PM&R最新文献

{"title":"Basal cell carcinoma on amputated limb following radiation therapy for heterotopic ossification.","authors":"Gabriela Pinero-Crespo, Meredith E Thomley, Aashish Bhatt, Jeffrey Heckman, Thomas Beachkofsky","doi":"10.1002/pmrj.13336","DOIUrl":"10.1002/pmrj.13336","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"868-870"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manual muscle testing of upper limb muscle strength in persons with tetraplegia undergoing surgical restoration of elbow extension: A scoping review.","authors":"Sabrina Koch-Borner, Ursina Arnet, Ann-Sofi Lamberg, Silvia Schibli, Jennifer Dunn","doi":"10.1002/pmrj.13348","DOIUrl":"10.1002/pmrj.13348","url":null,"abstract":"<p><p>Tetraplegia often leads to upper limb disability due to triceps paralysis, affecting workspace and mobility. Restoring elbow extension via muscle-tendon or nerve transfer requires preoperative donor muscle strength assessment and postoperative evaluation. Manual muscle testing (MMT) is common, but inconsistencies in grading systems and procedures hinder cross-study comparisons. This study aims to examine how MMT is reported for assessing shoulder and elbow muscle strength in patients with tetraplegia undergoing elbow extension restoration. The review focuses on grading systems, targeted muscles, and testing procedures and positions used in MMT to advocate for standardization. A literature survey was conducted in September 2021 and repeated in September 2023 across five databases: Allied and Complementary Medicine Database, Embase, Medline, CINAHL, and Scopus. The search strategy utilized subject headings and keywords related to \"upper limb reconstructive surgery,\" \"tendon transfer surgery,\" \"nerve transfer surgery,\" and \"tetraplegia.\" Studies describing clinical information about assessment or outcomes of shoulder and elbow muscle strength using MMT in surgical elbow extension restoration in tetraplegia were included. Extracted data included study characteristics, surgical intervention, muscles tested, and description of how MMT is performed. These data were then analyzed to categorize and interpret existing practices. A total of 29 studies met the inclusion criteria. Among these, 66% focused on muscle-tendon, and 34% addressed nerve transfers. Donor strength was assessed preoperatively in 55% and postoperatively in 34%. Elbow extension strength was consistently reported postoperatively but only preoperatively in 83% of studies. Only five studies specified the positions used for muscle testing, but these positions varied. Despite numerous studies on elbow extension restoration outcomes in people with tetraplegia, there is no consistent approach for reporting muscle strength. Consistent reporting of pre- and postoperative muscle strength, including testing positions, is required to obtain standardized MMT positions. Similarly, the adoption of a universal scale could improve outcome reporting and synthesis.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"850-860"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care utilization and cost in the dual diagnosis of combined traumatic spinal cord injury and traumatic brain injury compared to traumatic brain injury alone: An analysis using MarketScan.","authors":"Julian Marcet, Elsa Alvarez-Madrid, Zakari Dymock, McKenna Hamm, Axler Jean Paul, Kelly E Gartner, Camilo Castillo, Beatrice Ugiliweneza, Darryl Kaelin","doi":"10.1002/pmrj.13404","DOIUrl":"https://doi.org/10.1002/pmrj.13404","url":null,"abstract":"<p><strong>Background: </strong>Independently, traumatic brain injuries (TBI) and traumatic spinal cord injuries (TSCI) can be catastrophic for patients and their caregivers. However, the potential additive effect in the dual diagnosis (DD) of these injuries remains poorly understood.</p><p><strong>Objective: </strong>To elucidate the health care utilization and costs associated with DD compared to isolated mild, moderate, or severe TBI.</p><p><strong>Design: </strong>Retrospective observational longitudinal study.</p><p><strong>Setting: </strong>Merative MarketScan Research Database (2000-2022).</p><p><strong>Participants: </strong>Individuals 18 years or older who were hospitalized for TBI (205,504 total) were separated into study groups: (1) 105,324 mild TBI; (2) 93,499 moderate TBI; (3) 1195 severe TBI; and (4) 5486 DD.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcomes: </strong>Demographics, comorbidities, complications, and health care utilization (index hospitalization length of stay, rehabilitation services, emergency room visits, outpatient services, payments).</p><p><strong>Results: </strong>The median age for patients with DD was 51 years, significantly higher than that for patients with mild and moderate TBI. Patients with DD had the highest proportion of individuals with no comorbidities at the time of injury. During index hospitalization, patients with DD had higher complication rates, length of stay, and payments than patients with mild and moderate TBI. At 12 months post-discharge, patients with DD had higher rates of renal-genital-urinary, neuromusculoskeletal, and gastrointestinal complications compared to all isolated TBI groups. Additionally, patients with DD were more likely to utilize at least one rehabilitation service. Patients with DD had 5% higher rate of hospitalizations compared to patients with moderate TBI and greater utilization of outpatient services compared to those with mild and moderate TBI. Patients with DD had significantly higher total payments at 12 months than those with mild and moderate TBI but lower payments than those with severe TBI.</p><p><strong>Conclusion: </strong>Our findings show worse outcomes and higher health care utilization for individuals with DD compared to those with mild and moderate TBI and similar or slightly better outcomes and utilization compared to those with severe TBI. This study highlights the challenges of DD and provides data to support specialized resource allocation for patients with DD.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A socioecological approach to understanding and positively affecting the intersectionality between disability, race and ethnicity, climate change, and rehabilitation outcomes: A scoping review.","authors":"Prateek Grover, Monica Verduzco-Gutierrez, Thiru Annaswamy","doi":"10.1002/pmrj.13401","DOIUrl":"10.1002/pmrj.13401","url":null,"abstract":"<p><strong>Background: </strong>Health care outcomes for people with disability may be disproportionately affected by climate change through multiple interlinked factors, which are not well understood. Objective With use of scoping review methodology, this study aimed to model this intersectionality using socioecological (SE) levels to connect person-level rehabilitation diagnoses with systems/policy-level climate change and use this model to identify multilevel factors, rehabilitation outcomes, and responsive strategies from literature.</p><p><strong>Methods: </strong>A scoping review of literature was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews methodology from three databases (PubMed Medline, Ovid Medline, CINAHL) using combinations of keywords (climate change), (rehabilitation), (disability), and (race). Logic and SE models were combined to model this intersectionality and create review forms that were used to abstract data. Common themes were collated (results), and additional experiential insight was added to provide contextual relevance (discussion).</p><p><strong>Results: </strong>Of 32 deduplicated articles, 11 met inclusion criteria for qualitative analysis. Rehabilitation outcomes included physical, economic, mental, cognitive, and mortality (person level); rehabilitation services disruption, medical supply delay, emergency capacity overwhelmed (organizational level); and disabled environment (community level). Responsive strategies included education, backup supplies, planning, social support/utility registration (person level); competency assessment/training, physical medicine and rehabilitation physicians (PM&R) assisting patient in planning, providing pre-/postevent services, and establishing cross-coverage (interpersonal level); telerehabilitation, energy/resources conservation, PM&R inclusion in disaster mitigation planning (organization level); building accessible/resilient infrastructure, evidence-based practice guidelines through professional organizations (community level); and research funding, utility companies prioritizing power, and patients/providers included in planning (system/policy level).</p><p><strong>Discussion: </strong>Climate change impact on rehabilitation diagnoses such as spinal cord injury and limb loss, as well as intersectionality with rehabilitation outcomes and identified responsive strategies, has been comprehensively modeled using SE levels. Race is not a commonly identified factor.</p><p><strong>Conclusion: </strong>PM&R physicians can play a vital role in this intersectionality of disability, climate change, and rehabilitation outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of lower-extremity exoskeleton robot-assisted dual-task training versus walking training on gait and postural control after stroke: A randomized controlled trial.","authors":"Tingyu Zhang, Jiejiao Zheng, Jiming Tao, Yueying Xu, Xinglai Zhang, Chen Chen, Dongdong Liao, Xingyuan Li","doi":"10.1002/pmrj.13419","DOIUrl":"10.1002/pmrj.13419","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic tools are critical for poststroke rehabilitation. The potential benefits of dual-task training assisted by a lower-extremity exoskeleton robot to enhance gait and postural control have yet to be studied.</p><p><strong>Objective: </strong>To determine the effects of lower-extremity exoskeleton robot-assisted dual-task training on gait and postural control after stroke.</p><p><strong>Design: </strong>Single-blind, randomized controlled trial.</p><p><strong>Setting: </strong>Outpatient clinic and ward, Department of Rehabilitation Medicine, Huadong Hospital affiliated with Fudan University.</p><p><strong>Participants: </strong>Forty-four participants in the recovery and sequela phases of stroke with deficits in gait and postural control.</p><p><strong>Interventions: </strong>Participants were randomly assigned to two groups: lower-extremity exoskeleton robot-assisted walking cognitive dual-task training (experimental group) or lower-extremity exoskeleton robot-assisted walking training (control group). Each participant received 40 minutes per intervention, 1 time per day, 6 times per week for 3 weeks.</p><p><strong>Main outcome measures: </strong>The primary outcome was gait variability performance. The secondary outcomes included the Timed Up and Go, Berg Balance Scale, Montreal Cognitive Assessment, Fugl-Meyer assessment of lower extremity, and International Classification of Functioning, Disability and Health-activities and participation assessment scale.</p><p><strong>Results: </strong>Individuals who participated in exoskeleton robot-assisted walking cognitive dual-task training improved more than those in the control group in partial gait variability performance analysis, Timed Up and Go test, Berg Balance Scale, and Fugl-Meyer assessment for the lower extremities (p < .05).</p><p><strong>Conclusions: </strong>Compared to lower-extremity exoskeleton robot-assisted walking training, robot-assisted dual-task training improves gait and postural control, walking, balance, and lower extremity motor function in survivors of stroke.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-reach rehabilitation is feasible and led to functional gains in selected heart and/or lung transplantation recipients.","authors":"Jane Wu, Sonali Thakkar, Christine T Shiner, Yuriko Watanabe, Kavitha Muthiah, Steven G Faux","doi":"10.1002/pmrj.13433","DOIUrl":"10.1002/pmrj.13433","url":null,"abstract":"<p><strong>Background: </strong>In-reach rehabilitation is a relatively new model of care available in a small number of Australian public hospitals. These multidisciplinary teams deliver evidence-based structured rehabilitation to carefully selected patients during acute care. There are no published rehabilitation outcomes in heart and/or lung transplant recipients.</p><p><strong>Objective: </strong>To describe the rehabilitation outcomes of a cohort of heart and/or lung transplant recipients.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>One metropolitan institution with the largest heart and lung transplant service in Australia.</p><p><strong>Patients: </strong>Between 2014 and 2023, a total of 957 heart and/or lung transplants were performed at this institution.</p><p><strong>Intervention: </strong>In-reach rehabilitation was delivered to selected patients during the 10-year period. However, from 2019 onwards, patients were proactively screened by the rehabilitation team for eligibility as well as referred from the acute transplant teams.</p><p><strong>Main outcome measures: </strong>Functional independence measure (FIM) changes and percentage of patients going to inpatient rehabilitation after completion of acute care.</p><p><strong>Results: </strong>In-reach rehabilitation was received by 223 (24.3%) patients. With the exception of three patients (who died), the vast majority were able to complete an in-reach rehabilitation program and were discharged to the community (n = 98, 43.9%), inpatient rehabilitation (n = 119, 53.4%), or transferred to another hospital (n = 3, 1.3%), demonstrating feasibility. Across the cohort, the median admission and discharge FIM scores were 77.0 (interquartile range, 60-94.8) and 100 (interquartile range, 77-118), respectively, demonstrating significant functional improvements from start to finish of the in-reach rehabilitation program (p < .001). Over this period, the number of patients discharged to inpatient rehabilitation decreased as a proportion of the total number of transplants (25.7% in 2014, 47.8% in 2017, 34.7% in 2019, 26.2% in 2021, 8.0% in 2023). Proactive rehabilitation screening implemented from 2019 allowed for earlier and longer program delivery to more patients.</p><p><strong>Conclusions: </strong>In-reach rehabilitation is feasible in acute care after heart and/or lung transplantation and was associated with functional improvements. The addition of proactive rehabilitation screening appeared to improve the effectiveness of the in-reach rehabilitation program.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding medical students' knowledge and attitudes about cerebral palsy.","authors":"Brianna Callahan, Andrea Janis, Swetha Reddi, Andrew S Nowak, Ronald Thomas, Karin Przyklenk, Christina Santia, Charles Pelshaw","doi":"10.1002/pmrj.13420","DOIUrl":"10.1002/pmrj.13420","url":null,"abstract":"<p><strong>Background: </strong>Children with cerebral palsy and other disabilities face barriers in obtaining equitable medical care. Although many factors contribute to these disparities, physicians' lack of knowledge and comfort when caring for patients with cerebral palsy have been reported to play a role. We propose that this gap in understanding may reflect a deficit in disability education during medical school.</p><p><strong>Objective: </strong>To (1) obtain insight into medical students' knowledge regarding cerebral palsy at two medical schools in the United States; and (2) determine whether viewing a brief educational video increases short-term knowledge regarding cerebral palsy.</p><p><strong>Methods: </strong>All medical students attending Wayne State University School of Medicine and Central Michigan University College of Medicine in November-December 2023 were invited to participate in the study. Respondents completed a three-step survey, in which they answered nine multiple-choice knowledge-based questions about cerebral palsy, viewed a 10-minute educational video, and responded to the same nine knowledge-based questions after viewing the video.</p><p><strong>Results: </strong>A total of 221 surveys were received (response rate: 14%). For the submitted surveys in which paired data were available, the percentage of correct responses at baseline (prevideo), averaged for the nine knowledge-based questions, was 45 ± 15% and increased to 67 ± 11% after viewing the educational video (p < .01).</p><p><strong>Conclusions: </strong>Our results reveal that medical students' knowledge of cerebral palsy is limited and that a brief, focused educational session may have a short-term beneficial effect in mitigating this gap in knowledge.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural tissue reaction post interlaminar particulate steroid injection: A case series and systematic review.","authors":"Reza Ehsanian, Deion Ellis, Lillian Dennison, Jordan A Buttner, Byron Schneider, Byron F Stephens, David J Kennedy, Aaron Yang","doi":"10.1002/pmrj.13415","DOIUrl":"https://doi.org/10.1002/pmrj.13415","url":null,"abstract":"<p><strong>Background: </strong>Lumbar radicular pain is often treated with interlaminar epidural particulate corticosteroid injection (ILEPSI). However, little literature exists on epidural tissue changes post ILEPSI. Investigating these potential tissue changes is valuable because of their possible clinical implications.</p><p><strong>Objective: </strong>To report gross and histological epidural tissue changes after ILEPSI following spinal decompression surgery and compare the observed changes to those previously reported in the literature.</p><p><strong>Design: </strong>A retrospective case series and systematic literature review were conducted. Surgeons were blinded to the details of corticosteroid injections and the study's specific aims.</p><p><strong>Participants: </strong>Patients who underwent spinal decompression surgery and through retrospective chart review were found to have had ILEPSI prior to surgery.</p><p><strong>Methods: </strong>Four consecutive patients undergoing spinal decompression surgery were included in a convenience sample, all exhibiting abnormal epidural tissue formation. A retrospective chart review showed that each patient had received ILEPSI at the same spinal level before surgery. A systematic literature review, registered in International Prospective Register of Systematic Reviews, was subsequently conducted based on this novel finding.</p><p><strong>Results: </strong>Surgical biopsies from four patients undergoing spinal decompression after ILEPSI showed \"granulomatous-like reactions\" in the epidural space. A systematic literature review found no similar epidural reactions but did find comparable findings in dermatology literature.</p><p><strong>Conclusion: </strong>The epidural \"granulomatous-like reactions\" observed after ILEPSI are a novel finding, resembling tissue reactions from particulate corticosteroid administration. This suggests a potential link between ILEPSI and these reactions.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of balance training with visual occlusion on postural control in individuals with chronic ankle instability: A systematic review and meta-analysis of randomized controlled trials.","authors":"Peng Chen, Lulu Yin, Yaru Wei, Yixue Gong, Lin Wang","doi":"10.1002/pmrj.13413","DOIUrl":"https://doi.org/10.1002/pmrj.13413","url":null,"abstract":"<p><strong>Objective: </strong>Balance training with visual occlusion positively affects the improvement of proprioception and reduction of visual dependence in individuals with chronic ankle instability (CAI). However, the effect of visual occlusion balance training alone on postural control in individuals with CAI remains controversial. This review conducted a meta-analysis of existing randomized controlled trials (RCTs) to investigate the influence of balance training with visual occlusion on the postural control of individuals with CAI.</p><p><strong>Literature survey: </strong>PubMed, Embase, The Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure (CNKI), and WanFang database were searched until July 20, 2024. RCTs were eligible if they compared the effects of balance training with visual occlusion with balance training on the postural control of individuals with CAI.</p><p><strong>Methodology: </strong>The following information from the included articles was extracted: basic study information, interventions, and outcomes. The primary outcomes included Y-balance test (YBT) distance and center of pressure (COP) area, and the secondary outcomes were Cumberland ankle instability tool (CAIT) and Foot and Ankle Ability Measure (FAAM) scores.</p><p><strong>Synthesis: </strong>Eight RCTs were included in this work. The results show that balance training with visual occlusion significantly improved YBT distance (standardized mean difference [SMD] = 0.40 [95% confidence interval [CI], 0.23-0.57], p < .001) and CAIT scores (mean difference [MD] = 3.03 [95% CI, 1.76-4.29], p < .001) in individuals with CAI compared with balance training alone. However, no significant difference was found between the two groups in terms of the COP area (SMD = 0.18 [95% CI, 0.51-0.86], p = .62) and FAAM scores (MD = 1.79 [95% CI, -0.03 to 3.62], p = .05).</p><p><strong>Conclusions: </strong>Compared with balance training alone, balance training with visual occlusion may help improve the dynamic postural control ability of individuals with CAI. However, its effect on static postural control ability still needs further study.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between running gait biomechanics and femoral neck bone stress injuries in female runners.","authors":"Kristin E Whitney, Mayela Leal Chanchi, Pierre A d'Hemecourt, Andrea Stracciolini, Mininder Kocher, Corey Dawkins, Sarah Willwerth, Alexandra F DeJong Lempke","doi":"10.1002/pmrj.13418","DOIUrl":"https://doi.org/10.1002/pmrj.13418","url":null,"abstract":"<p><strong>Background: </strong>Femoral neck stress fractures are prevalent injuries among young female runners, yet biomechanical and strength features have not been well-described in adolescents and young adults.</p><p><strong>Objective: </strong>To compare running gait biomechanics and strength measures of female runners diagnosed with a femoral neck bone stress injury (BSI) to healthy female runner controls.</p><p><strong>Design: </strong>Retrospective case-control study.</p><p><strong>Setting: </strong>Outpatient sports medicine department.</p><p><strong>Patients: </strong>There were 18 female runners with a history of femoral neck BSI (age: 20.3 ± 1.0 years, BMI: 19.8 ± 0.6 kg/m²) and 18 healthy female runners without femoral neck BSI (age: 18.3 ± 0.7 years, BMI: 21.5 ± 0.6 kg/m²).</p><p><strong>Methods: </strong>Participants underwent instrumented running gait analyses with 2-dimensional videos, and standardized handheld dynamometry hip strength measures.</p><p><strong>Main outcome measures: </strong>Primary outcomes included spatiotemporal, kinematic, and kinetic running gait biomechanics, and tri-planar hip muscle strength. Non-parametric Mann-Whitney U tests were used to compare participant demographics. Linear regressions were used to compare strength and continuous gait outcomes, and logistic regressions were used to compare categorical gait outcomes between groups, covarying for age and body mass index (α = .05).</p><p><strong>Results: </strong>A higher proportion of those with a history of femoral neck BSI demonstrated limb midline cross-over (Adjusted Probability [Adj.]: 65.0% vs. 38.5 %; p = .04), contralateral pelvic drop (Adj.: 99.0% vs. 52.9%; p = .02), medial knee displacement (Adj.: 67.0% vs. 37.9%; p = .03), and pronation at midstance (Adj.: 86.5% vs. 41.2%; p = .02) compared to those without a history of BSI. Those with a history of femoral neck BSI had lower hip abduction strength on dynamometry testing (1.64 ± 0.30 Nm/kg vs. 1.99 ± 0.66 Nm/kg; p = .01).</p><p><strong>Conclusions: </strong>Female runners with a history of femoral neck BSI demonstrated characteristic coronal plane gait and hip abductor strength deficits, suggesting an association between impaired lower limb proximal and distal biomechanics during femoral neck BSI recovery.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}