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Brachial Plexus Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Janice He, Bassem Elhassan, Rohit Garg
Range of motion examination is important as supple joints will not only provide patients with good upper extremity function should they have neurologic recovery, but also determine whether a patient is a good candidate for reconstructive procedures. Patients can develop significant joint stiffness if they have decreased use or no use of their extremity during their workup or observation period. An examination should include:Shoulder motion in flexion, extension, adduction, abduction, internal rotation and external rotationElbow motion in flexion and extensionForearm pronation and supinationWrist flexion and extensionDigital flexion and extension, abduction and adduction
Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis in Children and Young People
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
It is important for the young person and their family to understand that fatigue and weakness are exacerbated by excessive rest and inactivity. The effects of inactivity are: Significant effects occur within one to four weeks of bed rest.Reduced muscle volume and strength.Reduced muscle protein and increased connective tissue.Reduced bone mineral density.Joint stiffness.Reduced BMR.Altered white cell function.Changes in immune response.Effect on mood and circadian rhythm.
Joint Stiffness
Published in Verna Wright, Eric L. Radin, Mechanics of Human Joints, 2020
The structure of this chapter pursues these themes. Following a brief historical review, current biomechanical assessments of joint stiffness and recent attempts to define exactly why patients experience this symptom are described.
A comparison of the biomechanical and clinical effects of a biaxial ankle-foot orthosis and lateral wedge insole in individuals with medial knee osteoarthritis
Published in Disability and Rehabilitation, 2022
Kourosh Barati, Ismail Ebrahimi Takamjani, Alireza Shamsoddini, Habib Ejraei Dolatabad
The biaxial AFO and the lateral wedge insole did not show significant effects on knee joint stiffness, in agreement with a previous study [14]. An extended follow-up period might result in a significant difference. According to the study by Zeni and Higginson [42], the knee joint stiffness for individuals with moderate knee osteoarthritis was not more than the stiffness for a healthy population of about the same age. Our sample was composed of individuals with knee osteoarthritis grade II and grade III, and a significant increase in knee joint stiffness was observed in individuals with more severe knee osteoarthritis [42]. Therefore, it is possible that 2 weeks follow-up was not sensitive enough for our population, but it could be appropriate for individuals with more severe knee osteoarthritis, which already has an increased knee joint stiffness. The optimal daily wedge insole use has been previously reported to be 5–10 h per day [43]. In our study, the biaxial AFO wearing time was 7.61 ± 1.25 h a day and lateral wedge insole wearing time was 7.48 ± 1.50 h per day which is in line with the optimal daily orthosis use. Furthermore, 65% of participants (N = 20) selected the lateral wedge insole as their preferred orthosis because of the bulk issue.
Familial cold autoinflammatory syndrome with rheumatoid arthritis
Published in Baylor University Medical Center Proceedings, 2021
Brooke Walterscheid, Jeannie Nguyen, Swetha Gadwala, Goutam Shome, Michelle Tarbox, James A. Tarbox
Our 49-year-old patient was the only one who additionally presented with morning joint stiffness lasting approximately 1 hour, as well as joint pain and swelling involving bilateral metacarpophalangeal, proximal interphalangeal, and wrist joints unrelated to cold exposure. He was the only family member with a strongly positive anticyclic citrulline peptide antibody >250 units, rheumatoid factor of 20 IU/mL (upper limit of normal is 14 IU/mL), and both an elevated erythrocyte sedimentation rate and C-reactive protein. He was diagnosed with RA based on history and criteria of the American College of Rheumatology.5 X-rays of the bilateral hands showed no erosions, and administration of methotrexate, recurrent steroids, and nonsteroidal anti-inflammatory drugs failed to improve his symptoms. Unfortunately, this patient was lost to follow-up prior to treatment of his concurrent FCAS. All other family members dramatically improved with canakinumab 150 mg subcutaneously every 8 weeks.
The outcome of a preoperative one-minute sit-to-stand test is associated with ventilation time after cardiac surgery
Published in Scandinavian Cardiovascular Journal, 2021
Jan Gofus, Martin Vobornik, Vladimir Koblizek, Marek Pojar, Jan Vojacek
Between May 2017 and May 2019, 30 patients were enrolled in the study. All of them completed their postoperative follow-up. We recorded a significant early postoperative drop in STST outcome in both groups (p = .02 for group A; p = .003 for group B), later improving to preoperative values 3 months after surgery (p = .13 for group A; p = .17 for group B) (see Figure 2). No cases of chest pain, dyspnea or other complications were recorded during STST. However, three patients (2 from group A and one from group B) were unable to perform the test on postoperative day 7. Therefore, we recorded its value as zero. In other instances, some of the patients were unable to perform the test without interruption, particularly so on postoperative day 7. The most common reason for this occurrence was knee or hip joint stiffness.