Effect of the position of the interphalangeal joint on movements of the trapeziometacarpal joint during thumb opposition

The Kapandji test is a simple method to score thumb opposition; however, the position of the interphalangeal joint of the thumb during this test has not been described. We aimed to quantitatively examine the effect of the thumb interphalangeal joint position on movements of the trapeziometacarpal joint during thumb opposition using the Kapandji test. The Kapandji test was carried out in 20 healthy participants during thumb interphalangeal joint extension and flexion. Movements of the joints and the activity of thenar muscles were recorded using motion capture and electromyography, respectively. We found that interphalangeal joint extension increased the trapeziometacarpal joint movement and thenar muscle activity compared with interphalangeal joint flexion, which contributed to thumb opposition at Kapandji Positions 0–6. These findings suggest the position of the thumb interphalangeal joint affects the trapeziometacarpal joint during thumb opposition, and assessment of thumb opposition using the Kapandji test is best done with the thumb interphalangeal joint in extension.

Association between Kinesiophobia and Knee Pain Intensity, Joint Position Sense, and Functional Performance in Individuals with Bilateral Knee Osteoarthritis

In current clinical practice, fear of movement has been considered a significant factor affecting patient disability and needs to be evaluated and addressed to accomplish successful rehabilitation strategies. Therefore, the study aims (1) to establish the association between kinesiophobia and knee pain intensity, joint position sense (JPS), and functional performance, and (2) to determine whether kinesiophobia predicts pain intensity, JPS, and functional performance among individuals with bilateral knee osteoarthritis (KOA). This cross-sectional study included 50 participants (mean age: 67.10 ± 4.36 years) with KOA. Outcome measures: The level of kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity using a visual analog scale (VAS), knee JPS using a digital inclinometer, and functional performance using five times sit-to-stand test. Knee JPS was assessed in target angles of 15°, 30°, and 60°. Pearson’s correlation coefficients and simple linear regressions were used to analyze the data. Significant moderate positive correlations were observed between kinesiophobia and pain intensity (r = 0.55, p < 0.001), JPS (r ranged between 0.38 to 0.5, p < 0.05), and functional performance (r = 0.49, p < 0.001). Simple linear regression analysis showed kinesiophobia significantly predicted pain intensity (B = 1.05, p < 0.001), knee JPS (B ranged between 0.96 (0° of knee flexion, right side) to 1.30 (15° of knee flexion, right side)), and functional performance (B = 0.57, p < 0.001). We can conclude that kinesiophobia is significantly correlated and predicted pain intensity, JPS, and functional performance in individuals with KOA. Kinesiophobia is a significant aspect of the recovery process and may be taken into account when planning and implementing rehabilitation programs for KOA individuals.

Effect of Topical Cooling with Ice and Cold Spray on Knee Joint Position Sense of Athletes with Patellofemoral Pain Syndrome

Background: Patellofemoral pain syndrome (PFPS) is one of the most common knee injuries in athletes and non-athletes. Due to the pain and muscle inhibition, it is possible that the disorder has negative effects on joint position sense. Cryotherapy is one of the most common methods applied in sports injuries. Objectives: The aim of this study was to evaluate the effect of topical cooling with ice and cold spray on knee joint position sense of athletes with PFPS. Methods: In this quasi-experimental study, 30 athletes with PFSP were divided into two groups of cold spray and crushed ice application. The effect of cooling on joint position sense was measured by the target reconstruction method (30° of knee flexion) while standing. In order to analyze the data, SPSS 23 and statistical tests of Shapiro-Wilk, paired t-test, and independent t-tests were used. The absolute error of 30° knee flexion angle reconstruction immediately after cryotherapy was significantly higher than before it in various cooling methods. Nevertheless, crushed ice application had a greater impact on the accuracy of joint position sense than spraying. Results: The results of this study indicate the negative effects of cryotherapy on the accuracy of the knee joint position sense (P < 0.05). However, cryotherapy with crushed ice application has a greater effect on reducing the accuracy of joint position sense (P < 0.001) than cold spray (P < 0.001). Conclusions: Decreased accuracy of position sense is likely to cause mechanical instability and increase the rate of injury. Therefore, it is recommended to use crushed ice application rather than topical cooling to reduce the knee joint position sense.

In vivo soft tissue compressive properties of the human hand

Background/Purpose Falls onto outstretched hands are the second most common sports injury and one of the leading causes of upper extremity injury. Injury risk and severity depends on forces being transmitted through the palmar surface to the upper extremity. Although the magnitude and distribution of forces depend on the soft tissue response of the palm, the in vivo properties of palmar tissue have not been characterized. The purpose of this study was to characterize the large deformation palmar soft tissue properties. Methods In vivo dynamic indentations were conducted on 15 young adults (21–29 years) to quantify the soft tissue characteristics of over the trapezium. The effects of loading rate, joint position, tissue thickness and sex on soft tissue responses were assessed. Results Energy absorbed by the soft tissue and peak force were affected by loading rate and joint angle. Energy absorbed was 1.7–2.8 times higher and the peak force was 2–2.75 times higher at high rate loading than quasistatic rates. Males had greater energy absorbed than females but not at all wrist positions. Damping characteristics were the highest in the group with the thickest soft tissue while damping characteristics were the lowest in group with the thinnest soft tissues. Conclusion Palmar tissue response changes with joint position, loading rate, sex, and tissue thickness. Accurately capturing these tissue responses is important for developing effective simulations of fall and injury biomechanics and assessing the effectiveness of injury prevention strategies.

Use of a suspended and straightened knee joint position when fixing steel plates can prevent the increase in postoperative posterior tibial slope after open‑wedge high tibial osteotomy

Background Posterior tibial slope (PTS) increases after medial open-wedge high tibial osteotomy (OWHTO) is challenging for patients. This study aims to determine whether use of a suspended and straightened knee joint position during the fixing of steel plates can prevent an increase in the PTS after OWHTO. Methods This study retrospectively analyzed 112 subjects (122 knees) [34 males, 78 females; mean age 59.1 ± 6.6 (range 48–76) years; mean body mass index 28.06 ± 3.61 kg/m2] who underwent OWHTO. A total of 78 knees that were suspended and extended by placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the suspended and straightened knee joint position (SSP) group, and 44 knees that were kept naturally straightened without placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the naturally straightened knee joint position (NSP) group. Patients were clinically assessed according to the visual analog pain scale (VAS), the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, the Knee Society Scores (KSS) knee and function scores, the Hospital for Special Surgery (HSS) knee scores and the Lysholm knee scores. Radiological assessment was performed according to the changes in the PTS between preoperation, 1-day postoperation, and the final follow-up periods. Ultimately, the difference in postoperative PTS changes between the two groups was statistically analyzed. The median follow-up period was 2.2 years (range 1.6–3.7 years). Results In the final follow-up period, significant improvements were observed in the clinical VAS scores, WOMAC scores, KSS knee and function scores, HSS scores and the Lysholm knee scores in both groups (P < 0.001), and no difference was found between the two groups. Radiological assessment showed that there was no statistical difference in the preoperative PTS between the two groups. The 1-day postoperative PTS and the most recent follow-up PTS were significantly greater than the preoperative PTS in the NSP group (t = − 3.213, − 6.406, all P < 0.001), but no significant increase was seen in the SSP group (P > 0.05). The increase in PTS in the NSP group was significantly greater than that in the SSP group at the 1-day postoperative (t = 2.243, P = 0.030) and final follow-up periods (t = 6.501, P < 0.001). Conclusions For OWHTO, the use of a suspended and straightened knee joint position rather than a naturally straightened knee joint position during the fixing of steel plates could effectively prevent the increase in postoperative PTS. Level of Evidence: Retrospective Study Level III.

The Effects of Estrogen and Progesterone Hormones on Active Hip Joint Position Sense in Healthy Women in Different Phases of a Menstrual Cycle

Introduction: The proprioceptive system is a sensory system based on an individual’s knowledge of his or her body. This knowledge is transmitted to the brain through inputs received from joints, muscles, tendons, and ligaments. As a result, these inputs inadvertently inform the brain of the state of the body’s muscles. Numerous factors can affect this system. This study aimed to investigate the effect of estrogen and progesterone hormones on understanding and recognizing the proprioceptive sense of hip joint in healthy women during the menstrual cycle. Materials and Methods: In this quasi-experimental study, 15 healthy women participated voluntarily. They had regular menstrual cycles without any history of disease and drug use. The concentration of estrogen and progesterone during a cycle in the follicular (4-6 days), ovulation, and luteal phases were evaluated to detect their effects on the sense of perception and cognition of the proprioceptive joint in the two movements of abduction and flexion by the target angle reconstruction method (30°). Results: The errors of active joint position sense were reduced in abduction and flexion during ovular and luteal phases compared to the follicular phase. However, in the flexion direction of hip movement, there was a significant difference in absolute error during hormonal changes in the menstrual cycle (P=0.000). Conclusion: The results showed that due to more involvement of motor control of hip muscles joint by motor neuron activity (increase release of estrogen hormone), all errors reduced in ovular and luteal phases compared to the follicular phase. The flexion movement is more disturbed, and due to more flexibility in this direction, absolute errors are significantly reduced. This reduction of errors in ovular and luteal phases compared to the regular stage of hormone release (follicular phase) may cause some rigidity in the hip joint and an increase of trauma in external mechanical forces. This study’s findings showed that the lowest proprioception sensation is in the follicular phase. Decreasing the concentration of sex hormones in this phase is likely to reduce the sense of recognition of the joint, thus increasing the likelihood of injury in this phase. Findings from this study showed that the lowest proprioceptic sensation is in the follicular phase. The results of this study showed that the least sense is Prvpryvsptyk in Fazfvlykvlar.