MANFAAT PEMBERIAN MANUAL TERAPI DAN CODMAN PENDULAR EXERCISE TERHADAP AKTIVITAS FUNGSIONAL PASIEN FROZEN SHOULDER

Background: Frozen shoulder is a joint disorder that causes limited motion of the shoulder joint in all directions of movement, causing both physical and functional problems. This activity aims to see the benefits of manual therapy and pendular codman exercises in increasing the activity of frozen patients at Grandmed Lubuk Pakam Hospital in 2019. Manual therapy methods and codman pendular exercises were given to 24 patients at the Physiotherapy Clinic of Grandmed Lubuk Pakam Hospital. The measuring instrument used to measure the functional activity ability of the shoulder is the index of shoulder pain and disability with the 0% -60% category being improving and 61% -100% being worse. Based on the results obtained during manual therapy and codman pendular exercise, it shows that the ability of the patient's shoulder functional activity has increased. where manual therapy and pendular codman exercise from 16 samples, the ability of shoulder functional activity with a SPADI value of 100% decreased and after manual therapy and pendular codman exercises for 3 times decreased to 12.5% ​​decreased and 87.5% improved. Based on these data it can be neglected that there is an effect of offering manual therapy exercises and pendular codman in increasing the patient's shoulder functional activity by 87.5%

The Effect of Straight Leg Raise Exercise with Static Bicycles on Increasing Quadriceps Muscle Strength in Knee Osteoarthritis Patients

Knee osteoarthritis is a degenerative disease characterized by pain and limited motion of the joints resulting in muscle weakness. Late consequences can lead to limited motion and shortening of intra and extra joint components. This study aimed to analyze the effect of straight leg raise and static bicycles on the increase in quadriceps muscle strength in patients with knee osteoarthritis. This study was an experimental study with a two-group pretest-posttest design. The research was conducted at the Salewangan Maros Hospital. The population was knee joint osteoarthritis patients aged 40-60 years and experienced quadriceps muscle weakness. The sample met the inclusion criteria obtained by simple random sampling technique so that sample size was 28 subjects, then randomized into two treatment groups, each of 14 subjects. The research data was the strength of the quadriceps muscles using manual muscle testing which was done twice, namely before and after the straight leg raise exercise with a static bicycle. Because the data distribution were not normal, the nonparametric analysis was used. The results of the Wilcoxon test analysis showed that there was a significant effect of giving straight leg raise (p = 0.002) and static bicycles (p = 0.005) training on increasing quadriceps muscle strength. The results of the Mann-Whitney test showed no significant differences between groups on the increase in quadriceps muscle strength (p = 0.481). The results showed that straight leg raises and static bicycles increased muscle strength and there was no difference between the two exercises. Keywords: knee osteoarthritis; exercise; muscle strength, static bicycle; straight leg raise

Full Dimensional Intuitive Motion Mapping Strategy for Minimally Invasive Surgical Robot with Redundant Passive Joints

Adding redundant passive joints to a robotic arm is an effective way to make the robot overcome the inherent incision constraint of minimally invasive surgery (MIS). However, due to the limited motion accuracy, it is difficult to realize full-dimensional intuitive motion based on traditional multi-axis coordinated control technology in this kind of MIS robots. To solve this problem, a separated position and orientation mapping strategy for MIS robot with redundant passive joints is proposed in the paper. The position and orientation mapping of the strategy are realized by coordinate motion control and joint direct control technique, respectively. To realize the intuitive motion under this condition, an inverse motion mapping method is further proposed. Compared with the existing mapping strategy, the proposed strategy is much more compact as the orientation mapping is greatly simplified. A large number of in-vivo trials based on the newly developed prototype have been conducted and results fully verify the effectiveness of the proposed strategy.

Comparison of Outcomes of Cheilectomy with and without Synthetic Hydrogel Interposition (Cartiva®)

Category: Midfoot/Forefoot; Other Introduction/Purpose: Cheilectomy and arthrodesis are the primary surgical treatments of hallux rigidus. While cheilectomy preserves limited motion, that motion can be the source of persistent pain that later requires arthrodesis. Cheilectomy with interposition arthroplasty using a synthetic hydrogel implant (Cartiva) has been proposed as an alternative to arthrodesis. Previous studies compared Cartiva to arthrodesis, but Cartiva is really a modification of cheilectomy, meant to improve its results by distracting the bony surfaces of the first MTP joint. This study compared outcomes of cheilectomy with Cartiva to cheilectomy alone. Methods: A retrospective cohort study assessed the results at 1-year minimum follow-up, identifying patients by CPT code for cheilectomy with (28291) and without (28289) Cartiva interposition. There were forty-five patients: 26 in the Cartiva group and 19 in the cheilectomy group. Tabulated data included: age, gender; preoperative, 6-month, and final postoperative total first MTP ranges of motion (ROM); preoperative and final postoperative VAS and SF-36 scores; and reoperation information. Hallux rigidus grade was assessed by Coughlin and Shurnas criteria. First MTP joint space was measured at the medial, midline, and lateral portions of the joint on both AP and lateral radiographs before, immediately following, and at maximum postoperative follow-up (16 month mean). For analysis, medial, midline, and lateral joint measurements were averaged to generate a composite measure of radiographic joint space. Follow-up means were 23 months for all patients, 18 for Cartiva and 28 for cheilectomy. Results: Mean age was 54. Mean preoperative grade was 2.6 for Cartiva and 2.1 for cheilectomy (p=0.037). Mean preoperative ROM was 44°. At 1 year follow-up, ROM was 39° for Cartiva and 47° for cheilectomy (p=0.95). Mean VAS improved from 5.8 to 2.0 and 3.0 for Cartiva and cheilectomy, respectively, at final follow-up (p=0.002, p=0.004). Following Cartiva, two week postoperative joint space means increased: AP midline 1.4 to 2.6 mm, AP composite 1.4 to 2.2 mm, and lateral midline 1.3 to 2.7 mm (p<0.001). At final follow-up, joint space measures returned to levels similar to cheilectomy: AP midline 1.3 vs. 1.2 mm, AP composite 1.1 vs. 1.2 mm, and lateral midline 1.6 vs. 1.2 mm (p>0.3). Five patients in each group (22%) underwent revision. Conclusion:: Cartiva offers similar intermediate-term ROM preservation and pain relief as cheilectomy in a cohort with higher grade hallux rigidus. Joint distraction gained by synthetic hydrogel interposition subsides with time to levels similar to cheilectomy. Revision surgery for persistent pain is common in both groups.

Mg-Based Micromotors with Motion Responsive to Dual Stimuli

Mg-based micromotors have emerged as an extremely attractive artificial micro/nanodevice, but suffered from uncontrollable propulsion and limited motion lifetime, restricting the fulfillment of complex tasks. Here, we have demonstrated Mg-based micromotors composed of Mg microspheres asymmetrically coated with Pt and temperature-sensitive poly(N-isopropylacrylamide) (PNIPAM) hydrogel layers in sequence. They can implement different motion behaviors stemming from the driving mechanism transformation when encountering catalyzed substrates such as H2O2 and respond to both H2O2 concentration and temperature in aqueous environment. The as-constructed Mg-based micromotors are self-propelled by Pt-catalyzed H2O2 decomposition following the self-consuming Mg-H2O reaction. In this case, they could further generate bilateral bubbles and thus demonstrate unique self-limitation motion like hovering when the phase transformation of PNIPAM is triggered by decreasing temperature or when the H2O2 concentration after permeating across the PNIPAM hydrogel layer is high enough to facilitate bubble nucleation. Our work for the first time provides a stimuli-induced “hovering” strategy for self-propelled micromotors, which endows Mg-based micromotors with an intelligent response to the surroundings besides the significant extension of their motion lifetime.

Effect of Acoustic Shock on Submarine

The carried-out analysis of the dynamics of a submarine body’s translational motion affected by an acoustic shock in the ideal medium provides for the possibility to evaluate the physical properties of the medium and elastic properties of the external body of the submarine to the value of limited motion of a submersible vehicle. The results of analysis provide for the possibility to conduct a comparative analysis of the submersible vehicle’s translational motion affected by an acoustic shock, taking into account the peculiarities of the motion medium, or rather taking into account the viscosity of the real medium. In this work, evaluative measurements of the features of moving the layout of the submarine were carried out. The limiting values of the displacement of the layout of the submarine are established for the case of the presence of an external artificial diffuse disturbance. A fluid with air bubbles from a compressed air cylinder was used to create an artificial diffuse perturbation. Such conditions are possible with intensive local bombardment or the presence of other high-speed underwater vehicles involved in local underwater operations.

Anthropomorphic Prosthetic Hand with Combination of Light Weight and Diversiform Motions

Most prosthetic hands adopt an under-actuated mechanism to achieve dexterous motion performance with a lightweight and anthropomorphic design. Many have been verified in laboratories, and some have already been commercialized. However, a trade-off exists between the dexterity and the light weight of such prosthetic hands. In general, current commercially available prosthetic hands usually consider one aspect at the expense of the other, such as obtaining diversiform hand motions but an increased weight, or achieving lightweight design but with limited motion functions. This study attempts to attain a balance between the two factors, by realizing diversiform hand motions while reducing the weight as far as possible. An anthropomorphic prosthetic hand is proposed with only three servomotors embedded in a human-sized palm, with multiple functions, such as a stable/adaptive grasp and passive hyperextension. The proposed hand can achieve 13 grasp types with over 80% of the grasp motions under the Cutkosky taxonomy, while it weighs only 132.5 g, at less than 36% of the prosthesis weight limitation based on the study of Kay et al.

Ankle Range of Motion after Total Ankle Replacement with and without Heel Cord Lengthening

Category: Ankle, Ankle Arthritis Introduction/Purpose: Though total ankle replacement (TAR) has become a well-accepted alternative to fusion for treatment of end-stage ankle osteoarthritis (OA), controversy still exists regarding the appropriate indications. In 80% of the cases, trauma accounts for the primary cause of end-stage ankle OA. In these cases, the soft tissue conditions are often poor and the remaining ankle range of motion (ROM) limited. Additionally, performing a heel cord lengthening (HCL) should theoretically increase ankle ROM. However, it remains unclear to which extent a preoperative stiff ankle can become mobile after a TAR, with or without a HCL. The purpose of this study was to assess the gained ROM after TAR in end-stage ankle OA, and whether it is beneficial for patients who additionally underwent a HCL. Methods: Out of 605 primary TAR performed at our institution between 2006 and 2015, 288 ankles (280 patients; age 64.1 [39 – 88]; male, 151; female, 129) were identified with a neutral hindfoot alignment, no degenerative changes or previous fusions of adjacent joints, and no previous ligament reconstruction and tendon transfers at time of TAR. Medial and lateral gutter debridement as well as a complete posterior capsule resection was performed before the prosthesis was inserted. The ankle was then gradually mobilized into dorsiflexion. If a minimum of 10° dorsiflexion could not be obtained, HCL was performed (percutaneous triple hemisection). Postoperatively, the ankle was protected by a walker and weight-bearing was permitted as tolerated. ROM was determined during weight-bearing with the use of a goniometer preoperatively and 2-years postoperatively. Pearson correlation analysis and paired t-test were used for statistical analysis. Results: Out of 288 ankles, 41 (14.2%) underwent additional HCL. Preoperative ROM correlated with the ROM 2-years after TAR, independent whether a HCL was performed (p < 0.01) or not (p < 0.01). ROM for the ankles where no HCL was performed was 35° preoperatively and 34° 2-years postoperatively. For the ankles in which a HCL was performed, it was 28° preoperatively and 28° 2-years postoperatively. Pearson correlation analysis showed that patients with a low ROM preoperatively tended to get more motion after TAR, whereas patients with an extensive preoperative ROM even lost some motion after receiving a TAR system (Figure 1). Conclusion: The data suggests that a HCL procedure has little potential to ameliorate a preoperative low ROM. A TAR system however, may help increase the ROM in patients with little preoperative ROM while in patients with extensive preoperative ROM it may even cause a loss of ROM. The data further suggests that the heel cord contracture is not the only cause of limited motion in end-stage ankle OA, and that whether TAR nor TAR in combination with HCL should be performed with the goal of gaining ROM for the treatment of end-stage OA.