The “Fight Bite” Saline Joint Loading Test: Effectiveness in Detecting Simulated Traumatic Metacarpophalangeal Arthrotomies

Background: The saline load test is routinely used to recognize other joints’ traumatic arthrotomies; however, there are currently no studies evaluating the novelty of this test for metacarpophalangeal joints (MCPJs). This study aimed to investigate the effectiveness and sensitivity of saline load testing in identifying the traumatic arthrotomies of the MCPJs using human cadavers. Methods: This was a cadaveric study of 16 hands (79 MCPJs). Traumatic arthrotomies were created using 11-blade stab-incisions, followed by blunt probing into the joint on the radial or ulnar side of the flexed MCPJs. A 3-mL syringe was used to inject intra-articular methylene-blue-dyed saline from the contralateral side. The volume at saline extravasation was recorded. Test sensitivity and factors influencing extravasation volume were assessed. Results: The mean (range) volume injected to identify arthrotomy of all MCPJs was 0.18 mL (0.1-0.4 mL). The mean volume to identify MCPJ arthrotomy of the thumb, index, long, ring, and small fingers was 0.16 mL (0.1-0.3 mL), 0.19 mL (0.1-0.3 mL), 0.21 mL (0.1-0.4 mL), 0.17 mL (0.1-0.3 mL), and 0.16 mL (0.1-0.3 mL), respectively. Cadaver age, laterality, and joint range of motion were not significantly associated with the injected volume at extravasation( P > .05, each). Injection volumes of 0.3 and 0.32 mL were required to detect arthrotomies at 95% and 99% sensitivities across all MCPJs. None of the MCPJs required > 0.4 mL to detect arthrotomy. Conclusions: Saline joint loading volumes to detect traumatic arthrotomy were similar for all MCPJs. Injection volumes of 0.32 mL is suggested for 99% sensitivity. Our findings provide the first report, to our knowledge, on intra-articular injection volumes expected to detect an arthrotomy of MCPJ. This is critical for further validation using in vivo clinical studies.

Application of Multimode Health Education Combined with Humanistic Care in Pain Management of Patients with Femoral Fracture and Its Influence on VAS Score

Objective. To explore the application of multimode health education combined with humanistic care in pain management of patients with femoral fracture and its influence on VAS score. Methods. A total of 120 patients with femoral fracture admitted in our hospital (May 2017–May 2021) were selected as the research objects. The patients who received routine health education were included into the routine group, and the patients who received multimode health education combined with humanistic care were included into the combined group, with 60 cases in each group. The pain management effect of the two groups was compared after nursing intervention. Results. No significant difference was found in age, BMI, fracture sites, gender, education degree, and residence between the two groups ( P > 0.05). The awareness rate of health knowledge of the combined group was as high as 93.33%, which was obviously higher than that of the routine group ( P < 0.05). Compared with the routine group, excellent rates of sitting durability and joint range of motion in the combined group were obviously higher ( P < 0.05), and poor rates of sitting durability and joint range of motion in the combined group were obviously lower ( P < 0.05). Compared with the routine group, VAS scores of the combined group at 1 d, 2 d, and 3 d after admission and at 1 d, 2 d, and 3 d after surgery were remarkably lower ( P < 0.05). Compared with the routine group, compliance of exercise, medical waist belt using, and working posture of the combined group 1 week, 1 month, and 6 months after surgery was obviously higher ( P < 0.05). Compared with the routine group, the scores of Rasmussen and Johner-Wruhs of the combined group 6 months after surgery were conspicuously higher ( P < 0.05). Conclusion. The application of multimode health education combined with humanistic care in pain management of patients with femoral fracture can effectively relieve pain, improve the awareness rate of health knowledge, promote the recovery of lower limb function, and enhance the prognosis of quality of life for patients.

Penerapan Latihan ROM (RANGE OF MOTION) Terhadap Rentang Gerak Ekstremitas Pada Pasien Stroke

Stroke is a disease caused by an acute neurological deficit in blood vesseldisorders leading to the brain that occur suddenly and can cause physical disability or death.The common complain are mobility impairment or decreased range of movement of the extremities.This study aimed to increase the range of movement of the extremities by doing Range on Motion exercises in families who have a history of stroke.There are two post-stroke patients involved in this study and give the Range of Motion exercise.The method used is to measure the degree of joint range of motion before performing ROM exercises then ROM exercises ranging from flexion, extension, hyperextension, adduction, abduction, and so on then measure the degree of joint range of motion with a goniometer measuring instrument and the results are recorded on the observation sheet.Goniometer was used to measurement the range of movement of the extremities.Range of Motion was performed for 7 days, each movement of 10 seconds duration.The results show that the range of movement increased in both patients. Accordingly, the Range of Motion exercises proved can increase the range of movement of the extremities in stroke patients.Families are expected to doing the Range of Motion exercise independently at home.Keywords:Range of motion; Range of movement; Stroke. AbstrakStroke adalah penyakit yang disebabkan oleh defisit neurologis akut pada gangguan pembuluh darah menuju otak yang terjadi secara tiba-tiba dan dapat menyebabkan kecacatan fisik atau kematian.Keluhan yang sering dikeluhkan adalah gangguan mobilitas atau penurunan jangkauan gerak ekstremitas. Penelitian ini bertujuan untuk meningkatkan jangkauan gerak ekstremitas dengan melakukan latihan Range on Motion pada keluarga yang memiliki riwayat stroke.Ada dua pasien pasca stroke yang terlibat dalam penelitian ini dan memberikan latihan Range of Motion.Metode yang dilakukan mengukur derajat rentang gerak sendi sebelum dilakukan latihan ROM kemudian latihan ROM mulai dari gerakan fleksi, ekstensi, hiperekstensi, addukksi, abduksi, dan lain sebagainya kemudian mengukur kembali derajat rentang gerak sendi dengan alat ukur goniometer dan hasilnya catat dilembar observasi.Goniometer digunakan untuk mengukur jangkauan gerakan ekstremitas.ROM dilakukan selama 7 hari, setiap gerakan durasi 10 detik.Hasil penelitian menunjukkan bahwa rentang gerak meningkat pada kedua pasien. Dengan demikian, latihan Range of Motion terbukti dapat meningkatkan jangkauan gerak ekstremitas pada pasien stroke. Keluarga diharapkan melakukan latihan Range of Motion secara mandiri di rumah.Kata kunci:Range of motion; Rentang gerak; Stroke.

Functional Movement Screen task scores and joint range-of-motion: a construct validity study

Little is known about the construct validity of the Functional Movement Screen (FMS). We aimed to assess associations between FMS task scores and measures of maximum joint range-of-motion (ROM) among university varsity student-athletes from 4 sports (volleyball, basketball, ice hockey, and soccer). Athletes performed FMS tasks and had their maximum ankle, hip and shoulder ROM measured. Multivariable linear regression was used to estimate associations between FMS task scores and ROM measurements. 101 university student-athletes were recruited (52 W/49 M; mean age 20.4±1.9 years). In general, athletes with higher FMS task scores had greater ROM compared to those with lower task scores. For example, athletes who scored 2 on the FMS squat task had 4˚ (95% CI, 1˚ to 7˚) more uni-articular ankle dorsiflexion ROM compared with those who scored 1, while those who scored 3 on the FMS squat task had 10˚ (4˚ to 17˚) more uni-articular ankle dorsiflexion ROM compared with those who scored 1. Large variation in ROM measurements was observed. In sum, substantial overlap in joint ROM between groups of athletes with different FMS task scores weakens the construct validity of the FMS as an indicator of specific joint ROM.

Adjustments in the Range of Angular Motion during Walking after Amputation of the Toes: A Case Report

The forefoot plays an important role in providing body support and propulsion during walking. We investigated the effect of forefoot dysfunction on the gait pattern of a young adult with partial bilateral amputation of the toes. We measured our participant’s gait kinematics during barefoot and shod overground walking and analysed time-distance and joint range of motion (RoM) parameters against a group of healthy adults. Forefoot dysfunction gait is improved by footwear and walking experience; however, this improvement was still remarkably different (exceeded 95% CI) when compared to healthy gait at matching walking speed. Compared to healthy gait, walking barefoot had a slower speed and a 30% reduction in ankle and knee joint RoM, but a larger hip RoM. Shod gait resulted in a remarkable increase in ankle RoM and walking speed compared to barefoot gait. These results are consistent with the important role of the forefoot (tarsals and metatarsophalangeal joints) and suggest that footwear can facilitate gait function following toe amputation.

Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes

Background High plantar pressures are associated with increased foot ulcer risk in people with diabetes. Identification of high plantar pressures in people with diabetes is clinically challenging due to time and cost constraints of plantar pressure testing. Factors affecting foot biomechanics, including reduced joint range of motion and foot deformity, are implicated in the development of high plantar pressures and may provide a method to clinically identify those at risk of pressure related complications. The aim of this study was to investigate the contribution of joint range of motion and foot deformity measures on plantar pressures in a community dwelling group with diabetes. Methods Barefoot (Tekscan HR Mat™) and in-shoe (Novel Pedar-X®) plantar pressure variables, weight bearing ankle dorsiflexion, hallux range of motion, lesser toe deformities and hallux abductus (HAV) scale were assessed in 136 adults with diabetes (52.2% male; mean age 68.4 years). Multivariate multiple linear regression was used to assess the effect of the four biomechanical factors plus neuropathy and body mass index on plantar pressure variables. Non-parametric bootstrapping was employed to determine the difference in plantar pressure variables for participants with two or more foot biomechanical pathologies compared to those with less than two pathologies. Results Almost one third (32%) of the cohort had two or more foot biomechanical pathologies. Participants with two or more foot biomechanical pathologies displayed significant increases in all barefoot plantar pressure regions (except forefoot), compared to those with less than two pathologies. No significant changes were found for the in-shoe plantar pressure variables. The regression model explains between 9.9% (95%CI: 8.4 to 11.4%) and 29.6% (95% CI: 28.2 to 31%), and between 2.5% (1.0 to 4.0%) and 43.8% (95% CI: 42.5–44.9%), of the variance in the barefoot and in-shoe plantar pressure variables respectively. Conclusions Participants presenting with two or more factors affecting foot biomechanics displayed higher peak pressures and pressure time integrals in all foot regions compared to those with less than two factors. The tests used in this study could help clinicians detect elevated plantar pressures in people with diabetes and present an opportunity for early preventative interventions.

Measurement Method of Human Lower Limb Joint Range of Motion Through Human-Machine Interaction Based on Machine Vision

To provide stroke patients with good rehabilitation training, the rehabilitation robot should ensure that each joint of the limb of the patient does not exceed its joint range of motion. Based on the machine vision combined with an RGB-Depth (RGB-D) camera, a convenient and quick human-machine interaction method to measure the lower limb joint range of motion of the stroke patient is proposed. By analyzing the principle of the RGB-D camera, the transformation relationship between the camera coordinate system and the pixel coordinate system in the image is established. Through the markers on the human body and chair on the rehabilitation robot, an RGB-D camera is used to obtain their image data with relative position. The threshold segmentation method is used to process the image. Through the analysis of the image data with the least square method and the vector product method, the range of motion of the hip joint, knee joint in the sagittal plane, and hip joint in the coronal plane could be obtained. Finally, to verify the effectiveness of the proposed method for measuring the lower limb joint range of motion of human, the mechanical leg joint range of motion from a lower limb rehabilitation robot, which will be measured by the angular transducers and the RGB-D camera, was used as the control group and experiment group for comparison. The angle difference in the sagittal plane measured by the proposed detection method and angle sensor is relatively conservative, and the maximum measurement error is not more than 2.2 degrees. The angle difference in the coronal plane between the angle at the peak obtained by the designed detection system and the angle sensor is not more than 2.65 degrees. This paper provides an important and valuable reference for the future rehabilitation robot to set each joint range of motion limited in the safe workspace of the patient.