiflexion and plantar flexion strength measurement: a design, validation, and user experience study. Sci Rep 2023; 13:22221. [PMID: 38097727 PMCID: PMC10721896 DOI: 10.1038/s41598-023-49263-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
Monitoring ankle strength is crucial for assessing daily activities, functional ability, and preventing lower extremity injuries. However, the current methods for measuring ankle strength are often unreliable or not easily portable to be used in clinical settings. Therefore, this study proposes a portable dynamometer with high reliability capable of measuring ankle dorsiflexion and plantar flexion. The proposed portable dynamometer comprised plates made of aluminum alloy 6061 and a miniature tension-compression load cell. A total of 41 healthy adult participants applied maximal isometric dorsiflexor and plantar flexor forces on a Lafayette Handheld Dynamometer (HHD) and the portable dynamometer. The results were cross-validated, using change in mean, and two independent examiners evaluated the inter-rater and test-retest reliabilities in separate sessions using intraclass correlation coefficients, standard error of measurement, and minimal detectable change. Both dorsiflexion and plantar flexion measurements demonstrated a strong correlation with the HHD (r = 0.827; r = 0.973) and showed high inter-rater and test-retest reliabilities. Additionally, the participant responses to the user experience questionnaire survey indicated vastly superior positive experiences with the portable dynamometer. The study findings suggest that the designed portable dynamometer can provide accurate and reliable measurements of ankle strengths, making it a potential alternative to current methods in clinical settings.
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Affiliation(s)
- Seung Yeon Cho
- Interdisciplinary Program in Bioengineering, The Graduate School, Seoul National University, Seoul, South Korea
| | - Youho Myong
- Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sungwoo Park
- Interdisciplinary Program in Bioengineering, The Graduate School, Seoul National University, Seoul, South Korea
- Institute of Innovative Medical Technology, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Minwoo Cho
- Department of Transdisciplinary Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea.
| | - Sungwan Kim
- Interdisciplinary Program in Bioengineering, The Graduate School, Seoul National University, Seoul, South Korea.
- Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
- Institute of Bioengineering, Seoul National University, Seoul, South Korea.
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Verspeelt P, DE Muynck M, Vanderstraeten G, Vanden Bossche L, Stassijns G, Öczakar L. External to internal glenohumeral strength ratio in non-traumatic rotator cuff pathologies. Acta Orthop Belg 2023; 89:207-211. [PMID: 37924536 DOI: 10.52628/89.2.11566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Background and study aims A correct agonist -antagonist strength relationship for shoulder external and internal rotation is necessary for functional stability of the shoulder. This strength relationship is described by the ratio of external to internal strength (ER/IR).The aim of this stydy is to produce comparative data as regards the ER/IR ratio in subjects with different non-traumatic rotator cuff diseases. Design and setting A cross-sectional study in an outpatient clinic in a tertiary care university hospital. Methods In 55 subjects with rotator cuff disease (confirmed by physical examination and assessed by ultrasound and magnetic resonance arthrography), the ER/IR ratio of the shoulder was isometrically measured with a hand-held dynamometer and compared with values pertaining to the unaffected shoulder of the same individuals. Results The mean ER/IR values in the overall group were 0.89 (SD 0.18) and 0.94 (SD 0.22) for the affected and unaffected shoulders, respectively. The ratio was 0.87 (SD 0.23) in patients with subdeltoid bursitis, 0.88 (SD 0.16) in rotator cuff tendinopathy and 0.87 (SD 0.22) in patients with rotator cuff tears. Conclusions The ER/IR ratio appears to be similar between the affected and unaffected shoulders of subjects with nontraumatic cuff pathologies.
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Hile ES, Ghazi M, Chandrashekhar R, Rippetoe J, Fox A, Wang H. Development and Earliest Validation of a Portable Device for Quantification of Hallux Extension Strength (QuHalEx). Sensors (Basel) 2023; 23:4654. [PMID: 37430569 PMCID: PMC10223981 DOI: 10.3390/s23104654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 07/12/2023]
Abstract
Hallux strength is associated with sports performance and balance across the lifespan, and independently predicts falls in older adults. In rehabilitation, Medical Research Council (MRC) Manual Muscle Testing (MMT) is the clinical standard for hallux strength assessment, but subtle weakness and longitudinal changes in strength may go undetected. To address the need for research-grade yet clinically feasible options, we designed a new load cell device and testing protocol to Quantify Hallux Extension strength (QuHalEx). We aim to describe the device, protocol and initial validation. In benchtop testing, we used eight precision weights to apply known loads from 9.81 to 78.5 N. In healthy adults, we performed three maximal isometric tests for hallux extension and flexion on the right and left sides. We calculated the Intraclass Correlation Coefficient (ICC) with 95% confidence interval and descriptively compared our isometric force-time output to published parameters. QuHalEx benchtop absolute error ranged from 0.02 to 0.41 (mean 0.14) N. Benchtop and human intrasession output was repeatable (ICC 0.90-1.00, p < 0.001). Hallux strength in our sample (n = 38, age 33.5 ± 9.6 years, 53% female, 55% white) ranged from 23.1 to 82.0 N peak extension force and 32.0 to 142.4 N peak flexion, and differences of ~10 N (15%) between toes of the same MRC grade (5) suggest that QuHalEx is able to detect subtle weakness and interlimb asymmetries that are missed by MMT. Our results support ongoing QuHalEx validation and device refinement with a longer-term goal of widespread clinical and research application.
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Affiliation(s)
- Elizabeth S. Hile
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center College of Allied Health, 1200 North Stonewall Ave., Oklahoma City, OK 73117, USA; (J.R.); (A.F.)
- OU Health Stephenson Cancer Center, 800 NE 10th Street, Oklahoma City, OK 73104, USA
| | - Mustafa Ghazi
- Infant Neuromotor Control Laboratory, Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
| | - Raghuveer Chandrashekhar
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32603, USA; (R.C.); (H.W.)
| | - Josiah Rippetoe
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center College of Allied Health, 1200 North Stonewall Ave., Oklahoma City, OK 73117, USA; (J.R.); (A.F.)
| | - Ashley Fox
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center College of Allied Health, 1200 North Stonewall Ave., Oklahoma City, OK 73117, USA; (J.R.); (A.F.)
| | - Hongwu Wang
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32603, USA; (R.C.); (H.W.)
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Villalón-González M, Fernández de Luco-Santamaría Í, Cuesta-Barriuso R, López-Pina JA, Pérez-Llanes R. Hemophilic Arthropathy of the Knee and Its Association with Reduced Muscle Strength and Activation and the Pressure Pain Threshold: A Case-Control Study. J Clin Med 2023; 12:3275. [PMID: 37176715 PMCID: PMC10179255 DOI: 10.3390/jcm12093275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/29/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: Hemophilia is characterized by recurrent hemarthrosis leading to degenerative arthropathy. The aim was to evaluate the differences in muscle strength and activity and the pressure pain threshold between patients with knee arthropathy and their healthy peers; (2) Methods: A case-control study in which 23 adult patients with knee arthropathy and 24 healthy peers matched in terms of characteristics were recruited. The study variables were quadriceps muscle strength, muscle activation and the pressure pain threshold; (3) Results: There were significant differences between the two groups in quadriceps strength on the dominant (CI95%: 64.69, 129.2) and non-dominant (CI95%: 29.95, 93.55) sides and in the pressure pain threshold on the dominant (CI95%: 3.30, 43.54) and non-dominant (CI95%: 3.09, 45.25) sides. There were differences in neuromuscular fatigue on the non-dominant side in the vastus medialis (CI95%: 8.72, 21.51), vastus lateralis (CI95%: 4.84, 21.66) and rectus femoris (CI95%: 6.48, 24.95) muscles; (4) Conclusions: Muscle strength and the pressure pain threshold are lower in patients with hemophilia. Quadriceps muscle activation in patients with hemophilic knee arthropathy does not in any way differ from activation in healthy subjects. However, muscle fatigue is greater in patients with knee arthropathy. Strength training in patients with hemophilia should focus on the activation of the vastus medialis and lateralis muscles.
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Affiliation(s)
| | | | - Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, 33006 Oviedo, Spain
| | | | - Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain; (Í.F.d.L.-S.); (R.P.-L.)
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Schreiber-Katz O, Siegler HA, Wieselmann G, Kumpe M, Ranxha G, Petri S, Osmanovic A. Improvement of muscle strength in specific muscular regions in nusinersen-treated adult patients with 5q-spinal muscular atrophy. Sci Rep 2023; 13:6240. [PMID: 37069197 PMCID: PMC10107562 DOI: 10.1038/s41598-023-31617-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/14/2023] [Indexed: 04/19/2023] Open
Abstract
Real-world data have shown mild improvement of overall motor function in adult patients treated with nusinersen, the first approved therapy for 5q-spinal muscular atrophy (SMA). However, knowledge about preferably targeted muscle functions is sparse. The aim of this study was to evaluate strength of distinct muscles and body regions in adult SMA patients in the early course of nusinersen therapy. 72 muscles of 15 patients were tested on the Medical Research Council (MRC) 0-10 scale (translated into MRC %) from nusinersen start to 14 months of treatment. The whole body muscular strength improved slightly or remained stable in 80% of SMA patients with a median improvement of + 2%. However, relevant increases of muscle strength of distinct regions were identified in the proximal upper limbs and shoulder girdle (median + 8%) and in muscle groups with a preserved function pre-treatment, even in more advanced diseased SMA patients. MRC grading was additionally performed in seven patients enrolled during ongoing treatment. Here, further improvement of muscle strength until month 18-26 was seen with the highest increases in the proximal upper and lower limbs. Our findings suggest that sole evaluation of the overall muscle strength might underestimate nusinersen therapy benefits.
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Affiliation(s)
| | | | - Gary Wieselmann
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Mareike Kumpe
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Gresa Ranxha
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Alma Osmanovic
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany.
- Essen Center for Rare Diseases (EZSE), University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
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Morin M, Hébert LJ, Perron M, Petitclerc É, Lake SR, Duchesne E. Psychometric properties of a standardized protocol of muscle strength assessment by hand-held dynamometry in healthy adults: a reliability study. BMC Musculoskelet Disord 2023; 24:294. [PMID: 37060020 PMCID: PMC10103411 DOI: 10.1186/s12891-023-06400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Maximal isometric muscle strength (MIMS) assessment is a key component of physiotherapists' work. Hand-held dynamometry (HHD) is a simple and quick method to obtain quantified MIMS values that have been shown to be valid, reliable, and more responsive than manual muscle testing. However, the lack of MIMS reference values for several muscle groups in healthy adults with well-known psychometric properties limits the use and the interpretation of these measures obtained with HHD in clinic. OBJECTIVE To determine the intra- and inter-rater reliability, standard error of measurement (SEM) and minimal detectable change (MDC) of MIMS torque values obtained with HHD. METHODS Intra and Inter-rater Reliability Study. The MIMS torque of 17 muscle groups was assessed by two independent raters at three different times in 30 healthy adults using a standardized HHD protocol using the MEDup™ (Atlas Medic, Québec, Canada). Participants were excluded if they presented any of the following criteria: 1) participation in sport at a competitive level; 2) degenerative or neuromusculoskeletal disease that could affect torque measurements; 3) traumatic experience or disease in the previous years that could affect their muscle function; and 4) use of medication that could impact muscle strength (e.g., muscle relaxants, analgesics, opioids) at the time of the evaluation. Intra- and inter-rater reliability were determined using two-way mixed (intra) and random effects (inter) absolute agreement intraclass correlation coefficients (ICC: 95% confidence interval) models. SEM and MDC were calculated from these data. RESULTS Intra- and inter-rater reliability were excellent with ICC (95% confidence interval) varying from 0.90 to 0.99 (0.85-0.99) and 0.89 to 0.99 (0.55-0.995), respectively. Absolute SEM and MDC for intra-rater reliability ranged from 0.14 to 3.20 Nm and 0.38 to 8.87 Nm, respectively, and from 0.17 to 5.80 Nm and 0.47 to 16.06 Nm for inter-rater reliability, respectively. CONCLUSIONS The excellent reliability obtained in this study suggest that the use of such a standardized HHD protocol is a method of choice for MIMS torque measurements in both clinical and research settings. And the identification of the now known metrological qualities of such a protocol should encourage and promote the optimal use of manual dynamometry.
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Affiliation(s)
- Marika Morin
- Department of Health Sciences, Université du Québec à Chicoutimi, 555 Bd de l'Université, Chicoutimi, QC, G7H 2B1, Canada
| | - Luc J Hébert
- Department of Rehabilitation, and Department of Radiology and Nuclear Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Interdisciplinary Research Group On Neuromuscular Diseases (GRIMN), Integrated University Center of Health and Social Services of Saguenay-Lac-St-Jean, Jonquiere, Canada
- Interdisciplinary Research Centre for Rehabilitation and Social Integration (CIRRIS), Integrated University Center of Health and Social Services of the Capitale-Nationale, Quebec City, QC, Canada
| | - Marc Perron
- Department of Rehabilitation, and Department of Radiology and Nuclear Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Émilie Petitclerc
- Interdisciplinary Research Centre for Rehabilitation and Social Integration (CIRRIS), Integrated University Center of Health and Social Services of the Capitale-Nationale, Quebec City, QC, Canada
| | - Shanna-Rose Lake
- Interdisciplinary Research Centre for Rehabilitation and Social Integration (CIRRIS), Integrated University Center of Health and Social Services of the Capitale-Nationale, Quebec City, QC, Canada
| | - Elise Duchesne
- Department of Health Sciences, Université du Québec à Chicoutimi, 555 Bd de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
- Interdisciplinary Research Group On Neuromuscular Diseases (GRIMN), Integrated University Center of Health and Social Services of Saguenay-Lac-St-Jean, Jonquiere, Canada.
- Intersectoral Center for Sustainable Health, Université du Québec À Chicoutimi, Chicoutimi, QC, Canada.
- Research Center of Charles-Le Moyne (CRCLM), Sherbrooke, QC, Canada.
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McGee CW, Burbach K, McIlrath S. Test-retest Reliability and Precision of the Rotterdam Intrinsic Hand Myometer. J Hand Surg Am 2023:S0363-5023(23)00046-1. [PMID: 36907726 PMCID: PMC10492894 DOI: 10.1016/j.jhsa.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/26/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The purpose of this study was to determine the test-retest reliability and precision of Rotterdam Intrinsic Hand Myometer (RIHM) in healthy adults. METHODS Twenty-nine participants originally recruited via convenience sampling at a Midwestern state fair returned approximately 8 days later for retest. An average of three trials for each of the five intrinsic hand strength measurements were collected using the same technique that was used during initial testing. Test-retest reliability was assessed using the intraclass correlation coefficient or ICC(2,3) and precision was evaluated using the standard error of measurement (SEM), and the minimal detectable change (MDC90)/MDC%. RESULTS Across all measures of intrinsic strength, the RIHM and its standardized procedures had excellent test-retest reliability. Index finger metacarpophalangeal flexion demonstrated the lowest reliability, and right small finger abduction, left thumb carpometacarpal abduction, and index finger metacarpophalangeal abduction tests had the highest reliability. Precision, as evidenced by SEM and MDC values, was excellent for tests of left index and bilateral small finger abduction strength and acceptable for all other measurements. CONCLUSIONS Test-retest reliability and precision of RIHM across all measurements was excellent. CLINICAL RELEVANCE These findings indicate that RIHM is a reliable and precise tool in measuring intrinsic strength of hands of healthy adults, although further research is needed in clinical populations.
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Affiliation(s)
- Corey W McGee
- Program in Occupational Therapy, Center for Allied Health Programs, University of Minnesota, Minneapolis, MN; Program in Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, MN.
| | - Karin Burbach
- Program in Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, MN
| | - Samantha McIlrath
- Essentia Health Polinsky Medical Center, Department of Occupational Therapy, Duluth, MN
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11
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Watanuki K, Koga H. Case report: Diagnostic clues for anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase myopathy in pediatric patients. Front Pediatr 2023; 11:1102539. [PMID: 36994439 PMCID: PMC10040642 DOI: 10.3389/fped.2023.1102539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) myopathy is a recently recognized pathology, but appears less common in children and the characteristics of pediatric cases remain unclear. Case report We report a pediatric case of anti-HMGCR myopathy accompanied by skin rash. Motor function and serum creatine kinase level normalized after combinational treatment including early intravenous immunoglobulin, methotrexate, and corticosteroid. Literature review We searched PubMed and identified reports with detailed clinical information of 33 pediatric patients <18 years old with anti-HMGCR myopathy. Among these 33 patients and our own case, skin rash and maximum serum creatine kinase level >5,000 IU/L were observed in 44% (15 patients) and 94% (32 patients), respectively. Skin rash was present in 15 of the 22 patients (68%) ≥7 years old and none of the 12 patients (0%) <7 years old. Among the 15 patients with skin rash, 12 (80%) presented with erythematous rash. Conclusion Erythematous skin rash may offer a clue to the diagnosis of anti-HMGCR myopathy in children with muscle weakness and serum creatine kinase level >5,000 IU/L in the absence of other myositis-specific antibodies, particularly in patients ≥7 years old. Our results suggest the importance of early anti-HMGCR testing in pediatric patients with these manifestations.
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Affiliation(s)
- Keisuke Watanuki
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
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12
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Ucero-Lozano R, Pérez-Llanes R, López-Pina JA, Cuesta-Barriuso R. 180-degree immersive VR motion visualization in the treatment of haemophilic ankle arthropathy. Haemophilia 2023; 29:282-289. [PMID: 36261396 PMCID: PMC10092164 DOI: 10.1111/hae.14683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/12/2022] [Accepted: 10/04/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Patients with haemophilic arthropathy suffer chronic pain that affects and restricts their quality of life. Visualization of movement through immersive virtual reality is used for pain management. AIM To evaluate the efficacy of 180-degree immersive VR motion visualization therapy in patients with haemophilic ankle arthropathy. METHODS Prospective, multicentre pilot study. Fifteen adult patients with bilateral haemophilic ankle arthropathy were recruited (mean age: 42.73 ± 12.36 years). The intervention lasted 4 weeks, with daily home sessions of 180-degree immersive motion visualization. The patients were given virtual reality glasses to use with their smartphones. From the YouTube mobile app® they accessed the recorded video with access from the He-Mirror App®. The study variables were joint state (Haemophilia Joint Health Score), pressure pain threshold (pressure algometer), muscle strength (dynamometry) and range of motion (goniometry). Three evaluations were performed: at baseline (T0), after the intervention (T1) and at the end of a 16-week follow-up period (T2). RESULTS No patient developed ankle hemarthrosis during the experimental phase. In the repeated measures analysis we found statistically significant differences in joint state (F = 51.38; η2 p = .63), pressure pain threshold of the lateral malleolus (F = 12.34; η2 p = .29) and range of motion (F = 11.7; η2 p = .28). CONCLUSIONS Therapy using immersive motion visualization does not cause hemarthrosis. This intervention can improve joint condition, pressure pain threshold and range of motion in patients with ankle arthropathy. Changes greater than the MDC were reported in more than 40% of patients for the variables pressure pain threshold, anterior tibialis strength and range of motion, which were considered clinically relevant.
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Affiliation(s)
| | - Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
| | | | - Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine, University of Oviedo, Oviedo, Spain
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13
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Kawanishi K, Fukuda D, Miyashita T, Kitagawa T, Niwa H, Okuno T, Kinoshita T, Tsutsumi M, Kudo S. Effects of Compression Intervention on the Thigh Using Elastic Bandage on Lateral Femoral Pain After Trochanteric Fractures: A Multicenter Randomized Controlled Trial. Gerontol Geriatr Med 2023; 9:23337214231214405. [PMID: 38035263 PMCID: PMC10683377 DOI: 10.1177/23337214231214405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
A trochanteric fracture is one type of hip fracture. Management of postoperative pain after trochanteric fracture that is caused by decreased gliding between tissues in the lateral thigh is not established. The aim of this study was to examine the effect of compression of the thigh using an elastic bandage on trochanteric fracture after surgery. Multicenter randomized controlled trial was conducted in collaboration with the Comprehensive Rehabilitation Unit (sub-acute rehabilitation Unit) in two hospitals. Eligible volunteers (n = 34) with trochanteric fractures after surgery were randomly assigned to two groups. In the treatment group, participants practiced standing and walking under compression of the thigh with an elastic bandage. The control group was blinded to the intervention and practiced standing and walking under non-compression of the thigh with an elastic bandage. Both groups underwent a standard physical therapy program 2 times a day, daily. Two-way repeated measures of ANOVA showed significant main effect between the groups for gliding between tissue (p < .001), lateral femoral pain (p < .001), subcutaneous tissue thickness (p = .044). Compression of the thigh with an elastic bandage significantly improved subcutaneous tissue thickness, gliding between tissues, lateral thigh pain. Gait velocity improved with these functional improvements.
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Affiliation(s)
- Kengo Kawanishi
- Morinomiya University of Medical Sciences, Osaka, Japan
- Kano General Hospital, Osaka, Japan
| | | | | | - Takashi Kitagawa
- Morinomiya University of Medical Sciences, Osaka, Japan
- Higashi Osaka Hospital, Osaka, Japan
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14
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Kiss F, Farkas N, Nagy G, Minier T, Kumánovics G, Faludi R, Czirják L, Varjú C. Minimal Clinically Important Differences (MCID) for the Functional Assessment of Chronic Illness Therapy Fatigue Scale in Patients with Systemic Sclerosis. Int J Environ Res Public Health 2022; 20:771. [PMID: 36613093 PMCID: PMC9819291 DOI: 10.3390/ijerph20010771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Systemic sclerosis (SSc) is characterized by significant fatigue, causing diminished quality of life (QoL). The aim of this study was to examine fatigue levels and their associations with clinical factors and determine the minimal clinically important difference (MCID) value for the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-FS). (2) Methods: A total of 160 SSc patients and 62 individuals without SSc were followed-up over a 12-month period by measuring the FACIT-FS and the Visual Analogue Scale and the Short Form 36 Vitality Score analyzing changes in exhaustion. (3) Results: Fatigue was strongly correlated with HRQoL, level of pain, emotional disorders, physical capability and functionality. The MCID values for FACIT-FS were calculated as -3 for deterioration and +4 for improvement after a 12-month follow-up. The predictors of improvement of fatigue from baseline parameters were the significant disease activity, the patients' poorer functionality and the short disease duration. Patients with scleroderma-related interstitial lung disease at baseline had approximately tripled risks for worsening fatigue. The independent influential factors regarding the changing of FACIT-FS were improving or worsening in the same direction in reference to physical condition, gastrointestinal and emotional factors. (4) Conclusions: Fatigue is a multi-dimensional symptom, which is strongly correlated to HRQoL. MCID values of FACIT-FS can be useful tools in monitoring the changes of HRQoL in clinical trials and in daily practice among patients with SSc.
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Affiliation(s)
- Franciska Kiss
- Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, H-7624 Pécs, Hungary
| | - Gabriella Nagy
- Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary
| | - Tünde Minier
- Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary
| | - Gábor Kumánovics
- Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary
| | - Réka Faludi
- Heart Institute, Medical School, University of Pécs, H-7624 Pécs, Hungary
| | - László Czirják
- Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary
| | - Cecília Varjú
- Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary
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15
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Duarte NS, Bittencourt KC, Soares CO, Ferreira CRG, Soares WM, Tavares VB, da Silva ASA, da Costa Priante CH, das Neves PFM, da Silva Souza G, de Campos Gomes F, Carneiro Nunes EF, Rodrigues CNC, de Melo Neto JS. Sexual Function, Physical Activity, Mean Amplitudes and Maximal Voluntary Contraction of Pelvic Floor Muscles Are Related to Handgrip Strength: A Cross-Sectional Study. Healthcare (Basel) 2022; 11. [PMID: 36611588 DOI: 10.3390/healthcare11010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 01/03/2023] Open
Abstract
Pelvic floor musculature assessment methods are generally invasive, subjective, and technologically expensive. Therefore, there is a need to identify other methods that can predict changes in the function of these muscles. This study aimed to verify whether the levels of strength and myoelectric activity of pelvic floor muscles (PFM) can be related to handgrip strength (HGS), to ensure faster and earlier identification of possible dysfunctions of this musculature. Furthermore, we verified whether these variables vary across different age groups. This was a cross-sectional observational study involving 44 healthy women. The women were divided into two groups: the young (18−35 years) and middle-aged (36−55 years) adult groups. Social, anthropometric, and clinical data were collected from the participants, and a functional assessment of their PFM was performed by bidigital palpation, electromyographic biofeedback (sEMG), and HGS (using a dynamometer). The levels of physical and sexual activity were measured using the International Physical Activity Questionnaire (IPAQ) and Sexual Quotient−Female version (SQ-F) questionnaire. There were no differences in HGS, power/pressure, sEMG, SQ-F score, or IPAQ score between the two groups (p > 0.05). Moderate correlation (r = 0.601; p = 0.019) was observed during multivariate analysis. HGS is related to mean amplitudes (p = 0.123), MVC (p = 0.043), sexual function (p = 0.049), and physical activity (p = 0.004). We therefore conclude that there were no differences between HGS and PFM strength in young adult and middle-aged women. Furthermore, HGS is related to the PFM functionality, sexual function, and physical activity.
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16
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Ucero-Lozano R, Pérez-Llanes R, López-Pina JA, Cuesta-Barriuso R. Approach to Knee Arthropathy through 180-Degree Immersive VR Movement Visualization in Adult Patients with Severe Hemophilia: A Pilot Study. J Clin Med 2022; 11:jcm11206216. [PMID: 36294536 PMCID: PMC9605271 DOI: 10.3390/jcm11206216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
(1) Background: Hemarthrosis is a typical clinical manifestation in patients with hemophilia. Its recurrence causes hemophilic arthropathy, characterized by chronic joint pain. Watching movement recorded from a first-person perspective and immersively can be effective in the management of chronic pain. The objective of this study was to evaluate the effectiveness of an immersive virtual reality intervention in improving the pain intensity, joint condition, muscle strength and range of motion in patients with hemophilic knee arthropathy. (2) Methods: Thirteen patients with hemophilic knee arthropathy were recruited. The patients wore virtual reality glasses and watched a flexion-extension movement of the knee on an immersive 180° video, recorded from a first-person perspective over a 28-day period. The primary variable was the pain intensity (visual analog scale). The secondary variables were the joint status (Hemophilia Joint Health Score), quadriceps and hamstring strength (dynamometry), and range of motion (goniometry). (3) Results: After the intervention period, statistically significant differences were observed in the intensity of the joint pain (Standard error [SE] = 19.31; 95% interval confidence [95%CI] = -1.05; -0.26), joint condition (SE = 18.68; 95%CI = -1.16; -0.52) and quadriceps strength (SE = 35.00; 95%CI = 2.53; 17.47). We found that 38.46% and 23.07% of the patients exhibited an improvement in their quadriceps muscle strength and joint condition above the minimum detectable change for both variables (8.21% and 1.79%, respectively). (4) Conclusions: One hundred and eighty degree immersive VR motion visualization can improve the intensity of joint pain in patients with hemophilic knee arthropathy. An intervention using immersive virtual reality can be an effective complementary approach to improve the joint condition and quadriceps strength in these patients.
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Affiliation(s)
| | - Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain
| | | | - Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, 33006 Oviedo, Spain
- Correspondence: ; Tel.: +34-985103386
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17
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Verreydt I, Vandekerckhove I, Stoop E, Peeters N, van Tittelboom V, Van de Walle P, Van den Hauwe M, Goemans N, De Waele L, Van Campenhout A, Hanssen B, Desloovere K. Instrumented strength assessment in typically developing children and children with a neural or neuromuscular disorder: A reliability, validity and responsiveness study. Front Physiol 2022; 13:855222. [PMID: 36338500 PMCID: PMC9627606 DOI: 10.3389/fphys.2022.855222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/27/2022] [Indexed: 01/11/2023] Open
Abstract
The aim of this study was to determine the clinimetric properties, i.e., reliability, validity and responsiveness of an instrumented strength assessment in typically developing (TD) children and children with cerebral palsy (CP) and Duchenne muscular dystrophy (DMD). Force (N), torque (Nm) and normalized torque (Nm/kg) were defined for maximal voluntary isometric contractions (MVICs) of the lower limb muscles using a pre-established protocol. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) of TD children (n = 14), children with CP (n = 11) and DMD (n = 11) were used to evaluate intra-rater reliability for the three cohorts and the inter-rater intersession as well as inter-rater intrasession reliability for TD children. Construct validity was assessed by comparing MVICs in TD children (n = 28) to children with CP (n = 26) and to children with DMD (n = 30), using the Kruskal Wallis and post-hoc Mann-Whitney U tests. Responsiveness was investigated by assessing changes in MVICs following a strength intervention in CP (n = 26) and a 1 and 2 year follow-up study in DMD (n = 13 and n = 6, respectively), using the Wilcoxon Signed-Rank test. The overall intra-rater reliability, was classified as good to excellent for 65.1%, moderate for 27.0% and poor for 7.9% of the measures (47.6%, 76.2%, and 66.7% good-excellent; 28.6%, 23.8%, and 33.7% moderate; 23.8%, 0%, and 0% poor in TD, CP, and DMD, respectively), while ICC values for TD children were slightly lower for inter-rater intrasession reliability (38.1% good-excellent, 33.3% moderate and 26.6% poor) and for inter-rater intersession reliability (47.6% good-excellent, 23.8% moderate and 28.6% poor). Children with CP and DMD were significantly weaker than TD children (p < 0.001) and the majority of these strength differences exceeded the MDC. Children with CP significantly improved strength after training, with changes that exceeded the SEMs, whereas only limited strength decreases over time were observed in the DMD cohort. In conclusion, the investigated instrumented strength assessment was sufficiently reliable to confirm known-group validity for both cohorts and could detect the responsiveness of children with CP after a strength intervention. However, more research is necessary to determine the responsiveness of this assessment in children with DMD regarding their natural decline.
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Affiliation(s)
- Ineke Verreydt
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Elze Stoop
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
| | - Nicky Peeters
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium,Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Patricia Van de Walle
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium,Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Antwerpen, Belgium,Heder, Laboratory of Clinical Movement Analysis Antwerp, Antwerpen, Belgium
| | - Marleen Van den Hauwe
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium,Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Goemans
- Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Anja Van Campenhout
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium,Pediatric Orthopedics, Department of Orthopedics, University Hospitals, Leuven, Leuven, Belgium
| | - Britta Hanssen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium,Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium,*Correspondence: Kaat Desloovere,
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Manchado I, Motta LM, Blanco G, González J, Garcés GL. Isometric Knee Muscle Strength and Patient-Reported Measures Five Years after Anterior Cruciate Ligament Reconstruction: Comparison of Single versus Dual Autograft Hamstring Tendon Harvesting. J Clin Med 2022; 11:jcm11195682. [PMID: 36233550 PMCID: PMC9572358 DOI: 10.3390/jcm11195682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
There is some controversy regarding the use of one or two hamstring tendons for anterior cruciate ligament reconstruction (ACLR). In this study, two cohorts of 22 male patients underwent an ACLR with hamstring tendon autografts. One cohort was reconstructed through an all-inside technique with the semitendinosus tendon (ST group) and the other with the semitendinosus and gracilis tendons (ST-G group). Anterior tibial translation (ATT), Lysholm, and IKDC scores were assessed preoperatively and five years postoperation. Additionally, isometric knee muscle strength was manually measured in both groups and in another cohort of 22 uninjured control male subjects five years after the operation. There were no significant differences in ATT and Lysholm scores between the operated groups. The IKDC score was lower in the ST-G group than in the ST group—9.57 (CI 14.89−4.25) (p < 0.001). No significant differences between injured and uninjured knees were detected in hamstring to quadriceps ratio strength and quadriceps limb symmetry index of the two operated groups, but the hamstring limb symmetry index was significantly lower in the ST-G group than in the ST and control groups. This study shows that using an ST-G autograft for ACLR yielded less flexor strength and worse results in some patient-reported outcome measures (PROM) than using an ST autograft five years after the operation. The observed results let us suggest that the use of one autograft hamstring tendon for ACLR is clinically preferable to the use of two hamstring tendons.
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Affiliation(s)
- Ignacio Manchado
- Hospital Perpetuo Socorro, 35007 Las Palmas, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Luci M. Motta
- Hospital Perpetuo Socorro, 35007 Las Palmas, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | | | - Jesús González
- Unidad de Investigación, Hospital Dr Negrin, 35007 Las Palmas, Spain
| | - Gerardo L. Garcés
- Hospital Perpetuo Socorro, 35007 Las Palmas, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
- Correspondence: ; Tel.: +34-696-471-915
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Oliveira DG, Oliveira GM, Kirkwood RN. Clinimetric Properties of the Applied Kinesiology Manual Muscle Test in Adults With and Without Pain: A Methodological Study. J Chiropr Med 2022; 21:260-269. [DOI: 10.1016/j.jcm.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
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20
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Kaiser M, Brambrink S, Benditz A, Achenbach L, Gehentges M, König MA. Increase in Lower Limb Strength after Multimodal Pain Management in Patients with Low Back Pain. Medicina (B Aires) 2022; 58:medicina58070837. [PMID: 35888556 PMCID: PMC9319983 DOI: 10.3390/medicina58070837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/07/2022] [Accepted: 06/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The aim of the present study was to evaluate the efficacy of a multimodal pain therapy (MPM) regarding the objective parameter muscle strength of segment-dependent lower limb muscle groups before and after such a treatment. Materials and Methods: 52 patients with a history of low back pain and/or leg pain received standardized multimodal pain management. Strength of segment indicating lower limb muscles were assessed for each patient before and after ten days of treatment by handheld dynamometry. Results: Overall strength increased significantly from 23.6 kg ± 6.6 prior to treatment to 25.4 ± 7.3 after treatment, p ≤ 0.001. All muscle groups significantly increased in strength with exception of great toe extensors. Conclusions: Despite lower basic strength values at the beginning of treatment, all investigated muscle groups, except for the great toe extensors, showed a significant increase of overall strength after completion of the multimodal pain management concept. Increased overall strength could help with avoiding further need of medical care by supporting patients’ autonomy in daily life activities, as well as maintaining working abilities. Thus, our study is the first to show a significant positive influence on lower limb strength in patients with low back pain after a conservative MPM program.
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Affiliation(s)
- Moritz Kaiser
- Department of Orthopedic Surgery, Regensburg University Medical Center, 93077 Bad Abbach, Germany; (S.B.); (M.G.); (M.A.K.)
- Correspondence: (M.K.); (A.B.)
| | - Sara Brambrink
- Department of Orthopedic Surgery, Regensburg University Medical Center, 93077 Bad Abbach, Germany; (S.B.); (M.G.); (M.A.K.)
| | - Achim Benditz
- Department of Orthopedic Surgery, Regensburg University Medical Center, 93077 Bad Abbach, Germany; (S.B.); (M.G.); (M.A.K.)
- Correspondence: (M.K.); (A.B.)
| | - Leonard Achenbach
- Department of Orthopedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Würzburg, 97074 Würzburg, Germany;
| | - Matthias Gehentges
- Department of Orthopedic Surgery, Regensburg University Medical Center, 93077 Bad Abbach, Germany; (S.B.); (M.G.); (M.A.K.)
| | - Matthias Alexander König
- Department of Orthopedic Surgery, Regensburg University Medical Center, 93077 Bad Abbach, Germany; (S.B.); (M.G.); (M.A.K.)
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Barrons R. Statin-Associated Autoimmune Myopathy: Review of the Literature. J Pharm Pract 2022; 36:383-393. [PMID: 35707933 DOI: 10.1177/08971900211040291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Statin-associated autoimmune myopathy (SAAM) is a rare adverse event characterized by progressive muscle symptoms despite discontinuation, requiring immunosuppressive therapy for remission. The objective of this review was to characterize SAAM, for timely detection, while examining the literature for effective treatment considerations. METHODS PubMed search was conducted from 2010 to 2020 was for relevant case series and studies of at least 8 patients displaying muscle discomfort or weakness, anti-HMGCR antibodies, exposure to statins, and biopsies consistent with SAAM. RESULTS Three case series and 3 case cohort studies identified 199 patients with SAAM. Exhibiting a mean age of 63.74 years, patients were more likely Caucasian (81%) and female (1.2X), and required a mean duration of 4.75 years before symptomatic. The presentation involved proximal muscle weakness (94%), myalgias (37%) and dysphagia (23%), accompanied by a mean creatinine kinase of 6383 IU/L. Most patients (57%) required 2 or more immunosuppressive (IMS) agents to achieve 62% remission. After 2 years of treatment, 15% of patients without remission reported symptomatic improvement, while another 12% were refractory to treatment. CONCLUSION Delayed onset of SAAM greater than 4 years from statin initiation may create a low index of suspicion. However, progression of symptoms beyond 2 months from statin discontinuation and positive anti-HMGCR antibodies requires immunosuppressive agents. Data and expert opinion support use of at least two IMS medications upon diagnosis for a minimum of 2 years. Therapy success depends on timely recognition and initiation of IMS combinations to achieve earlier remission and symptomatic improvement.
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Affiliation(s)
- Robert Barrons
- School of Pharmacy, 15543Wingate University, Wingate, NC, USA
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Cuesta-Barriuso R, Pérez-Llanes R, Donoso-Úbeda E, Ucero-Lozano R. LongHest project: A prospective, observational study of extended half-life treatment in the musculoskeletal health of patients with severe haemophilia A. Haemophilia 2022; 28:857-864. [PMID: 35561281 PMCID: PMC9541876 DOI: 10.1111/hae.14592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/21/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022]
Abstract
Background Prophylactic treatment is the gold standard in the treatment of patients with haemophilia. Prophylaxis with extended half‐life (EHL) treatment has shown long‐term safety and efficacy in patients with haemophilia. Aim To evaluate the efficacy of prophylaxis with EHL treatment in the frequency of haemarthrosis and musculoskeletal health in adult patients with severe haemophilia A. Methods Prospective cohort study. Forty‐six patients with severe haemophilia A were recruited. The frequency of haemarthrosis (self‐reports), joint condition (Haemophilia Joint Health Score), pain intensity (visual analogue scale), range of motion (goniometry), and strength (dynamometry) and muscle activation (surface electromyography) were evaluated. Three assessments were carried out: at baseline (T0), at 6 months (T1) and at 12 months following treatment (T2). Results There were significant changes in the within‐subject effect in the frequency of haemarthrosis in elbow (F(1.05;96.20) = 3.95; P < .001) and knee (F(1.73;157.99) = 9.96; P < .001). Significant within‐subject effect in elbow pain intensity (F(2;182) = 63.51; P < .001) was found. The mean values of the frequency haemarthrosis in elbow (from .66±1.01 to .04±.20) and knees (from .55±.68 to .33±.53) decrease after the period study. The intensity of elbow pain and (from 3.08±1.69 to 2.67±1.73), decrease after the 12‐month follow‐up period. Conclusions Prophylaxis with extended half‐life treatment reduces the frequency of haemarthrosis in elbow and knee in adult patients with haemophilia. EHL treatment reduces the intensity of elbow pain in patients with haemophilic arthropathy.
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Affiliation(s)
- Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine, University of Oviedo, Oviedo, Spain.,Royal Victoria Eugenia Foundation, Madrid, Spain
| | - Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
| | - Elena Donoso-Úbeda
- Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
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23
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Sato C, Kamijo YI, Sakurai Y, Araki S, Sakata Y, Ishigame A, Murai K, Yoshioka I, Tajima F. Three-week exercise and protein intake immediately after exercise increases the 6-min walking distance with simultaneously improved plasma volume in patients with chronic cerebrovascular disease: a preliminary prospective study. BMC Sports Sci Med Rehabil 2022; 14:38. [PMID: 35292094 PMCID: PMC8922777 DOI: 10.1186/s13102-022-00429-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/02/2022] [Indexed: 05/31/2023]
Abstract
Background Blood volume (BV) is a critical factor for physical endurance in chronic stroke patients, while hypervolemia can worsen hypertension in these patients. This prospective study assessed whether rehabilitation combined with protein supplementation immediately after each exercise for 3 weeks would improve plasma volume (PV) and BV as well as physical endurance without worsening hypertension. Methods Ambulatory patients with chronic cerebrovascular disease who received a 3-week rehabilitation program with high protein jelly (intervention group [PG]; n = 8; 10-g protein) or protein-free jelly (control group [CG]; n = 8) consumed within 30 min after each exercise. PV and BV were assessed while measuring the 6-min walking distance (6MWD), peak oxygen consumption (VO2peak), strength of knee extension, and resting blood pressure before and after the intervention. Two-way ANOVA was used to determine whether there was an interaction of time × group. The difference between before and after intervention or between the groups by post-hoc test (Tukey’s test) at the level of P < 0.05. Results The 6MWD increased only in the PG (P = 0.001; an interaction of Group and Time, P = 0.037). PV and BV increased only in the PG (P < 0.05). VO2peak and strength of knee extension in the paralysed limb increased in both groups (P < 0.05). The resting blood pressure did not worsen after the intervention. Conclusions In chronic post-stroke patients, 3-week rehabilitation combined with protein intake immediately after exercise increased 6MWD simultaneously with increased PV and BV, but it did not increase resting blood pressure. The present regimen is acceptable and effective for ambulatory patients with chronic cerebrovascular disease. Name of the registry Examining effects of protein supplementation on functional improvement during rehabilitation intervention in chronic stroke patients Trial registration number UMIN000028009; date of registration: 30/06/2017. This study was registered prospectively. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00429-x.
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Affiliation(s)
- Chika Sato
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan.,Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan
| | - Yoshi-Ichiro Kamijo
- Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan. .,Institute of Sports Science and Environmental Physiology, Medical Centre for Health Promotion and Sports Science, Wakayama Medical University, 2-1 Honmachi, Wakayama, 640-8033, Japan. .,Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan.
| | - Yuta Sakurai
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan
| | - Shohei Araki
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan
| | - Yuki Sakata
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan.,Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan
| | - Ayana Ishigame
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan
| | - Kota Murai
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan.,Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan
| | - Izumi Yoshioka
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan
| | - Fumihiro Tajima
- Nachi-Katsuura Research Centre of Sports Medicine and Balneology, Nachi-Katsuura Balneologic Town Hospital, 1185-4 Tenma-Nachi-katuurachou, Higashimuro gun, 649-5331, Japan.,Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan.,Institute of Sports Science and Environmental Physiology, Medical Centre for Health Promotion and Sports Science, Wakayama Medical University, 2-1 Honmachi, Wakayama, 640-8033, Japan
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24
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Gregory WJ, Saygin D. Assessment of Physical Activity and Muscle Function in Adult Inflammatory Myopathies. Curr Rheumatol Rep 2022. [PMID: 35244882 DOI: 10.1007/s11926-022-01059-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The aim is to summarize the outcome measures used in the assessment and monitoring of muscle function and physical activity in the management idiopathic inflammatory myopathy. RECENT FINDINGS Assessment techniques have progressed and matured over the past decade, and new options are now available to clinicians working in this field. Newer outcome measures, including the Functional Index-3 and wearable motion sensors are reviewed, as well as the current application of more established measures. The available outcome measures for use in clinical practice in idiopathic inflammatory myopathies with regard to muscle function and physical activity have expanded over the past 15 years. There are valid and reliable options for several domains and methods for assessing these factors. In a busy clinical setting, efficiency is important, but there also needs to be considered the choosing of tools that work together to give the fullest picture of the status of the patient.
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25
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Ghasemi M, Emerson CP, Hayward LJ. Outcome Measures in Facioscapulohumeral Muscular Dystrophy Clinical Trials. Cells 2022; 11:cells11040687. [PMID: 35203336 PMCID: PMC8870318 DOI: 10.3390/cells11040687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is a debilitating muscular dystrophy with a variable age of onset, severity, and progression. While there is still no cure for this disease, progress towards FSHD therapies has accelerated since the underlying mechanism of epigenetic derepression of the double homeobox 4 (DUX4) gene leading to skeletal muscle toxicity was identified. This has facilitated the rapid development of novel therapies to target DUX4 expression and downstream dysregulation that cause muscle degeneration. These discoveries and pre-clinical translational studies have opened new avenues for therapies that await evaluation in clinical trials. As the field anticipates more FSHD trials, the need has grown for more reliable and quantifiable outcome measures of muscle function, both for early phase and phase II and III trials. Advanced tools that facilitate longitudinal clinical assessment will greatly improve the potential of trials to identify therapeutics that successfully ameliorate disease progression or permit muscle functional recovery. Here, we discuss current and emerging FSHD outcome measures and the challenges that investigators may experience in applying such measures to FSHD clinical trial design and implementation.
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Affiliation(s)
- Mehdi Ghasemi
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA; (C.P.E.J.); (L.J.H.)
- Wellstone Muscular Dystrophy Program, Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
- Correspondence: ; Fax: +1-508-856-4485
| | - Charles P. Emerson
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA; (C.P.E.J.); (L.J.H.)
- Wellstone Muscular Dystrophy Program, Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Lawrence J. Hayward
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA; (C.P.E.J.); (L.J.H.)
- Wellstone Muscular Dystrophy Program, Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
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Bergs PMJ, Maas DM, Janssen MCH, Groothuis JT. Feasible and clinical relevant outcome measures for adults with mitochondrial disease. Mol Genet Metab 2022; 135:102-108. [PMID: 34961688 DOI: 10.1016/j.ymgme.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 11/29/2022]
Abstract
There is no consensus on clinical outcome measures that reflect function, activities and participation which are suitable for adults with mitochondrial diseases (MD). The aim of this study was to determine feasible and clinically relevant outcome measures for patients with MD . In 156 adult patients with MD, endurance, balance, strength and mobility tests were evaluated. All tests showed a negative deviation to healthy reference values. Balance tests were feasible and significantly correlated with clinical severity. The Åstrand cycle test was not feasible in 55%, whereas the feasibility of the 6 min walking test is unclear in patients with MD.
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Affiliation(s)
- Peggy M J Bergs
- Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Department of Rehabilitation, Nijmegen, the Netherlands; Radboud Center for Mitochondrial Medicine, Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
| | - Daphne M Maas
- Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Department of Rehabilitation, Nijmegen, the Netherlands; Radboud Center for Mitochondrial Medicine, Department of Rehabilitation, Radboud university medical center, Nijmegen, the Netherlands
| | - Mirian C H Janssen
- Radboud Center for Mitochondrial Medicine, Department of Rehabilitation, Radboud university medical center, Nijmegen, the Netherlands; Radboud Center for Mitochondrial Medicine, Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
| | - Jan T Groothuis
- Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Department of Rehabilitation, Nijmegen, the Netherlands; Radboud Center for Mitochondrial Medicine, Department of Rehabilitation, Radboud university medical center, Nijmegen, the Netherlands.
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27
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Gupta L, Mago A, Naveen R, Knitza J, Shinjo S, Aggarwal R. Patient-centred outcomes for monitoring disease remotely in idiopathic inflammatory myopathies. Indian J Rheumatol 2022. [DOI: 10.4103/injr.injr_171_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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28
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Manchado I, Alvarez D, Motta LM, Blanco G, Saavedra P, Garcés GL. Correlation among Knee Muscle Strength and Self-Reported Outcomes Score, Anterior Tibial Displacement, and Time Post-Injury in Non-Coper Anterior Cruciate Ligament Deficient Patients: A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:13303. [PMID: 34948910 DOI: 10.3390/ijerph182413303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/16/2022]
Abstract
Little attention has been paid to knee muscle strength after ACL rupture and its effect on prognostic outcomes and treatment decisions. We studied hamstrings (H) and quadriceps (Q) strength correlation with a patient-reported outcome measures score (International Knee Documentation Committee, IKDC), anterior tibial translation (ATT), and time post-injury in 194 anterior cruciate ligament deficient patients (ACLD) who required surgery after a failed rehabilitation program (non-copers). The correlation between knee muscle strength and ATT was also studied in 53 non-injured controls. ACLD patients showed decreased knee muscle strength of both the injured and non-injured limbs. The median (interquartile range) values of the H/Q ratio were 0.61 (0.52-0.81) for patients' injured side and 0.65 (0.57-0.8) for the non-injured side (p = 0.010). The median H/Q ratio for the controls was 0.52 (0.45-0.66) on both knees (p < 0.001, compared with the non-injured side of patients). The H/Q, ATT, and time post-injury were not significantly correlated with the IKDC score. ATT was significantly correlated with the H/Q of the injured and non-injured knees of patients, but not in the knees of the controls. Quadriceps strength and H/Q ratio were significantly correlated with ATT for both limbs of the patients. IKDC score correlated significantly with the quadriceps and hamstrings strengths of the injured limb but not with the H/Q ratio, ATT or time passed after injury.
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29
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Merry K, Napier C, Chung V, Hannigan BC, MacPherson M, Menon C, Scott A. The Validity and Reliability of Two Commercially Available Load Sensors for Clinical Strength Assessment. Sensors (Basel) 2021; 21:8399. [PMID: 34960492 DOI: 10.3390/s21248399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/24/2021] [Accepted: 12/14/2021] [Indexed: 12/03/2022]
Abstract
Objective: Handheld dynamometers are common tools for assessing/monitoring muscular strength and endurance. Health/fitness Bluetooth load sensors may provide a cost-effective alternative; however, research is needed to evaluate the validity and reliability of such devices. This study assessed the validity and reliability of two commercially available Bluetooth load sensors (Activ5 by Activbody and Progressor by Tindeq). Methods: Four tests were conducted on each device: stepped loading, stress relaxation, simulated exercise, and hysteresis. Each test type was repeated three times using the Instron ElectroPuls mechanical testing device (a gold-standard system). Test–retest reliability was assessed through intraclass correlations. Agreement with the gold standard was assessed with Pearson’s correlation, interclass correlation, and Lin’s concordance correlation. Results: The Activ5 and Progressor had excellent test–retest reliability across all four tests (ICC(3,1) ≥ 0.999, all p ≤ 0.001). Agreement with the gold standard was excellent for both the Activ5 (ρ ≥ 0.998, ICC(3,1) ≥ 0.971, ρc ≥ 0.971, all p’s ≤ 0.001) and Progressor (ρ ≥ 0.999, ICC(3,1) ≥ 0.999, ρc ≥ 0.999, all p’s ≤ 0.001). Measurement error increased for both devices as applied load increased. Conclusion: Excellent test–retest reliability was found, suggesting that both devices can be used in a clinical setting to measure patient progress over time; however, the Activ5 consistently had poorer agreement with the gold standard (particularly at higher loads).
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30
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Kiper P, Rimini D, Falla D, Baba A, Rutkowski S, Maistrello L, Turolla A. Does the Score on the MRC Strength Scale Reflect Instrumented Measures of Maximal Torque and Muscle Activity in Post-Stroke Survivors? Sensors (Basel) 2021; 21:s21248175. [PMID: 34960269 PMCID: PMC8708806 DOI: 10.3390/s21248175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/16/2022]
Abstract
It remains unknown whether variation of scores on the Medical Research Council (MRC) scale for muscle strength is associated with operator-independent techniques: dynamometry and surface electromyography (sEMG). This study aimed to evaluate whether the scores of the MRC strength scale are associated with instrumented measures of torque and muscle activity in post-stroke survivors with severe hemiparesis both before and after an intervention. Patients affected by a first ischemic or hemorrhagic stroke within 6 months before enrollment and with complete paresis were included in the study. The pre- and post-treatment assessments included the MRC strength scale, sEMG, and dynamometry assessment of the triceps brachii (TB) and biceps brachii (BB) as measures of maximal elbow extension and flexion torque, respectively. Proprioceptive-based training was used as a treatment model, which consisted of multidirectional exercises with verbal feedback. Each treatment session lasted 1 h/day, 5 days a week for a total 15 sessions. Nineteen individuals with stroke participated in the study. A significant correlation between outcome measures for the BB (MRC and sEMG p = 0.0177, ρ = 0.601; MRC and torque p = 0.0001, ρ = 0.867) and TB (MRC and sEMG p = 0.0026, ρ = 0.717; MRC and torque p = 0.0001, ρ = 0.873) were observed post intervention. Regression models revealed a relationship between the MRC score and sEMG and torque measures for both the TB and BB. The results confirmed that variation on the MRC strength scale is associated with variation in sEMG and torque measures, especially post intervention. The regression model showed a causal relationship between MRC scale scores, sEMG, and torque assessments.
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Affiliation(s)
- Pawel Kiper
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy
- Correspondence: (P.K.); (A.T.)
| | - Daniele Rimini
- Medical Physics Department-Clinical Engineering, Salford Care Organisation, Salford M6 8HD, UK;
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Alfonc Baba
- Rehabilitation Unit, Azienda Ospedale Università Padova, 35128 Padua, Italy;
| | - Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland;
| | - Lorenza Maistrello
- Laboratory of Neurorehabilitation Technologies, San Camillo IRCCS, 30126 Venice, Italy;
| | - Andrea Turolla
- Laboratory of Neurorehabilitation Technologies, San Camillo IRCCS, 30126 Venice, Italy;
- Correspondence: (P.K.); (A.T.)
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31
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Ding CL, Zhang CL, Hua F, Xi SD, Zhou QW, Wang HJ, Chen JJ, Qiu J. Traumatic carotid-cavernous fistula with perimedullary venous drainage and delayed myelopathy: A case report. Med Int (Lond) 2021; 1:16. [PMID: 36698535 PMCID: PMC9829088 DOI: 10.3892/mi.2021.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/15/2021] [Indexed: 01/28/2023]
Abstract
Traumatic carotid-cavernous fistula (TCCF) with perimedullary venous drainage and delayed myelopathy is a relatively rare clinical lesion. Endovascular embolization using embolic agents is the preferred treatment for patients with a poor collateral circulation. The present study describes the case of a 45-year-old male with TCCF, who presented with progressive cervical myelopathy for 1 month. A previous history of the patient included an anterior skull base fracture induced by a traffic accident 2 years prior. Cervical spinal magnetic resonance imaging (MRI) revealed dilated perimedullary veins and cervical spinal cord edema. Cerebral digital subtraction angiography revealed a direct CCF with perimedullary venous drainage. The patient received endovascular treatment with coils and an Onyx liquid embolic system to occlude the fistula, and his symptoms were relieved when he was discharged 3 weeks later. The patient then felt normal and a cervical spinal MRI revealed the disappearance of the perimedullary veins dilation and spinal cord edema at the 6-month follow-up. To the best of our knowledge, only three cases of CCFs with perimedullary venous drainage presenting with myelopathy have been previously reported. The present study also discussed the possible pathological mechanisms for this rare presentation. Moreover, it is suggested that the possibility of CCFs as a cause of cervical myelopathy needs to be taken into consideration.
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Affiliation(s)
- Chun-Long Ding
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China
| | - Chun-Lei Zhang
- Department of Neurosurgery, 904th Hospital of Chinese People's Liberation Army Joint Logistic Support, Wuxi, Jiangsu 214000, P.R. China
| | - Feng Hua
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China,Correspondence to: Dr Feng Hua, Department of Neurosurgery, Xishan People's Hospital, 1128 Dacheng Road, Anzhen, Xishan, Wuxi, Jiangsu 214000, P.R. China
| | - Shao-Dong Xi
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China
| | - Qin-Wei Zhou
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China
| | - Hui-Jun Wang
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China
| | - Jun-Jie Chen
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China
| | - Jie Qiu
- Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China
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Noll K, Dowdell BT, Ridgel AL. Mobility Improvements After a High-cadence Dynamic Cycling Intervention in an Individual with Motor Neuron Disease: A Case Study. Int J Exerc Sci 2021; 14:791-801. [PMID: 34567360 PMCID: PMC8439687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Previous exercise studies in individuals with motor neuron disease have shown some positive benefits but the stress of regular exercise could result in overuse weakness in this population. The purpose of this case study is to determine the efficacy, and tolerability of a high-cadence dynamic cycling intervention in an individual with motor neuron disease. A 67-year-old male with significant lower extremity weakness and a diagnosis of idiopathic motor neuron disease completed six 30-minute sessions of high cadence dynamic cycling over a two-week period using a custom-built motorized ergometer with the motor speed set at 80 revolutions per minute. This intervention resulted in an 80.4 m increase in walking distance during the six-minute walk test (21% increase), with a lower rating of perceived exertion than at baseline. Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised scores improved slightly (2.4%) suggesting that the intervention was tolerated, and it did not compromise the participant's physical function. These data show that this intervention can improve mobility, is well-tolerated and minimizes the risk of overuse weakness in an individual with motor neuron disease.
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Affiliation(s)
- Kristin Noll
- Exercise Science and Physiology Program, Kent State University, Kent, OH, USA
| | - Brian T Dowdell
- Exercise Science and Physiology Program, Kent State University, Kent, OH, USA
| | - Angela L Ridgel
- Exercise Science and Physiology Program, Kent State University, Kent, OH, USA
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33
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Lim J, Eftimov F, Verhamme C, Brusse E, Hoogendijk JE, Saris CGJ, Raaphorst J, De Haan RJ, van Schaik IN, Aronica E, de Visser M, van der Kooi AJ. Intravenous immunoglobulins as first-line treatment in idiopathic inflammatory myopathies: a pilot study. Rheumatology (Oxford) 2021; 60:1784-1792. [PMID: 33099648 PMCID: PMC8023983 DOI: 10.1093/rheumatology/keaa459] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/08/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES We explored efficacy and safety of IVIg as first-line treatment in patients with an idiopathic inflammatory myopathy. METHODS In this investigator-initiated phase 2 open-label study, we included 20 adults with a newly diagnosed, biopsy-proven idiopathic inflammatory myopathy, and a disease duration of less than 9 months. Patients with IBM and prior use of immunosuppressants were excluded. The standard treatment regimen consisted of IVIg (Privigen) monotherapy for 9 weeks: a loading dose (2 g/kg body weight) and two subsequent maintenance doses (1 g/kg body weight) with a 3-week interval. The primary outcome was the number of patients with at least moderate improvement on the 2016 ACR/EULAR Total Improvement Score. Secondary outcomes included time to improvement, the number of patients requiring rescue medication and serious adverse events. RESULTS We included patients with DM (n = 9), immune-mediated necrotizing myopathy (n = 6), non-specific myositis/overlap myositis (n = 4) and anti-synthetase syndrome (n = 1). One patient was excluded from analyses because of minimal weakness resulting in a ceiling effect. Eight patients (8/19 = 42.0%; Clopper-Pearson 95% CI: 19.6, 64.6) had at least moderate improvement by 9 weeks. Of these, six reached improvement by 3 weeks. Seven patients required rescue medication due to insufficient efficacy and prematurely ended the study. Three serious adverse events occurred, of which one was pulmonary embolism. CONCLUSION First-line IVIg monotherapy led to at least moderate improvement in nearly half of patients with a fast clinical response in the majority of responders. TRIAL REGISTRATION Netherlands Trial Register identifier, NTR6160.
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Affiliation(s)
- Johan Lim
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Filip Eftimov
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Camiel Verhamme
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Esther Brusse
- Department of Neurology, Erasmus UMC, Rotterdam, The Netherlands
| | - Jessica E Hoogendijk
- Department of Neurology, Brain Centre Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - Christiaan G J Saris
- Department of Neurology, Radboud UMC, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joost Raaphorst
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Rob J De Haan
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ivo N van Schaik
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Spaarne Gasthuis, Haarlem, The Netherlands
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marianne de Visser
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Anneke J van der Kooi
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Pfister PB, Knols RH, de Bie RA, de Bruin ED. Feasibility of a blended therapy approach in the treatment of patients with inflammatory myopathies. Arch Physiother 2021; 11:14. [PMID: 34039438 PMCID: PMC8157458 DOI: 10.1186/s40945-021-00108-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Inflammatory myopathies (IMs) are a group of rare conditions characterized by proximal and often symmetrical muscle weakness and reduced muscle endurance. The recommended medical treatment is based on corticosteroids in combination with immunosuppressants. This anti-inflammatory therapy serves to inhibit and prevent inflammation but does not influence impaired muscle strength. Exercise, particularly progressive resistance training, plays therefore an important role in IMs management. Blended therapy, a combination of face-to-face treatment and telerehabilitation, may be a powerful therapy option in improving exercise program adherence in these patients. Methods The feasibility of a 12-week interactive tablet-based home exercise program combined with face-to-face therapy sessions – a ‘blended therapy’ approach - was evaluated using a quasi-experimental one-group pre-post comparison design. Primary outcomes were recruitment, attrition and adherence rates, plus measures of acceptance (Technology Acceptance Model Questionnaire (TAM)) and satisfaction (satisfaction questionnaire). Secondary outcomes comprised potential effects of the intervention on muscle strength and function, activity limitation, disability and health-related quality of life. Results Thirteen of the included 14 participants completed the study without any related adverse events. Mean adherence to exercise program was 84% (range: 25–100%) and participants indicated high acceptance of the intervention with mean TAM scores between 6.1 and 6.5 points. Overall satisfaction with the therapy sessions, the home program, and the technology was good. Approximately half the participants wished for longer training periods and more training sessions per week. There were inconsistent effects on muscle strength, muscle function, activity limitation, disability, and health-related quality of life. Conclusion Blended therapy combining the use of an interactive tablet-based resistance training program with face-to-face therapy sessions is feasible and safe and participants` acceptance with this approach was high. Furthermore, results were obtained that might be useful in selecting appropriate assessments and sample sizes in future trials. Trial registration NCT03713151. Supplementary Information The online version contains supplementary material available at 10.1186/s40945-021-00108-z.
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Affiliation(s)
- Pierrette Baschung Pfister
- Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Nursing and Allied Health Professions Office, Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland.,Department of Epidemiology, CAPHRI Care And Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Ruud H Knols
- Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Rob A de Bie
- Department of Epidemiology, CAPHRI Care And Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland. .,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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Saygin D, Oddis CV, Moghadam-Kia S, Rockette-Wagner B, Neiman N, Koontz D, Aggarwal R. Hand-held dynamometry for assessment of muscle strength in patients with inflammatory myopathies. Rheumatology (Oxford) 2021; 60:2146-2156. [PMID: 33026081 DOI: 10.1093/rheumatology/keaa419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/09/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Muscle weakness in idiopathic inflammatory myopathies (IIMs) is conventionally assessed using manual muscle testing (MMT). However, more objective tools must be developed to accurately and reliably quantify muscle strength in myositis patients. Hand-held dynamometry (HHD) is a quantitative, portable device with reported reliability in neuromuscular disorders. Our aim was to assess the reliability, validity and responsiveness of HHD in myositis. METHODS Myositis patients [DM, necrotizing myopathy (NM), PM and anti-synthetase syndrome] evaluated at the University of Pittsburgh myositis centre were prospectively enrolled. Each patient was assessed at 0, 3 and 6 months for validated outcome measures of myositis disease activity and physical function. At each visit, muscle strength was assessed using both MMT and HHD (Micro FET2, Hoggan Health Industries, Draper, UT, USA). The reliability, validity and responsiveness of the HHD was assessed using standard statistical methods. RESULTS Fifty IIM patients (60% female; mean age 51.6 years; 6 PM, 9 NM, 24 DM and 11 anti-synthetase syndrome) were enrolled. HHD showed strong test-retest intrarater reliability (r = 0.96) and interrater reliability (r = 0.98). HHD correlated significantly with the MMT score (r = 0.48, P = 0.0006) and myositis disease activity and functional measures. Longitudinal analysis showed a significant and strong association between the HHD and MMT as well as 2016 ACR/EULAR myositis response criteria (r = 0.8, P < 0.0001) demonstrating responsiveness. The mean effect size and standardized response mean of HHD was large: 0.95 and 1.03, respectively. MMT had a high ceiling effect compared with HHD. CONCLUSION HHD demonstrated strong reliability, construct validity and responsiveness in myositis patients. External validation studies are required to confirm these findings.
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Affiliation(s)
| | - Chester V Oddis
- Division of Rheumatology and Clinical Immunology, Department of Medicine
| | | | - Bonny Rockette-Wagner
- Department of Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Nicole Neiman
- Division of Rheumatology and Clinical Immunology, Department of Medicine
| | - Diane Koontz
- Division of Rheumatology and Clinical Immunology, Department of Medicine
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, Department of Medicine
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Kong SS, Pham T, Fortis A, Raval A, Bhanusali N. Yoga as a Novel Adjuvant Therapy for Patients with Idiopathic Inflammatory Myopathies. Int J Yoga 2021; 14:75-82. [PMID: 33840980 PMCID: PMC8023441 DOI: 10.4103/ijoy.ijoy_78_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 12/31/2022] Open
Abstract
Context: Recent studies have demonstrated that physical activity is well tolerated by patients with idiopathic inflammatory myopathies (IIMs) and can have additional benefits as an adjuvant therapy to pharmacologic agents, especially if started early. To date, no studies have examined the effects of yoga on patients with IIMs. Aims: The aim of this study was to evaluate the effects of yoga on self-reported difficulty in performing activities of daily living (ADL) and muscle strength in patients with mild-to-moderate IIMs. Subjects and Methods: A longitudinal cohort study in which participants were assessed using the Myositis Activities Profile (MAP) and manual muscle testing (MMT) before and after the completion of an 8-week instructor-guided yoga course was performed. Statistical Analysis Used: Wilcoxon signed-ranked test was performed for statistical analysis. Results: The average posttreatment MAP scores of six participants demonstrated an increase of 2.51 points, while the average MMT score of four participants demonstrated an increase of 11 points. Conclusions: This study is the first study to date to examine the effect of yoga as an adjuvant complementary therapy for patients with IIM. Continued research should be done on the effect of yoga as an adjuvant therapy, for in addition to increase in muscle strength and ability to perform ADL, yoga may offer potential improvements in mood, mental health, and sleep.
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Affiliation(s)
- Steve S Kong
- Department of Medicine, Highland Hospital Alameda Health, Oakland Ca, USA
| | - Thanh Pham
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Allyson Fortis
- College of Nursing, University of South Alabama, Mobile, AL, USA
| | - Alpa Raval
- Healing Arts Specialist Orlando Health UF Cancer Center, School of Integrative Yoga, Orlando, FL, USA
| | - Neha Bhanusali
- Department of Medicine, University of Central Florida, Orlando, FL, USA
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Sterkele I, Pfister PB, Knols R, de Bruin ED. Eine Alternative zur klassischen Testtheorie? – Eine exemplarische Anwendung der Generalisierbarkeitstheorie auf der Basis von Sekundärdaten. physioscience 2021. [DOI: 10.1055/a-1201-6872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Hintergrund Messungen bilden die Grundlage des wissenschaftsbasierten therapeutischen Vorgehens. Messfehler sind jedoch ein verbreitetes Problem. Um Fehlerquellen zu ermitteln, sind erweiterte statistische Modelle notwendig. Im Gegensatz zur klassischen Testtheorie ermöglicht die Generalisierbarkeitstheorie, mehrere Fehlerquellen gleichzeitig zu untersuchen.
Ziel Vergleich der klassischen Testtheorie und der Generalisierbarkeitstheorie anhand eines physiotherapeutischen Beispiels zur Reliabilitätsermittlung und deren Ergebnisse.
Methode Die Messeigenschaft „Reliabilität“ wurde anhand von Daten einer vorangegangenen Reliabilitätsstudie, in der die klassische Testtheorie zum Einsatz kam, untersucht. Dazu wurde exemplarisch eine Generalisierbarkeitsstudie durchgeführt.
Ergebnisse Die Variabilität ging hauptsächlich von den Probanden und der Probanden-Untersucher-Interaktion aus. Unabhängig von fixen oder zufälligen Facetten waren die Generalisierbarkeitskoeffizienten für alle Bedingungen (overall, inter-rater, intra-Messzeitpunkte) exzellent.
Schlussfolgerung Die Ergebnisse deuten darauf hin, dass die Generalisierbarkeitstheorie gegenüber der klassischen Testtheorie Vorteile hat. Diese ermöglicht es, einen wirkungsvollen und effizienten Einsatz von Messinstrumenten im klinischen Alltag zu ermitteln.
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Affiliation(s)
- Iris Sterkele
- Physiotherapie Ergotherapie USZ, Universitätsspital Zürich, Zürich, Schweiz
| | - Pierrette Baschung Pfister
- Physiotherapie Ergotherapie USZ, Universitätsspital Zürich, Zürich, Schweiz
- Forschungszentrum Physiotherapie Ergotherapie USZ, Universitätsspital Zürich, Zürich, Schweiz
| | - Ruud Knols
- Physiotherapie Ergotherapie USZ, Universitätsspital Zürich, Zürich, Schweiz
- Forschungszentrum Physiotherapie Ergotherapie USZ, Universitätsspital Zürich, Zürich, Schweiz
- Departement Gesundheitswissenschaften und Technologie, Institut für Bewegungswissenschaften und Sport, ETH Zürich, Zürich, Schweiz
| | - Eling D de Bruin
- Departement Gesundheitswissenschaften und Technologie, Institut für Bewegungswissenschaften und Sport, ETH Zürich, Zürich, Schweiz
- Division of Physiotherapy, Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden
- Research Line Functioning and Rehabilitation, Department of Epidemiology, School CAPHRI Care and Public Health Research Institute, Maastrich University, The Netherland
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Alsayed A, Kamil R, Rowe V, Salim MSF, Ramli HR, As'arry A. Quantification of the Therapist's Gentle Pull for Pinch Strength Testing Based on FMA and MMT: An Experimental Study with Healthy Subjects. Diagnostics (Basel) 2021; 11:225. [PMID: 33540890 DOI: 10.3390/diagnostics11020225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 11/23/2022] Open
Abstract
Static pinch strength against a therapist’s gentle pull is evaluated using the pincer grasp component of the Fugl Meyer Assessment (FMA) to assess pinch impairment after stroke. In the pincer grasp component, therapists applied a gentle pull to distinguish between a score of 1 (moderate pinch impairment) and a score of 2 (no pinch impairment). The gentle pull is described as a resistance equivalent to a manual muscle test (MMT) score 4/5. The accepted use of “gentle” as a qualitative description for the pull results is a non-standardized subjective interpretation. The goal of this paper was to determine the quantitative value of the gentle pull applied by the therapists as in their clinical practice using a pinch–pull gripping system. The FMA protocol was used to standardize the body and fingers positions of three occupational therapists who were then instructed to apply a gentle pull of 4/5 MMT using their thumb and index fingers (in a tip-to-tip pinch). The results show that the therapists exerted a mean gentle pull (4/5 MMT score) of 6.34 ± 0.98 N with high reliability and acceptable repeatability. In investigating the ability of healthy subjects to resist the gentle pull, 50 adult male volunteers were instructed to pinch the pincer object and resist a dynamic loading exerted by the pinch–pull gripping system as much as possible to the moment the pincer object slips away. The results show that all subjects were able to exert a pulling force higher than the quantitative value of the gentle pull.
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Sørensen L, Oestergaard LG, van Tulder M, Petersen AK. Measurement properties of handheld dynamometry for assessment of shoulder muscle strength: A systematic review. Scand J Med Sci Sports 2021; 30:2305-2328. [PMID: 33463791 DOI: 10.1111/sms.13805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/15/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022]
Abstract
Like any assessment tool, handheld dynamometry (HHD) must be valid and reliable in order to be meaningful in clinical practice and research. To summarize the evidence of measurement properties of HHD for the assessment of shoulder muscle strength. Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and PEDro were searched up to February 2020. Inclusion criteria were studies (a) evaluating HHD used on the glenohumeral joint, (b) evaluating measurement properties, and (c) included individuals ≥ 18 years old with or without shoulder symptoms. Exclusion criteria were studies (a) including patients with neurologic, neuromuscular, systemic diseases, or critical illness or bed-side patients and (b) that did not report the results separately for each movement. In total, 28 studies with 963 participants were included. The reliability results showed that 98% of the intraclass correlation coefficient (ICC) values were ≥0.70. The measurement error showed that the minimal detectable change in percent varied from 0% to 51.0%. The quality of evidence was high or moderate for the majority of movements and type of reliability examined. Based on the evidence of low or very low quality of evidence, the convergent validity and discriminative validity of HHD were either sufficient, indeterminate, or insufficient. The reliability of HHD was overall sufficient, and HHD can be used to distinguish between individuals on the group level. The measurement error was not sufficient, and evaluation of treatment effect on the individual level should be interpreted with caution.
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Affiliation(s)
- Lotte Sørensen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Maurits van Tulder
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Health Sciences, Amsterdam Movement Sciences research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemette Krintel Petersen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Abstract
BACKGROUND Extremity strength testing is used to determine the ability of industrial employees to perform a physically demanding occupation safely, evaluate post-injury impairment, and monitor return to function after injury. There is an unmet clinical need for a robust and granular source of normative reference values to serve as a resource for baseline data on upper extremity isometric strength. OBJECTIVE Develop normative reference data for upper extremity strength among industrial employees and investigate associations between strength and physical job demands. METHODS Upper extremity strength data from 107,102 industrial employees were collected post-hire. In this study, isometric tests for pinch; hand grip; wrist pronation and supination; and flexion of the wrist, elbow, and shoulder strength were retrospectively analyzed in relationship to sex, age, and job level. Associations between strength scores and five levels of work, defined the United States Department of Labor's Dictionary of Occupational Titles by level of physical difficulty (1-5), were determined. RESULTS Higher strength scores were positively associated with more physically demanding job levels (P < 0.001), and there was a progressive increase in strength scores with increased physical job demands for both sexes (P = 0.0002). All strength scores differed significantly by decade of age (P < 0.001). All scores except for pinch strength demonstrated a moderate or high positive correlation with job level (r≥0.50). CONCLUSIONS The normative reference upper extremity strength data collected in this study for industrial employees may be useful for evaluating rehabilitation and recovery following injury or illness. In order to utilize normalized strength data as a post-injury reference, it is important to consider job level in addition to age and sex, as these variables are highly correlated with baseline upper extremity strength.
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Affiliation(s)
- Gary Harbin
- Salina Sports Medicine Clinic, Salina, KS, USA
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Marques C, Kakehasi AM, Gomides APM, Paiva EDS, Dos Reis Neto ET, Pileggi GCS, Provenza JR, Mota L, Xavier RM, Ferreira GA, Pinheiro MM. A Brazilian Cohort of Patients With Immuno-Mediated Chronic Inflammatory Diseases Infected by SARS-CoV-2 (ReumaCoV-Brasil Registry): Protocol for a Prospective, Observational Study. JMIR Res Protoc 2020; 9:e24357. [PMID: 33156812 PMCID: PMC7744142 DOI: 10.2196/24357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with immune-mediated rheumatic diseases (IMRD) are at increased risk of infections, including significant morbidity and high mortality. Considering the potential for unfavorable outcomes of SARS-CoV-2 infection in patients with IMRD, several questions were raised regarding the impact of COVID-19 at the start of the pandemic. OBJECTIVE This paper presents the protocol of a study that aims to prospectively evaluate patients with IMRD and a confirmed COVID-19 diagnosis (using criteria provided by the Brazilian Ministry of Health). METHODS The study comprised a prospective, observational cohort (patients with IMRD and COVID-19) and a comparison group (patients with only IMRD), with a follow-up time of 6 months to evaluate differences in health outcomes. The primary outcomes will be changes in IMRD disease activity after SARS-CoV-2 infection at 4 time points: (1) at baseline, (2) within 4-6 weeks after infection, (3) at 3 months after the second assessment (±15 days), and (4) at 6 months (±15 days). The secondary outcomes will be the progression rate to moderate or severe forms of COVID-19, need for intensive care unit admission and mechanical ventilation, death, and therapeutic changes related to IMRD. Two outcomes-pulmonary and thromboembolic events in patients with both IMRD and SARS-CoV-2 infection-are of particular interest and will be monitored with close attention (clinical, laboratory, and function tests as well as imaging). RESULTS Recruitment opened in May 2020, with 1300 participants recruited from 43 sites as of November 2020. Patient recruitment will conclude by the end of December 2020, with follow-up occurring until April 2021. Data analysis is scheduled to start after all inclusion data have been collected, with an aim to publish a peer-reviewed paper in December 2020. CONCLUSIONS We believe this study will provide clinically relevant data on the general impact of COVID-19 on patients with IMRD. TRIAL REGISTRATION Brazilian Registry of Clinical Trials RBR-33YTQC; http://www.ensaiosclinicos.gov.br/rg/RBR-33ytqc/. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24357.
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Affiliation(s)
- Claudia Marques
- Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | | | | | | | | | - Licia Mota
- Faculdade de Medicina, Universidade de Brasilia, Brasilia, Brazil
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Montagnese F, Rastelli E, Khizanishvili N, Massa R, Stahl K, Schoser B. Validation of Motor Outcome Measures in Myotonic Dystrophy Type 2. Front Neurol 2020; 11:306. [PMID: 32373059 PMCID: PMC7186332 DOI: 10.3389/fneur.2020.00306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/30/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction: Myotonic dystrophy type 2 (DM2) lacks disease-specific, validated, motor outcome measures (OMs), and patients' reported outcomes (PROs). This represents a limit for the monitoring of disease progression and treatment response. Our aim was to identify the most appropriate OMs to be translated in clinical practice and clinical trials on DM2. This study has been registered on clinicaltrials.gov NCT03603171 (https://clinicaltrials.gov/ct2/show/NCT03603171). Methods: Sixty-six patients with genetically confirmed DM2 underwent a baseline and a follow-up visit after 1 year. The tested OMs included: hand opening time, pressure pain threshold (PPT), manual muscle testing (MMT), hand held dynamometry (HHD), scale for the assessment and rating of ataxia (SARA), quantitative motor function test (QMFT), gait stairs Gowers chair (GSGC), 30-s sit to stand test, functional index 2 (FI-2) and 6MWT. The PROs included DM1-Active-C, Rasch-built Pompe-specific activity scale (R-Pact), fatigue and daytime sleepiness (FDSS), brief pain inventory short form (BPI-sf), myotonia behavior scale (MBS), and the McGill pain questionnaire. Results: All patients completed the MBS and the results correlated well with the hand-opening time. The PPT showed a low reliability, no correlation with pain questionnaires, and did not differentiate patients with or without myalgia. Both muscle strength assessments, MMT and HHD, showed good construct validity. The QMFT showed an acceptable ceiling effect (14.5%), good convergent and differential validity and performed overall better than GSGC. The SARA score showed high flooring effect and is not useful in DM2. 6MWT proved a valid outcome measure in DM2. The 30-s sit to stand is a feasible test with good convergent validity, showing a flooring effect of 20% as it cannot be used in more severely affected patients. The FI-2 is time-consuming and has a high ceiling effect. At the 1-year visit the only assessments able to detect a worsening of DM2 were HHD, QMFT, and 6MWT, which are the most sensitive to change, and therefore clinically meaningful OMs in DM2. Conclusion: The clinical meaningful motor outcome measures that best depict the multifaceted phenotype of DM2 and its slow progression are MBS, MMT, or HHD (depending on the clinical setting), QMFT, and the 6MWT.
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Affiliation(s)
- Federica Montagnese
- Department of Neurology, Friedrich-Baur-Institute, Klinikum der Universität, Ludwig-Maximilians-University, Munich, Germany
| | - Emanuele Rastelli
- Department of Neurology, Friedrich-Baur-Institute, Klinikum der Universität, Ludwig-Maximilians-University, Munich, Germany
| | - Nina Khizanishvili
- Department of Neurology, Friedrich-Baur-Institute, Klinikum der Universität, Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology, City Hospital Soest, Soest, Germany
| | - Roberto Massa
- Neuromuscular Diseases Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Kristina Stahl
- Department of Neurology, Friedrich-Baur-Institute, Klinikum der Universität, Ludwig-Maximilians-University, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, Klinikum der Universität, Ludwig-Maximilians-University, Munich, Germany
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Haskel JD, Feder OI, Mijares J, Castañeda P. Isolated Trochanteric Descent and Greater Trochanteric Apophyseodesis Are Not Effective in the Treatment of Post-Perthes Deformity. Clin Orthop Relat Res 2020; 478:169-75. [PMID: 31725028 DOI: 10.1097/CORR.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Greater trochanteric apophyseodesis and isolated trochanteric descent seek to prevent abductor weakness in patients with a hip deformity because of Legg-Calvé-Perthes disease; however, no studies have evaluated radiographic findings or abductor strength in children treated with these procedures. QUESTIONS/PURPOSES (1) Do children with Waldenström Stage III Legg-Calvé-Perthes disease treated with either isolated greater trochanteric descent or isolated greater trochanteric apophyseodesis achieve improved radiographic findings (Stulberg classification or neck-shaft angle) compared with those who underwent no surgical treatment? (2) Do children treated with one of those procedures achieve greater abductor strength than those who did not have surgery? METHODS Between 2006 and 2010, we treated 89 children with Waldenström Type III Legg-Calvé-Perthes disease (reossification). Of these, 27.9% (12 patients) underwent greater trochanteric descent, 25.6% (11 patients) underwent greater trochanteric apophyseodesis, and 46.5% (20 patients) did not have surgery. During that time, the decision to perform either apophyseodesis or trochanteric descent was made by the surgeon based on the subjective appearance of remaining growth from the greater trochanter. Nonsurgical management was chosen by the parents of the patients after the risks and benefits of surgery were discussed. During greater trochanteric descent, the greater trochanter was osteotomized and fixed distally with two 7.0-mm screws. During greater trochanteric apophyseodesis, the physis was identified fluoroscopically, and the lateral half of the growth plate was drilled. Nonoperative treatment involved serial clinical and radiographic evaluations every 3 to 6 months. All children in all groups were available for follow-up at a minimum of 6 years. The median follow-up durations for children undergoing greater trochanteric descent, greater trochanteric apophyseodesis, and control cohorts were 6.6 years (range 6.0-8.2 years), 6.5 years (range 6.1-9.2 years), and 7.4 years (range 6.0-9.1 years), respectively. On presentation, each patient's affected hip was classified according to the Stulberg classification by the operating surgeon and an orthopaedic surgeon not involved in the child's care. The neck-shaft angle was measured for each patient before surgery and at the final follow-up examination. Abductor strength was assessed by a pediatric orthopaedic fellow and a physical therapist with the patient in the lateral decubitus position. Each patient was given a muscle strength score on a scale of 0 to 10 points, per a modification of the Medical Research Council scale to allow for a narrower range. We had 80% power to detect an 8° difference in the neck-shaft angle between the greater trochanteric apophyseodesis and nonoperative management cohorts. A sample size of 6.8 patients per cohort would be necessary to detect the above endpoint. RESULTS With the numbers available, we found no differences among the groups in the proportion of patients with Stulberg Class 2 femoral heads (two of 12 patients in the isolated trochanteric descent group, three of 11 in the isolated trochanteric apophyseodesis group, and two of 20 who did not undergo surgery; p = 0.46). Likewise, there were no differences among the three groups in terms of the neck-shaft angle at a minimum of 6 years of follow-up (122° ± 6°, 119° ± 7°, and 126° ± 8° in the isolated trochanteric descent, isolated trochanteric apophyseodesis, and nonoperative groups, respectively). There were no differences among the groups in term of the median abductor strength test result: seven of 10 (range 6-8), six of 10 (range 6-8), and six of 10 (range 6-10; p = 0.34). CONCLUSION Because neither isolated greater trochanteric descent nor greater trochanteric apophyseodesis alone had an effect on hip morphology or abductor strength in children with sequellae of Legg-Calvé-Perthes disease, we conclude these types of extraarticular surgery are ineffective. Therefore, we no longer perform isolated trochanteric descent or apophyseodesis. LEVEL OF EVIDENCE Level III, therapeutic study.
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Mammen AL, Allenbach Y, Stenzel W, Benveniste O. 239th ENMC International Workshop: Classification of dermatomyositis, Amsterdam, the Netherlands, 14-16 December 2018. Neuromuscul Disord 2019; 30:70-92. [PMID: 31791867 DOI: 10.1016/j.nmd.2019.10.005] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/21/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Andrew L Mammen
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, 50 South Drive, Building 50, Room 1146, MD 20892, United States.
| | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunology, Pitié Salpetrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Werner Stenzel
- Department of Neuropathology, Charité-Universitatsmedizin, Berlin, Germany
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Pitié Salpetrière Hospital, AP-HP Sorbonne University, Paris, France
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Abstract
Purpose of review The aim of this review was to summarize key developments in classification and diagnosis of the idiopathic inflammatory myopathies (IIMs). Recent findings The recently published European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for the IIMs provide a comprehensive, accurate and data-driven approach to identification of IIM cases appropriate for inclusion in research studies. Further, recent studies have advanced understanding of clinical manifestations of the IIMs and delineated the role of imaging, particularly magnetic resonance. Summary The recent publication of the EULAR/ACR classification criteria will potentially greatly improve IIM research through more accurate case identification and standardization across studies. Future inclusion of newly recognized clinical associations with the MSAs may further improve the criteria's accuracy and utility. Clear and comprehensive understanding of associations between clinical manifestations, prognosis and multisystem involvement can aid diagnostic assessment; recent advances include delineation of such associations and expansion of the role of imaging.
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Giovannini S, Macchi C, Liperoti R, Laudisio A, Coraci D, Loreti C, Vannetti F, Onder G, Padua L; Mugello Study Working Group. Association of Body Fat With Health-Related Quality of Life and Depression in Nonagenarians: The Mugello Study. J Am Med Dir Assoc 2019; 20:564-8. [PMID: 30852165 DOI: 10.1016/j.jamda.2019.01.128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The association of body fat with health status and depression in the oldest old is still debated. The aim of this cross-sectional study is to investigate the association of body fat with health-related quality of life and depression in a sample of nonagenarians. DESIGN Data are from the Mugello study, a community-based project conducted in Italian older adults aged 90 years. SETTING AND PARTICIPANTS Total body fat was assessed by body impedance assessment. Participants were divided into 3 groups according to gender-specific tertiles of body fat percentage (BF%). Self-perceived mental and physical health status were assessed by the Mental Component Summary (MCS) and the Physical Component Summary (PCS) subscales derived from the 12-item Short Form Health Survey. Lower scores of MCS and PCS indicated poorer mental health and physical health status, respectively. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale, and a score ≥5 was used to identify participants with depression. RESULTS The mean age of 251 study participants was 92.5 years, and 173 (68.9%) were women. Participants were included in the low (n = 83), medium (n = 83), and high (n = 85) BF% groups. In the whole sample, mean scores at PCS progressively declined with the increasing BF% group (P = .004). This association was stronger in women, although no significant interaction was observed between the gender and BF% group (P = .63). No significant association between BF% and MCS was documented. Medium and high BF% were associated with a significantly higher probability of depression as compared with low BF% [odds ratio (OR) 2.15, 95% confidence interval (CI) 1.04-4.44, and OR 2.15, 95% CI 1.06-4.34, respectively]. This association was stronger in women, although no significant interaction was observed between gender and BF% group (P = .70). CONCLUSIONS AND IMPLICATIONS High BF% is significantly positively associated with poor health-related quality of life and depression, underpinning the clinical relevance to test BF% in older adults. These associations appear to be stronger in women than in men, highlighting the need to investigate deep inside this gender discrepancy.
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Bohannon RW. Considerations and Practical Options for Measuring Muscle Strength: A Narrative Review. Biomed Res Int 2019; 2019:8194537. [PMID: 30792998 PMCID: PMC6354207 DOI: 10.1155/2019/8194537] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/15/2018] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Abstract
Muscle strength impairments are related to mobility limitations and other untoward outcomes. This narrative review, therefore, describes considerations relative to the definition and measurement of muscle strength. Thereafter, practical options for measuring muscle strength are described and their clinimetric properties are delineated. Information provided herein may help students, clinicians, and researchers select the strength tests best suited to their research needs and limitations.
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Affiliation(s)
- Richard W. Bohannon
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University, Lillington, NC, USA
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