Lower extremity inter-joint coupling angles and variability during gait in pediatric hypermobility spectrum disorder.

Complex musculoskeletal complications in children with hypermobility spectrum disorder (HSD) include pain, proprioception deficits, and joint instability, which may result in movement dysfunction during walking. However, no studies have explored the inter-joint coordination deficits in children with HSD. The purpose of this study was to determine the lower extremity inter-joint coupling angles, patterns, and variability during walking in children with HSD compared to children without HSD (non-HSD).

Use of computed tomography to identify muscle quality subgroups, spatial mapping, and preliminary relationships to function in those with diabetic peripheral neuropathy.

Background: Decreased muscle volume and increased muscle-associated adipose tissue (MAAT, sum of intra and inter-muscular adipose tissue) of the foot intrinsic muscle compartment are associated with deformity, decreased function, and increased risk of ulceration and amputation in those with diabetic peripheral neuropathy (DPN).

Research Question: What is the muscle quality (normal, abnormal muscle, and adipose volumes) of the DPN foot intrinsic compartment, how does it change over time, and is muscle quality related to gait and foot function?

Methods: Computed tomography was performed on the intrinsic foot muscle compartment of 45 subjects with DPN (mean age: 67.2 ± 6.

The association of pain with gait spatiotemporal parameters in children with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder.

Background: Children with hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/hEDS) have a high prevalence of chronic pain, which may influence gait dynamics. However, little is known about pain outcomes and their association with gait spatiotemporal parameters in children with HSD/hEDS.

Research Question: Does pain correlate with gait spatiotemporal parameters in children with HSD/hEDS?

Methods: Eighteen children with HSD/hEDS and eighteen typically developing (TD) children participated in the study.

Rate of tarsal and metatarsal bone mineral density change in adults with diabetes mellitus and peripheral neuropathy: a longitudinal study.

Background: In people with diabetes (DM) and peripheral neuropathy (PN), loss of bone mineral density (BMD) in the tarsals and metatarsals contribute to foot complications; however, changes in BMD of the calcaneal bone is most commonly reported. This study reports rate of change in BMD of all the individual bones in the foot, in participants with DM and PN. Our aim was to investigate whether the rate of BMD change is similar across all the bones of the foot.

Pain Characteristics and Symptom Management in Children with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder.

Aims: This study aims to investigate pediatric hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD) pain features and management strategies.

Methods: This is a mixed-methods, cross-sectional study design using patient-reported outcomes in 21 children diagnosed with hEDS/HSD. Children who reported bothersome pain were interviewed for pain features.

Remote Research: Resources, Intervention Needs, and Methods in People with Diabetes and Peripheral Neuropathy.

Background: Stay-at-home orders associated with the SARS-CoV-2 (COVID-19) pandemic were particularly important for older adults with type 2 diabetes, at risk for severe COVID-19 complications. In response, research shifted to remote telehealth methodology. Study participant interests, equipment needs, and ability to adapt methods to the remote/telehealth environment were unknown.

Midfoot and ankle movement coordination during heel rise is disrupted in people with diabetes and peripheral neuropathy.

Background: A heel rise task can be used to evaluate midfoot and ankle movement dysfunction in people with diabetes mellitus and peripheral neuropathy. Quantifying movement coordination during heel rise is important to better understand potentially detrimental movement strategies in people with foot pathologies; however, coordination and the impact of limited excursion on coordination is not well-understood in people with diabetes.

Methods: Sixty patients with diabetes mellitus and peripheral neuropathy, and 22 older and 25 younger controls performed single-limb heel rise task.

Body mass index and maximum available midfoot motion are associated with midfoot angle at peak heel rise in people with type 2 diabetes mellitus and peripheral neuropathy.

Purpose: Midfoot movement dysfunction, as measured by heel rise performance, is associated with midfoot deformity in people with diabetes and peripheral neuropathy. Understanding contributors of midfoot movement dysfunction may help clinicians understand deformity progression. The purpose of this study was to determine the factors associated with midfoot angle at peak heel rise.

Association of toe-extension movement pattern magnitude and variability during three functional tasks with diabetic foot complications.

Background: A toe-extension movement pattern may contribute to metatarsophalangeal joint deformity and ulceration in people with diabetes. We sought to quantify the relationship between toe extension magnitude and variability during three functional tasks (ankle range of motion, sit to stand, walking) with metatarsophalangeal joint deformity, and identify potential mechanisms associated with a toe-extension movement pattern.

Methods: Individuals with diabetes and peripheral neuropathy were included (n = 60).

Heel Rise and Non-Weight-Bearing Ankle Plantar Flexion Tasks to Assess Foot and Ankle Function in People With Diabetes Mellitus and Peripheral Neuropathy.

Objective: The objective of this study was to examine the effects of diabetes mellitus and peripheral neuropathy (DMPN), limited joint mobility, and weight-bearing on foot and ankle sagittal movements and characterize the foot and ankle position during heel rise.

Methods: Sixty people with DMPN and 22 controls participated. Primary outcomes were foot (forefoot on hindfoot) and ankle (hindfoot on shank) plantar-flexion/dorsiflexion angle during 3 tasks: unilateral heel rise, bilateral heel rise, and non-weight-bearing ankle plantar flexion.

Midfoot and ankle motion during heel rise and gait are related in people with diabetes and peripheral neuropathy.

Background: Midfoot and ankle movement dysfunction in people with diabetes mellitus and peripheral neuropathy (DMPN) is associated with midfoot deformity and increased plantar pressures during gait. If midfoot and ankle motion during heel rise and push-off of gait have similar mechanics, heel rise performance could be a clinically feasible way to identify abnormal midfoot and ankle function during gait.

Research Question: Is midfoot and ankle joint motion during a heel rise associated with midfoot and ankle motion at push-off during gait in people with DMPN?

Methods: Sixty adults with DMPN completed double-limb heel rise, single-limb heel rise, and walking.

Relationships within and between lower and upper extremity dysfunction in people with diabetes.

Introduction: Diabetes mellitus (DM) is associated with systemic musculoskeletal system impairments suggesting concurrent development of lower and upper extremity musculoskeletal problems. This study aims to examine relationships between lower and upper extremity function in people with DM.

Methods: Sixty people with type 2 DM and peripheral neuropathy [mean (standard deviation); 67(6) years old, DM duration 14(10) yrs] completed the following measures: 1) Self-reports of function: Foot and Ankle Ability Measure (FAAM; higher = better function) and Shoulder Pain and Disability Index (SPADI; lower = better function), 2) Range of motion (goniometry): ankle dorsiflexion and shoulder flexion, and 3) Strength: unilateral heel rise power (UHR, 3D kinetics) and hand grip dynamometry.

Multi-System Factors Associated with Metatarsophalangeal Joint Deformity in Individuals with Type 2 Diabetes.

The underlying factors contributing to metatarsophalangeal joint deformity, a known precursor to skin breakdown in individuals with diabetes mellitus (DM), is likely to involve multiple body systems. The purpose of this cross-sectional study was to identify multi-system factors associated with metatarsophalangeal joint deformity in individuals with type 2 DM and peripheral neuropathy ( = 60). Metatarsophalangeal joint deformity was quantified with a computed tomography (CT) scan.

Metatarsophalangeal joint flexion affects dorsiflexor activity in subjects with a dominant extensor hallucis longus.

Background And Objectives: Normal dorsiflexion (DF) required for normal gait is achieved through balance of the tibialis anterior (TA) and extensor hallucis longus (EHL). Imbalance may induce ankle and foot deformities and exacerbate pathology. EHL dominance is associated with progressive TA weakness, attributable to muscle non-use.

Stretching position can affect levator scapular muscle activity, length, and cervical range of motion in people with a shortened levator scapulae.

Objectives: Levator scapulae (LS) muscle stretching exercises are a common method of lengthening a shortened muscle; however, the appropriate stretching position for lengthening the LS in people with a shortened LS remains unclear. The purpose of this study was to compare the effects of different stretching exercise positions on the LS and introduce effective stretching exercise methods to clinicians.

Participants: Twenty-four university students (12 men, 12 women) with a shortened LS were recruited.

Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture.

Background: Forward head posture is a head-on-trunk malalignment, which results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise and the suboccipital release technique have been used.

Objectives: The purpose of this study was to compare the immediate effects of craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise on craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis during craniocervical flexion exercise in subjects with forward head posture.

Reliability of levator scapulae index in subjects with and without scapular downward rotation syndrome.

Objectives: The objective of this study was to introduce levator scapulae (LS) measurement using a caliper and the levator scapulae index (LSI) and to investigate intra- and interrater reliability of the LSI in subjects with and without scapular downward rotation syndrome (SDRS).

Design: Two raters measured LS length twice in 38 subjects (19 with SDRS and 19 without SDRS).

Main Outcome Measures: For reliability testing, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated.

Various shrug exercises can change scapular kinematics and scapular rotator muscle activities in subjects with scapular downward rotation syndrome.

Scapular dyskinesis, characterized by scapular downward rotation syndrome (SDRS) affects scapula-humeral rhythm and results in shoulder dysfunction. Previous study has led to the recommendation of standard shrug exercise to contend with SDRS and strengthen the upper trapezius (UT) muscle. However, few researchers have examined which shrug exercise is most effective.

Shrug exercises combined with shoulder abduction improve scapular upward rotator activity and scapular alignment in subjects with scapular downward rotation impairment.

The aim of this research was to investigate which shoulder abduction angle (30°, 90°, 150°) during shrug exercise is superior for (1) activating the scapular upward rotators and (2) improving scapular and clavicular position in subjects with scapular downward rotation impairment. Twenty subjects performed shrug exercises at three different shoulder abduction angles (30°, 90°, 150°) which were obtained and maintained actively. Surface EMG data were collected from the levator scapulae (LS), upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) during shrug exercises.

Trunk muscle activation during different quadruped stabilization exercises in individuals with chronic low back pain.

Background And Purpose: The aim of this study was to compare the trunk muscle activities and the local/global activity ratios of the abdominal, back and trunk muscles during stabilization exercises such as one arm raise (AR), one leg raise (LR), and opposing arm/leg raise (ALR) in patients with chronic low back pain (LBP).

Method: Ten individuals with chronic LBP (five men and five women) participated in this study. The external oblique abdominis, internal oblique abdominis, multifidus, thoracic part of the lumbar iliocostalis and the local/global activity ratio were assessed, while quadruped stabilization exercises were performed (AR, LR, and ALR); each exercise was carried out three times.

A comparison of the reliability of the trochanteric prominence angle test and the alternative method in healthy subjects.

A wide range of intra- and inter-rater reliabilities of the trochanteric prominence angle test (TPAT) has been reported. We introduced the transcondylar angle test (TCAT) as an alternative to the TPAT and using a smartphone as a reliable measurement tool for femoral neck anteversion (FNA) measurement. The reliabilities of the TPAT and the TCAT, the reliability of using a smartphone as a clinical measurement tool, and the correlation between the difference value of medial knee joint space (KJS) between rest and tested positions and the difference value between the TPAT and TCAT were assessed.

Effects of different hip rotations on gluteus medius and tensor fasciae latae muscle activity during isometric side-lying hip abduction.

Context: Gluteus medius (Gmed) weakness is associated with some lower-extremity injuries. People with Gmed weakness might compensate by activating the tensor fasciae latae (TFL). Different hip rotations in the transverse plane may affect Gmed and TFL muscle activity during isometric side-lying hip abduction (SHA).