Range of Motion

The condition progresses in three stages: freezing (painful), frozen (adhesive) and thawing, and is often self-limiting , 2010 and Hui Bin Yvonne Chan, 2017). 9 months) there is a gradual onset of diffuse, severe shoulder pain that typically worsens at night , 2005). The pain will begin to subside during the frozen stage with a characteristic progressive loss of glenohumeral flexion, abduction, internal rotation and external rotation. (4–12 months) (Prestgaard, 2017 During the thawing stage, the patient gradual return of range of motion that takes 26 months to complete (Prestgaard, 2017 and Dias, Two types identified in the literature: Idiopathic and Secondary adhesive capsulitis (Lundberg, 1969). Idiopathic INTERNATIONAL JOURNAL OF CURRENT RESEARCH

The great volume of muscle mass, and abdomen, thighs and legs adipose tissue could limit hip flexion and knee flexion movements. According to Kapandji [39], the passive knee flexion movement is limited by the elas- tic contact of the muscle masses of the calf and the hip. The thighs areas, specially the backsides, are known to easily deposit fat and it is thought to be the main reason for the obesity associated range of motion reduction for the knee flexions [12].

The reliability of the instruments used, considered to be acceptable. It was also verified that stretches learnt and done by them are correct or not. The reasons for such results could be because of the following. After passive stretching, there is usually increase in range of motion of the respective joint. With autogenic inhibition, muscles being stretched is inhibited and is thought to simultaneously relax, however, that muscle relaxation is due to stress applied not due to autogenic inhibition, which is responsible for any improvement observed with passive stretching. Active stretching also places a tensile stress on the muscle being stretched, but in addition, is thought to be achieved through relaxation via reciprocal inhibition. 2 But tensile stress is common to both type of stretching and is probably the primary factor for increasing muscle flexibility, this explained that why the active and passive stretching regimens were equally effective in improving range of motion over time.

Anderson et al. 11 measured passive dorsiflexion range of motion (DFR) in asymptomatic subjects using a consistent torque applied to both the pre and post treatment measurements. The fifty-two subjects participating in the study had a history of unilateral ankle sprain, which became the ankle of focus for the trial. A single HVLA technique was performed to those subjects in the treatment group. Passive DFR was measured pre and post treatment with a Nicholas hand-held dynomometer, which provided a constant level of force that was recorded and used for both pre and post treatment measurements. There was no significant alteration found between the pre and post measurement in DFR of either control or treatment groups.

Despite extensive use by manual therapists, there is a lack of experimental evidence supporting the efficacy of MET, particularly within the thoracic region. 3,4,5 Two studies exist in the peer-reviewed literature that have examined the effect of MET on cervical and lumbar motion, and have demonstrated increased range of motion (ROM) following treatment. Schenk et al. 3 examined the effects of MET on ROM for cervical flexion, extension, axial rotation and lateral flexion over a four-week period involving multiple MET sessions to correct participants' pre-determined cervical restrictions, and recorded post-test ROM at the completion of the treatment series. Cervical axial rotation was significantly increased following the treatment period, however, the cervical flexion, extension and lateral flexion treatments failed to reveal statistically significant increases in ROM. Mean ROM values post-treatment for these

range of motion found for the affected shoulder, which was large and the non-affected shoulder, which was low. The CROM device is the most frequently reported meas- ure for cervical ROM and variable ICC values have been reported, both alone or when compared to other ROM instruments [8,25,26]. One study on patients with cervi- cal spine disorders reported inter-rater ICCs for active ROM greater than 0.80 with the Cervical Range of Motion Device (CROM device) compared to ICCs lower than 0.80 for visual estimation and a universal goniometer (Youdas et al 1991). Considering the results of this study it would be interesting to directly compare the CROM device with the EDI-320 inclinometer in a future study.

The Cervical Range of Motion device (CROM) is a validated piece of equipment for measuring cervical spine range of movement [22-25] and has been used in a number of cervical movement studies [8,26,27]. The de- vice consists of a plastic frame mounted over the nose and ears and secured with a strap. Flexion, extension and lateral flexion are recorded by two gravity goni- ometers. However, the CROM does not measure rota- tion and can only be used on participants in an upright position as the measurement system relies on gravity. A study by Schneider et al [28] compared cervical range of movement in seven different orthoses. The authors em- phasise the importance of effective immobilisation in both supine and upright positions; it is essential to be able to assess this in order to evaluate a cervical collar.

Physical therapeutic exercise (PTE) is the planned process of performing bo- dily movements, postures, or physical activities to provide a patient with the ability to remediate or prevent impairments at a minimum. The efficacy of the PTE involves measuring accurately the range of motion (ROM) of joint func- tions and parameters that indicate the onset of fatigue, jerky motion, and muscle/joint resistance to the PTE. A physical therapist (PT) typically deter- mines the efficacy of a PTE by measuring joint angles in clinical diagnosis to assess the ROM using the simple device Goniometer since motion capture systems are generally expensive, difficult to use, and currently not suited for real-time operations. The joint angle measurement using Goniometer suffers from low accuracy, low reliability and subjective. Furthermore, a patient when performing PTE by themselves at remote locations like their home or com- munity centers cannot use a Goniometer to determine the efficacy. In this study, we present the approach of using an inexpensive, simple human mo- tion capture system (HMCS) consisting of a single camera and a graphical processing unit (GPU) to perform the efficacy of the PTE in real-time. The approach involves the use of general purpose graphic processing unit (GPGPU) computer vision technique to track and record human motion and relate the tracked human motion to the prescribed physical therapy regimen in real-time. We have developed a tracking algorithm derived from the Klein’s algorithm known as the Modified Klein’s algorithm (MKA) capable of track- ing human body parts while the original Klein’s algorithm was only capable of tracking objects with sharp edges. The MKA algorithm is further modified for parallel execution on a GPU to operate in real-time. Using the GPU, we are able to track multiple markers in a high definition (HD) frame of the HD video in 1.77 msecs achieving near real-time capability of ROM measure- ments. Furthermore, the error in the ROM measurements in comparison to How to cite this paper: Kumar, R.R.P.,

Immobilisation of the cervical spine is a common procedure following traumatic injury. This is often precautionary as the actual incidence of spinal injury is low. Nonetheless, stabilisation of the head and neck is an important part of pre-hospital care due to the catastrophic damage that may follow if further unrestricted movement occurs in the presence of an unstable spinal injury. Currently available collars are limited by the potential for inadequate immobilisation and complications caused by pressure on the patient’s skin, restricted airway access and compression of the jugular vein. Alternative approaches to cervical spine immobilisation are being considered, and the investigation of these new methods requires a standardised approach to the evaluation of neck movement. This review summarises the research methods and scientific technology that have been used to assess and measure cervical range of motion, and which are likely to underpin future research in this field. A systematic search of international literature was conducted to evaluate the methodologies used to assess the extremes of movement that can be achieved in six domains. 34 papers were included in the review. These studies used a range of methodologies, but study quality was generally low. Laboratory investigations and biomechanical studies have gradually given way to methods that more accurately reflect the real-life situations in which cervical spine immobilisation occurs. Latterly, new approaches using virtual reality and simulation have been developed. Coupled with modern electromagnetic tracking technology this has considerable potential for effective application in future research. However, use of these technologies in real life settings can be problematic and more research is needed.

In recent years, a new imaging technique, cone beam computed tomography (CBCT), is becoming increasingly popular in dentistry. CBCT scanners are based on volumetric tomography, which consists of a two-dimensional detector and a three-dimensional x-ray beam. While conventional CT scanners use slices of x-ray exposure, CBCT uses cone shapes for image acquisition, thereby reducing the radiation dose and cost for the patient. In addition, CBCT technology allows the image to be captured in one rotation of the x-ray source, which reduces the scanning time. Hence the study aims at identifying and evaluating the bone changes and range of motion in the temporomandibular joint, thus making a reliable and accurate diagnosis of the temporomandibulardisorders which helps in timely intervention and in some cases for rendering a precise treatment plan for the at most benefit of the patient.

Snyder described these injuries as a superior labral anterior to posterior injury. Type 1 is described a fraying of the labrum with no involvement of the LHBT. Type 2 is most common in overhead athletes and is described as a peel-back lesion where the labrum peels off the glenoid fossa with involvement of the LHTB. Type 3 is described as a bucket-handle tear of the labrum without involvement of the LHBT. Type 4 is described as a bucket-handle tear with involvement of the LHBT. Type 2 SLAP tears are most common in overhead athletes and are thought to occur through two mechanisms (Erikson et al., 2016). Mechanism one proposes increased eccentric load during the deceleration phase of throwing which puts tension on the LHBT and the Biceps-labral complex (BLC) causing injury. The second mechanism is reported to occur at the late- cocking phase of throwing when the shoulder is in maximal abduction and external rotation. This motion causes torsion at the BLC and injury to the labrum. SLAP tears most likely occur from a combination of the mechanisms discussed above. After injury, patients may report various symptoms such as catching, locking, or clicking with pain, pain is usually described as “deep” in the shoulder, and overhead athletes will report the feeling of a dead arm. Physical exam may reveal limited range of motion in the shoulder due to pain, a feeling of instability, and loss of power/speed during activity. Current literature supports the use of anterior apprehension, anterior slide, crank (compression-rotation), biceps load two, and yergason’s test as orthopedic exams for diagnosis.

The third goal of this study was to examine the reliability of upright lumbar measures attained by each subject. The results are similar to those reported by Feipel et al. [11] utilizing the same OSI CA 6000 system, but with the standard strap fixation. Feipel et al. [11] also utilized a dif- ferent testing procedure (sitting on a rocker board) with guidance given to each subject to a specific point in the range of motion. It might be inferred that a level of passive input from the operators in the Feipel et al. [11] study may have influenced subject positioning. By contrast, the sub- jects in this present study utilized upright standing pos- ture, and were only given the command to attain or return to that upright standing posture without any other opera- tor influence. Overall, our subjects were consistent in their attainment of the upright position of the lumbar spine with all 3 operators. The slight variation which occurred in the examiner palpation and placement of the hook bases at T12 had no apparent influence on these results. Conclusion

Introduction: Foam rolling (FR) has become a very popular modality to provide self-myofascial release. FR is often used during the warm-up period or cool-down period and can purportedly improve range of motion (ROM), flexibility, and a variety of performance measures. Purpose: This study evaluated the acute effects of FR on ankle and knee ROM, hamstring flexibility, agility, and vertical jump height. Methods: Nineteen subjects (8 male, 11 female) completed a 15-minute FR session and a control condition (sitting quietly), on two separate days. Pre and post-testing evaluation included ankle dorsiflexion ROM, knee flexion ROM, a sit-and-reach test to assess hamstring flexibility, agility, and vertical jump height. Subjects also filled out a perceived benefits questionnaire. Results: There were no statistically significant differences for any of the criterion measures (p<.05), although knee ROM (p=.08) and hamstring flexibility (p=.07) approached significance. Subjectively subjects felt that FR increased ROM at the ankle and knee and improved their flexibility. Conclusions: FR, as conducted in this study, did not provide any physiologic benefit when used as a warm-up modality. However, FR may provide some psychological benefit as subjects perceived it to be beneficial.

Accurate measurement of the shoulder joint range of motion (ROM) is imperative in assessing postoperative clinical outcomes. Many research papers designed to evaluate clinical interventions utilize differences in ROM obtained by visual inspection to draw conclusions on differences in outcomes. The validity of these conclusions is based on the accuracy of these measurements. However, the literature denotes that visual inspection for ROM measurements results in inaccuracy based on intraobserver variability and reproducibility [1]-[3]. Orthopedic investigators are in need of quick and cost-effective methods of obtaining accurate measurement for ROM on physical exam. The purpose of this study is to investigate a new method for measuring shoulder ROM in an or- thopedic practice utilizing a smartphone application to improve accuracy from physical exam typically used for outcomes in research.

range of motion and cause fibrosis of the surrounding soft tissue. These deformities, together with the presence of periarticular osteopenia and cysts, cause postoperative flexion contractures [13, 18] (Figs. 1, 2). The average range of motion of hemophilic patients after total knee replacement is less than that in cases of patients with osteoarthritis. Intra-capsular fibrotic changes and extra- capsular muscle contractures are typical problems that affect the operative outcomes after TKA [19]. The atten- tion in preoperative planning should be focused on flexion contracture [13].

Objectives: A knee joint contracture, a loss in passive range of motion (ROM), can be caused by prolonged immobility. In a rat knee immobilization flexion contracture model, the posterior capsule was shown to contribute to an irreversible limitation in ROM, and collagen pathways were identified as differentially expressed over the development of a contracture. Collage- nases purified from Clostridium histolyticum are currently prescribed to treat Dupuytren’s and Peyronie’s contractures due to their ability to degrade collagen. The potential application of collagenases to target collagen in the posterior capsule was tested in this model.

approach to soft tissue injuries, and is evidenced in animal studies to promote the healing and regeneration of soft tissues. It has also been found to reduce pain and increase function in people with soft tissue dysfunction. The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. Handheld instrumentation is applied topically to locate and treat the underlying dysfunctional soft tissue through specific protocols for the application of particular pressures and shear forces. The purpose of this study was to examine the effects of Astym treatment on activities of daily living in women who had undergone a mastectomy following a diagnosis of breast cancer. A quasi-experiment involving 40 women, following a mastectomy, evaluated five outcome measures pre- and post-Astym treatment. All five measurement scores: Disabilities of the Arm, Shoulder, and Hand Outcome Measure; a clothing questionnaire on their ability to wear a bra; Patient-Specific Functional Scale; active range of motion of shoulder flexion; and active range of motion of abduction were also measured and all demonstrated significant changes. In this study, Astym treatment improved active range of motion in the involved quadrant and also improved function in patients following a mastectomy.

The kinematic motion analysis technique of the Dartfish Movement Analysis Software was compared against two other techniques being a digital EM tracking system, and a manual goniometer. The index PIP and MCP, and thumb MCP joints, were evaluated when preforming maximum flexion and maximum extension. A sample of five healthy participants aged 20-25 years (four right hand dominant and one left hand dominant) were recruited with three trials conducted for each movement. The results calculated from the one-way ANOVA analysis demonstrated no statistical difference between any of the three measurement techniques for the index PIP (P=0.3, 1-β=0.2), index MCP (P=0.05, 1-β=0.6), and thumb MCP (P=0.1, 1-β=0.4) range of motion. This analysis was not without challenges. The EM tracker wires which mount onto the anatomical landmarks, were bulky and took up a large amount of surface area on the dorsal aspect of the hand. This made it difficult to place the reflective markers on the participant’s joint locations for the Dartfish analysis. Also, while measuring the small joints of the hand, ensuring that the goniometer was appropriately placed was constantly monitored to obtain correct measurement values. This analysis also did not have sufficient power (1-β) as each test resulted in a power less than 0.8, therefore potentially causing errors in the statistical evaluations.

Manual therapy texts advocating peripheral manipulation assume that peripheral joints, like spinal articulations, respond to manipulation with an increased ROM. 8,12 However, very few studies have attempted to substantiate this proposition. Nield et al 13 were the first to publish a study on ankle manipulation and dorsiflexion range of motion (DFR). Their controlled study with asymptomatic subjects (N=21) used a single HVLA

Bony impingement is a common complication in reverse shoulder arthroplasty (RSA). Since its occurrence depends on patient anatomy and glenoid implant position, surgeons need to be aware of it when preoperatively planning an implant (Gutiérrez 2008, Li 2013, Smith 2015). Currently, methods exist to evaluate the impingement- free range-of-motion (ROM) during preoperative planning (Krekel 2009, Roche 2013). However, these methods do not result in one overall score, which is required for an objective comparison. Therefore, our study aims to quantify the impingement- free ROM in one objective score so that surgeons can easily optimize the implant position for each patient.