Rehabilitation Protocols: Are They Useful?

The Elbow ◽  
2017 ◽  
pp. 97-106
Author(s):  
Andrea Foglia ◽  
Paolo Bizzarri
Keyword(s):  
Rehabilitation Protocols

scholarly journals A Systematic Review of EMG Applications for the Characterization of Forearm and Hand Muscle Activity during Activities of Daily Living: Results, Challenges, and Open Issues

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3035
Author(s):  
Néstor J. Jarque-Bou ◽  
Joaquín L. Sancho-Bru ◽  
Margarita Vergara
Keyword(s):  
Activities Of Daily Living ◽  
Musculoskeletal System ◽  
Muscle Activity ◽  
Daily Living ◽  
Muscle Activation ◽  
Human Hand ◽  
Hand Motion ◽  
Biomechanical Models ◽  
Rehabilitation Protocols ◽  
Open Issues

The role of the hand is crucial for the performance of activities of daily living, thereby ensuring a full and autonomous life. Its motion is controlled by a complex musculoskeletal system of approximately 38 muscles. Therefore, measuring and interpreting the muscle activation signals that drive hand motion is of great importance in many scientific domains, such as neuroscience, rehabilitation, physiotherapy, robotics, prosthetics, and biomechanics. Electromyography (EMG) can be used to carry out the neuromuscular characterization, but it is cumbersome because of the complexity of the musculoskeletal system of the forearm and hand. This paper reviews the main studies in which EMG has been applied to characterize the muscle activity of the forearm and hand during activities of daily living, with special attention to muscle synergies, which are thought to be used by the nervous system to simplify the control of the numerous muscles by actuating them in task-relevant subgroups. The state of the art of the current results are presented, which may help to guide and foster progress in many scientific domains. Furthermore, the most important challenges and open issues are identified in order to achieve a better understanding of human hand behavior, improve rehabilitation protocols, more intuitive control of prostheses, and more realistic biomechanical models.

scholarly journals Review of Variability in Rehabilitation Protocols after Lateral Ankle Ligament Surgery

2021 ◽  
Vol 37 (1) ◽  
pp. e74-e75
Author(s):  
Christina Hermanns ◽  
Reed Coda ◽  
Sana Cheema ◽  
Matthew Vopat ◽  
Megan Bechtold ◽  
...  
Keyword(s):  
Lateral Ankle ◽  
Ankle Ligament ◽  
Rehabilitation Protocols ◽  
Lateral Ankle Ligament

scholarly journals The Evolving Approach to Treating Syndesmotic Injuries in the Elite Athlete: An International Perspective

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Kenneth Hunt ◽  
Shanthan Challa ◽  
Pieter D’Hooghe ◽  
Pam Kumparatana ◽  
Phinit Phisitkul ◽  
...  
Keyword(s):  
Return To Sport ◽  
High Impact ◽  
Optimal Treatment ◽  
The Body ◽  
Return To Play ◽  
Considerable Variability ◽  
Fixation Device ◽  
Flexible Devices ◽  
Fixation Devices ◽  
Rehabilitation Protocols

Category: Ankle, Sports Introduction/Purpose: There exists little consensus regarding optimal treatment protocols for syndesmotic injuries. Orthopaedic clinicians have implemented a variety of treatment strategies, ranging from immobilization to screw fixation to new flexible fixation devices. While the body of literature is growing with regard to both the biomechanics and clinical outcomes for various constructs and rehabilitation protocols, there is little consensus on the optimal treatment and return to sport strategy for these injuries. We endeavored to assess current approaches to syndesmotic injures by orthopedic foot and ankle specialists around the world in 6 athlete scenarios with increasing degree of injury. Commensurate with the lack of available data to guide treatments, we hypothesize that there will be variability in the treatment and management strategies for syndesmotic injuries. Methods: A REDcap survey was created with 27 questions, including respondent demographics, indications for treatment of syndesmotic injuries, preferred treatment, preferred technique for repairing the syndesmosis and post-operative management. Respondents were asked to choose their preferred fixation device and post-operative return to play protocols in six different athlete scenarios (moderate impact, high impact and very high impact and each with/without complete deltoid injury). The survey was disseminated among the memberships of 18 North American and International medical societies. Society members were surveyed via three emails disseminated 2 weeks apart. Frequencies and percentages were calculated for all categorical responses. Results: A total of 596 providers responded to the survey, including 337 American surgeons and 259 members of various international societies. There was a 70% survey completion rate with a wide geographic distribution among respondents. Flexible devices were the preferred fixation construct (48.1%), followed by screws (27.5%), hybrid fixation (18.5%) and other (5.9%). There was a higher preference for flexible devices among sports medicine trained providers. 62% of respondents noted that their rehabilitation protocols would not change for each athlete scenario. Considerable variability was present in anticipated full return to sport, ranging from immediately following injury to 6 months post-op (Fig 1). One-third of respondents indicated that they repair the deltoid greater than 50% of the time when injured. Conclusion: We found a wide variety of indications and treatment constructs employed by orthopaedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Although, flexible fixation devices are the preferred among all respondents but there was a considerable variability in device choices. Fellowship training also appears to affect the preferred fixation device choice. There also exists substantial variability in expected return to play for every athlete scenario (Fig 1). The diversity in approaches and post-operative recommendations underscores the need for evidence-based guidelines to inform management of syndesmotic injuries.

Microfracture for the Treatment of Symptomatic Cartilage Lesions of the Knee: A Survey of International Cartilage Regeneration & Joint Preservation Society

Cartilage ◽  
2020 ◽  
pp. 194760352095450
Author(s):  
Jesus Medina ◽  
Ignacio Garcia-Mansilla ◽  
Peter D. Fabricant ◽  
Thomas J. Kremen ◽  
Seth L. Sherman ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Regional Differences ◽  
Current Practice ◽  
Cartilage Regeneration ◽  
Postoperative Management ◽  
Cartilage Lesions ◽  
Significant Difference ◽  
Rehabilitation Protocols ◽  
Joint Repair ◽  
Vertical Walls

Objective The purpose of this study was to describe the current practice trends for managing symptomatic cartilage lesions of the knee with microfracture among ICRS (International Cartilage Regeneration & Joint Repair Society) members. Design A 42-item electronic questionnaire was sent to all ICRS members, which explored indications, surgical technique, postoperative management, and outcomes of the microfracture procedure for the treatment of symptomatic, full thickness chondral and osteochondral defects of the knee. Responses were compared between surgeons from different regions and years of practice. Results A total of 385 surgeons answered the questionnaire. There was a significant difference noted in the use of microfracture among surgeons by region ( P < 0.001). There was no association between the number of years in practice and the self-reported proportion of microfracture cases performed ( P = 0.37). Fifty-eight subjects (15%) indicated that they do not perform microfracture at all. Regarding indication for surgery, 56% of surgeons would limit their indication of microfracture to lesions measuring 2 cm2 or less. Half of the surgeons reported no upper age or body mass index limit. Regarding surgical technique, 90% of surgeons would recommend a formal debridement of the calcified layer and 91% believe it is important to create stable vertical walls. Overall, 47% of surgeons use biologic augmentation, with no significant difference between regions ( P = 0.35) or years of practice ( P = 0.67). Rehabilitation protocols varied widely among surgeons. Conclusions Indications, operative technique, and rehabilitation protocols utilized for patients undergoing microfracture procedures vary widely among ICRS members. Regional differences and resources likely contribute to these practice pattern variations.

scholarly journals A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Kerem Bilsel ◽  
Mehmet Erdil ◽  
Mehmet Elmadag ◽  
Hasan H. Ceylan ◽  
Derya Celik ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Tuberculous Meningitis ◽  
Shoulder Instability ◽  
Rare Complication ◽  
Central Nervous System Infection ◽  
Arthroscopic Stabilization ◽  
Anterior Instability ◽  
Glenohumeral Instability ◽  
Rehabilitation Protocols ◽  
Anterior Glenohumeral Instability

Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocols. Tuberculous meningitis may be a reason for neuromuscular shoulder instability. We describe a 12-year-old child with a recurrent anterior instability of the shoulder, which developed after tuberculous meningitis at 18 months of age. We applied arthroscopic treatment and stabilized the joint.

Systematic Review of Flexor Tendon Rehabilitation Protocols in Zone II of the Hand

2011 ◽  
Vol 127 (4) ◽  
pp. 1583-1592 ◽  
Author(s):  
Amy Chesney ◽  
Amitabh Chauhan ◽  
Abdullah Kattan ◽  
Forough Farrokhyar ◽  
Achilleas Thoma
Keyword(s):  
Systematic Review ◽  
Flexor Tendon ◽  
Rehabilitation Protocols ◽  
Zone Ii

Comparison of Two Rehabilitation Protocols on Patient- and Disease-Oriented Outcomes in Individuals With Chronic Ankle Instability

2017 ◽  
Vol 22 (3) ◽  
pp. 57-65 ◽  
Author(s):  
Kyle Kosik ◽  
Masafumi Treada ◽  
Ryan McCann ◽  
Samantha Boland ◽  
Phillip A. Gribble
Keyword(s):  
Ankle Instability ◽  
Dynamic Balance ◽  
Controlled Trial ◽  
Intervention Programs ◽  
Foot And Ankle ◽  
Balance Test ◽  
Randomized Controlled ◽  
Rehabilitation Protocols ◽  
Main Effect ◽  
Ability Measure

Proximal neuromuscular alterations are hypothesized to contribute to the patient- and disease-oriented deficits observed in CAI individuals. The objective was to compare the efficacy of two 4-week intervention programs with or without proximal joint exercises. Twenty-three individuals with CAI completed this single-blinded randomized controlled trial. Outcome measures included the Star Excursion Balance Test (SEBT) and the Foot and Ankle Ability Measure (FAAM). A time main effect was observed for the FAAM-ADL (p = .013), FAAM-Sport (p = .012), and posteromedial (p = .04) and posterolateral (p = .003) SEBT reach directions. No group main effect or time by group interaction was found. Four weeks of supervised rehabilitation improved self-reported function and dynamic balance in people with CAI.

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