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Current Reviews in Musculoskeletal... Apr 2022Consensus on the effects of soft tissue surgical intervention in the management of brachial plexus birth injury (BPBI) sequalae is lacking. The purpose of this review is... (Review)
Review
PURPOSE OF THE REVIEW
Consensus on the effects of soft tissue surgical intervention in the management of brachial plexus birth injury (BPBI) sequalae is lacking. The purpose of this review is to examine the available literature on the functional and structural outcomes following soft tissue surgical management of BPBI sequalae.
RECENT FINDINGS
EMBASE, PubMed, and MEDLINE were searched for related literature from the point of database inception until April 2021. Relevant papers were screened by two reviewers independently and in duplicate. A meta-analysis was performed using a random effects model. A total of 25 studies (852 patients) were included in the review, with the number included in each meta-analysis varying based on outcome of interest. There were significant improvements from pre- to post-operative time points for the following measures: Mallet aggregate scores (5.0 points, p<0.0001), active external rotation in adduction (48.9°, p=0.003), passive external rotation in adduction (64.6°, p< 0.00001), active abduction (46.2°, p<0.00001), glenoid version (14.4°, p< 0.00001), and percentage of the humeral head anterior to the scapular line (17.53°, p< 0.00001). Furthermore, data revealed an overall complication rate of 9.3% (79/852 patients) and a major complication rate of 0.47% (4/852 patients). Patients with BPBI sequela experience statistically significant improvements in functional, structural, and range of motion outcomes of the GH joint following soft tissue surgical management. Understanding the ideal indications for each procedure and age of surgical management with future prospective studies will help to optimize surgical management of these patients.
PubMed: 35156170
DOI: 10.1007/s12178-022-09747-6 -
World Journal of Clinical Cases Jul 2023Fibroblastic rheumatism (FR) is a rare fibroproliferative disease with an unknown etiology. The absence of typical symptoms makes early diagnosis challenging. This study...
BACKGROUND
Fibroblastic rheumatism (FR) is a rare fibroproliferative disease with an unknown etiology. The absence of typical symptoms makes early diagnosis challenging. This study aims to systematically review FR cases and present a case from our center to provide a comprehensive description of the clinical manifestations, diagnosis, and treatment, thereby assisting clinicians in early identification and timely management of FR, ultimately leading to improved prognosis.
CASE SUMMARY
FR is a rare fibroproliferative disease with an unknown etiology. It is characterized by rapidly progressive and destructive symmetrical inflammatory multiple arthritis. Here, we present a rare case of a 50-year-old female with symmetric inflammatory polyarthritis. We highlight the importance of a comprehensive medical history, histopathology, immunohistochemistry, and clinical manifestations of skin nodules, arthralgia, and arthritis for successful disease diagnosis. Despite employing non-steroidal anti-inflammatory drugs, corticosteroids, methotrexate, and tacrolimus, the patient's symptoms did not resolve, and joint destruction continued to progress. Early diagnosis, aggressive treatment with appropriate use of steroids and immunosuppressants, and further research to identify effective treatment strategies are crucial in preventing detrimental joint destruction and limb contractures.
CONCLUSION
A comprehensive review of the available literature emphasizes the importance of early and accurate diagnosis coupled with appropriate treatment for achieving favorable outcomes and preventing joint destruction and limb contractures.
PubMed: 37583864
DOI: 10.12998/wjcc.v11.i21.5136 -
Bone Feb 2024Arthrogryposis multiplex congenita (AMC) is a heterogeneous group of disorders associated with decreased fetal movement, with a prevalence between 1/3000 and 1/5200 live... (Review)
Review
INTRODUCTION
Arthrogryposis multiplex congenita (AMC) is a heterogeneous group of disorders associated with decreased fetal movement, with a prevalence between 1/3000 and 1/5200 live births. Typical features of AMC include multiple joint contractures present at birth, and can affect all joints of the body, from the jaw, and involving the upper limbs, lower limbs and spine. The jaws may be affected in 25 % of individuals with AMC, with limited jaw movement and mouth opening. Other oral and maxillofacial deformities may be present in AMC, including cleft palate, micrognathia, periodontitis and delayed teething. To our knowledge, oral and maxillofacial abnormalities have not been systematically assessed in individuals with AMC. Therefore, this scoping review was conducted to identify, collect, and describe a comprehensive map of the existing knowledge on dental and maxillofacial involvement in individuals with AMC.
METHODOLOGY
A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The PRISMA guidelines for scoping reviews were followed and databases were searched for empirical articles in English and French published until October 2022. We searched MEDLINE, Embase, Web of Science and ERIC databases. Two authors independently reviewed the articles and extracted the data.
RESULTS
Of a total of 997 studies that were identified, 96 met the inclusion criteria and were subsequently included in this scoping review. These 96 studies collectively provided insights into 167 patients who exhibited some form of oral and/or maxillofacial involvement. Notably, 25 % of these patients were within the age range of 0-6 months. It is worth highlighting that only 22 out of the 96 studies (22.9 %), had the primary objective of evaluating dental and/or maxillofacial deformities. Among the patients studied, a prevalent pattern emerged, revealing that severe anomalies such as micrognathia (56 %), high-arched palate (29 %), cleft palate (40 %), limited mouth opening (31 %), and dental anomalies (28 %) were frequently observed. Importantly, many of these patients were found to have more than one of these anomalies. Even though these maxillofacial impairments are known to be associated with dental problems (e.g., cleft palate is associated with oligodontia, hypodontia, and malocclusion), their secondary effects on the dental phenotype were not reported in the studies.
CONCLUSION
Our findings have uncovered a notable deficiency in existing literature concerning dental and maxillofacial manifestations in AMC. This underscores the need for interdisciplinary collaboration and the undertaking of extensive prospective cohort studies focused on AMC. These studies should assess the oral and maxillofacial abnormalities that can impact daily functioning and overall quality of life.
Topics: Infant, Newborn; Humans; Infant; Arthrogryposis; Cleft Palate; Micrognathism; Prospective Studies; Quality of Life
PubMed: 37951521
DOI: 10.1016/j.bone.2023.116955 -
Physiotherapy Research International :... 2002Stretching (that is, interventions that apply tension to soft tissues) induces increases in the extensibility of soft tissues, and is therefore widely administered to... (Review)
Review
BACKGROUND AND PURPOSE
Stretching (that is, interventions that apply tension to soft tissues) induces increases in the extensibility of soft tissues, and is therefore widely administered to increase joint mobility and reverse contractures. However, it is not clear whether the effects of stretching are lasting. A systematic review was conducted to determine if stretching (either self-administered, administered manually by therapists or by some external device such as a splint) produces lasting increases in the mobility of joints not directly affected by surgery, trauma or disease processes.
METHOD
In order to determine the lasting effects of stretching, only studies that measured joint range of motion (ROM) at least one day after the cessation of stretching were included. MEDLINE (from 1966 to June 2000), EMBASE (from 1988 to June 2000), the Cochrane Controlled Trials Register and PEDro databases were searched, and citation tracking was used to identify randomized studies that met the inclusion criteria. Each study was rated by two independent assessors on the PEDro scale, which rated trials according to criteria such as concealed allocation, blinding and intention-to-treat analysis.
RESULTS
Thirteen studies satisfied the inclusion criteria. All examined the effect of stretching (median number of stretch sessions = eight) on joint ROM in healthy subjects without functionally significant contractures. Four studies were of 'moderate' quality and the remaining nine were of 'poor' quality. The 'moderate' quality studies suggest that regular stretching increases joint ROM (mean increase in ROM = 8 degrees; 95% CI 6 degrees to 9 degrees) for more than one day after cessation of stretching and possibly that the effects of stretching are greater in muscle groups with limited extensibility.
CONCLUSIONS
The results of four 'moderate' quality studies show a convincing effect of stretching in people without functionally significant contracture. These findings require verification with high-quality studies. Lasting effects of intensive stretching programmes (for example, stretching applied for more than six weeks or for more than 20 minutes a day) or of stretching on people with functionally significant contracture have not yet been investigated with randomized studies.
Topics: Exercise Therapy; Humans; Muscle, Skeletal; Range of Motion, Articular; Treatment Outcome
PubMed: 11992980
DOI: 10.1002/pri.236 -
Disability and Rehabilitation 2015The purpose of this systematic review was to determine the effect of trunk restraint (TR) training on post-stroke compensatory trunk movements during functional reach,... (Review)
Review
PURPOSE
The purpose of this systematic review was to determine the effect of trunk restraint (TR) training on post-stroke compensatory trunk movements during functional reach, and to identify functional gains of TR within the context of the International Classification of Functioning, Disability and Health (ICF).
METHODS
Six databases were searched prior to 20 February 2013. Randomized control trials (RCTs) comparing the effects of a post-stroke reaching intervention with and without TR in the adult post-stroke population were included in this review. Data related to study inclusion/exclusion criteria, methodology, study participants and between-group outcomes (p < 0.05) were extracted. All outcomes were categorized according to functional domains defined within the ICF.
RESULTS
Five RCTs met the inclusion criteria. TR groups demonstrated significant between-group differences (p < 0.05) for decreased compensatory trunk displacement (4/5 RCTs), increased elbow extension (3/5 RCTs) and increased shoulder flexion (2/5 RCTs). All significant between-group differences fell within the Body Structure/Function domain of the ICF.
CONCLUSIONS
Trunk restraint is a simple, cost-effective technique that may help to reduce compensatory trunk/shoulder/elbow movements in the post-stroke adult population. Synthesis of study outcomes also highlights applications of TR to clinical practice and areas for further research. Implications for Rehabilitation The ability to use the shoulder and elbow to perform functional reach is a primary goal in post-stroke recovery; however, compensatory trunk movements are often used to achieve the reaching goal. Long-term use of compensatory strategies may contribute to secondary impairments, such as learned non-use, joint contractures and pain. Trunk restraint enables functional reach practice, while limiting compensatory strategies in the moderately to severely impaired stroke population.
Topics: Aged; Biomechanical Phenomena; Elbow Joint; Exercise Therapy; Female; Humans; International Classification of Functioning, Disability and Health; Male; Middle Aged; Movement; Movement Disorders; Randomized Controlled Trials as Topic; Recovery of Function; Restraint, Physical; Shoulder; Stroke Rehabilitation; Torso; Treatment Outcome
PubMed: 24963941
DOI: 10.3109/09638288.2014.932450 -
The Cochrane Database of Systematic... Apr 2007"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many... (Review)
Review
BACKGROUND
"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases.
OBJECTIVES
To conduct a systematic review of randomised trials of treatment for footdrop resulting from neuromuscular disease.
SEARCH STRATEGY
We searched the Cochrane Neuromuscular Disease Group Trials Register (July 2005), MEDLINE (January 1966 to July 2005), EMBASE (January 1980 to July 2005), AMED (January 1985 to July 2005) and CINAHL databases (January 1982 to July 2005).
SELECTION CRITERIA
Randomised and quasi-randomised trials of physical, orthotic and surgical treatments for footdrop resulting from lower motor neuron or muscle disease and related contractures were included. People with primary joint disease were excluded. Interventions included a 'wait and see' approach, physiotherapy, orthotics, surgery and pharmacological therapy. The primary outcome measure was ability to walk whilst secondary outcome measures included dorsiflexor torque and strength, measures of 'activity' and 'participation' and adverse effects.
DATA COLLECTION AND ANALYSIS
Methodological quality was evaluated by two authors using the van Tulder criteria. Three studies with altogether 139 participants were included in the review. Heterogeneity of the studies precluded pooling the data.
MAIN RESULTS
Early surgery did not significantly affect walking speed in a trial including 20 children with Duchenne muscular dystrophy. After one year, the mean difference (MD) of the 28 feet walking time was 0.00 seconds (95% confidence interval (CI) -0.83 to 0.83) and the MD of the 150 feet walking time was -2.88 seconds, (95% CI -8.18 to 2.42). In a trial with altogether 26 participants with Charcot-Marie-Tooth disease (hereditary motor and sensory neuropathy), long-term strength training significantly increased walking speed on a 6 metre timed walk (MD -0.70 seconds, 95% CI -1.17 to -0.23) but not on a 50 metre timed walk (MD -1.9 seconds, 95% CI -4.09 to 0.29). In a trial of a 24-week strength training programme in 28 participants with myotonic dystrophy, there was no significant change in walking speed on either a 6 or 50 metre walk.
AUTHORS' CONCLUSIONS
Using the primary outcome of ability to walk, only one study demonstrated a positive effect and that was an exercise programme for people with Charcot-Marie-Tooth disease. Surgery was not significantly effective in children with Duchenne Muscular Dystrophy. More evidence generated by methodologically sound trials is required.
Topics: Charcot-Marie-Tooth Disease; Child; Exercise Therapy; Gait Disorders, Neurologic; Humans; Male; Muscular Dystrophy, Duchenne; Treatment Outcome; Walking
PubMed: 17443532
DOI: 10.1002/14651858.CD003908.pub2 -
Journal of Healthcare Engineering 2017As one of the most common musculoskeletal complications following trauma, elbow contracture is a frequent source of disabled daily activities. Conventional interventions...
BACKGROUND
As one of the most common musculoskeletal complications following trauma, elbow contracture is a frequent source of disabled daily activities. Conventional interventions are inadequate to provide favorable outcome. The static progressive orthoses are getting popular in the treatment of this problem.
OBJECTIVE
The purpose of this review was to assess the effectiveness of static progressive orthoses for elbow contracture.
METHODS
Literatures when written in English published during 1 January 1997 and 31 January 2017 were searched in the following databases: Web of Science, Cochrane Library, PubMed, and EBSCOhost. Articles are quality-assessed by two assessors, each article was summarized in evidence tables, and a narrative synthesis was also performed.
RESULTS
Ten clinical trials were included. The study design and outcome measures used varied. Significant immediate improvement in the range of motion was reported by all studies, and those effects were still significant at follow-up. No significant difference was shown between static progressive and dynamic orthoses for elbow contracture in one randomized control trial.
CONCLUSIONS
Current low-quality evidence suggested that static progressive orthoses provided assistance for elbow contracture through improving range of motion. Further research is recommended using high-quality randomized controlled trials.
Topics: Clinical Trials as Topic; Contracture; Elbow; Elbow Joint; Humans; Orthotic Devices; Randomized Controlled Trials as Topic; Range of Motion, Articular; Splints
PubMed: 29081938
DOI: 10.1155/2017/7498094 -
Hong Kong Journal of Occupational... Jun 2018Fixed flexion deformity of the proximal interphalangeal joint can commonly occur following a traumatic injury impacting on hand function and occupational performance.... (Review)
Review
BACKGROUND/OBJECTIVE
Fixed flexion deformity of the proximal interphalangeal joint can commonly occur following a traumatic injury impacting on hand function and occupational performance. Numerous interventions have been proposed for fixed flexion deformity resolution. This paper investigates the efficacy of static or dynamic orthoses in reducing fixed flexion deformity contracture following traumatic proximal interphalangeal joint injury.
METHODS
A multi-database search of three databases (CINAHL, EMBASE, MEDLINE) was conducted. Data extracted for each study were design, patient descriptions, degree of fixed flexion deformity pre- and post-orthoses, and prescribed interventions and exercise programmes.
RESULTS
The search yielded 643 studies, of which eight met the inclusion criteria. Studies used heterogeneous methodologies investigating various orthotic interventions. Meta-analysis or pooling of results was not possible. Dissimilar orthotic wear regimes were noted in all studies and an alternative clinical significance outcome was found.
CONCLUSION
More research is required to support clinical reasoning in orthotic choice for fixed flexion deformity of the proximal interphalangeal joint post-traumatic injury.
PubMed: 30186081
DOI: 10.1177/1569186118764067 -
PloS One 2015The objective of this study was to systematically review the literature for a more comprehensive understanding of the complications of open elbow arthrolysis in patients... (Review)
Review
OBJECTIVE
The objective of this study was to systematically review the literature for a more comprehensive understanding of the complications of open elbow arthrolysis in patients with post-traumatic elbow stiffness and provide a reference for better prevention and treatment of them.
METHODS
The PubMed, EMBASE, Cochrane Library, and Google Scholar databases were searched for therapeutic studies with a set of inclusion and exclusion criteria. Data were extracted from selected articles, and a statistical analysis was performed to evaluate related factors and management of the complications.
RESULTS
Twenty-eight articles published between 1989 and 2013, involving 810 patients, were included. Most of the complications included in the selected articles were nerve complications, heterotopic ossification, elbow instability, infection, pin-related complications and repeat elbow contracture. The total complication rate was 24.3% ± 3.0%, and the reoperation rate was 34.0%. Furthermore, the statistical analysis revealed that preoperative range of motion (β = -0.004, P = 0.01) and proportion of female (β = 0.336, P = 0.04) were the independent factors affecting the total complication rate.
CONCLUSIONS
Various risk factors are related to each of the complications, and we found that patients with less preoperative ROM and a higher proportion of female gender may point to a higher total complication rate. Therefore, to further improve the overall outcomes of this procedure, more and larger prospective studies should be performed to further elucidate the effects of prophylactic interventions targeting the risk factors, thus improving the methods of prevention and treatment of complications.
Topics: Elbow Joint; Humans; Joint Diseases; Orthopedic Procedures; Range of Motion, Articular; Recovery of Function; Treatment Outcome; Elbow Injuries
PubMed: 26383106
DOI: 10.1371/journal.pone.0138547 -
The Journal of Hand Surgery Oct 2017To determine the role of night orthosis use after surgical correction of Dupuytren contracture. (Review)
Review
PURPOSE
To determine the role of night orthosis use after surgical correction of Dupuytren contracture.
METHODS
We searched MEDLINE, EMBASE, CINAHL, AMED, OTSeeker, and CENTRAL for articles published from inception of the databases to August 2015. Assessment was undertaken by 2 independent reviewers (O.A.S. and S.A.). Methodological quality of randomized controlled trials was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa instrument.
RESULTS
Seven studies met the standard for inclusion in this review. A total of 659 patients across these 7 studies were included in the analysis, with follow-up ranging from 3 to 72 months. None of the included studies assessed recurrence. The analysis revealed no significant improvement in range of motion of hand joints for patients who received a static night orthosis after Dupuytren surgery compared with patients without an orthosis. Similarly, no differences were found in patient-reported functional status across the 2 groups.
CONCLUSIONS
The current literature does not appear to support the use of static night orthosis in addition to hand therapy after surgical correction of Dupuytren contracture.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
Topics: Dupuytren Contracture; Humans; Orthotic Devices
PubMed: 28867249
DOI: 10.1016/j.jhsa.2017.06.100