James B Meiling, Andrea J Boon, Marianne T Luetmer, Peter C Rhee, Kitty Y Wu
{"title":"Ultrasound-guided needle electromyography of the extensor carpi radialis longus and brevis muscles for preoperative tendon transfer planning in cervical spinal cord injuries: technique description and case report.","authors":"James B Meiling, Andrea J Boon, Marianne T Luetmer, Peter C Rhee, Kitty Y Wu","doi":"10.1097/PHM.0000000000002813","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002813","url":null,"abstract":"<p><strong>Abstract: </strong>Reconstructive surgery, including tendon transfers, can potentially offer marked improvement in function in those with cervical spinal cord injuries. Given the anatomic redundancy of both the extensor carpi radialis longus (ECRL) and brevis (ECRB) in producing active wrist extension, one muscle can be utilized as a donor for a tendon transfer without sacrificing wrist extension. Needle electromyography (EMG) does not routinely evaluate the ECRL and ECRB, and the functional status of each muscle is difficult to discern based on clinical exam alone. Here is presented a case of a 20-year-old male with C6 complete tetraplegia and preserved active wrist extension who underwent a novel ultrasound (US) -guided EMG technique to accurately and reproducibly assess the ECRB and ECRL muscles. This technique was employed to aid his surgeon in determining candidacy for tendon transfer procedures utilizing the wrist extensors as donors. US-guided EMG showed intact volitional activation in both the ECRL and ECRB. Subsequent ECRL to flexor digitorum profundus tendon transfer was pursued, and he had preserved postoperative anti-gravity wrist extension strength through ECRB alone. Accurate assessment of the ECRL and ECRB allows for more complete preoperative planning and provides critical information on whether active pinch and grasp reconstruction as possible.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741005","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}
Leslie Rydberg, Dana Branch, Samuel K Chu, Emily Kivlehan, Jacqueline Neal
{"title":"Advancing Competency: Current Evidence and Future Directions for Mastery Learning in PM&R Residency Education.","authors":"Leslie Rydberg, Dana Branch, Samuel K Chu, Emily Kivlehan, Jacqueline Neal","doi":"10.1097/PHM.0000000000002827","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002827","url":null,"abstract":"<p><strong>Abstract: </strong>Mastery learning can be an effective method to ensure learner competence for specific procedures and skills. It has been used effectively in different fields of medicine. There is limited data within the field of Physical Medicine and Rehabilitation (PM&R) relating to the use of mastery learning, although a few early studies have shown promise and feasibility. PM&R requires expertise in a broad range of procedures and skills. Structured mastery learning programs may serve as a valuable tool to help PM&R learners achieve competency.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740995","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}
Donald Kasitinon, Reed Williams, Veena Peraka, Levent Özçakar, Nitin B Jain
{"title":"Accuracy and Efficacy of Intra-Articular Knee Injections/Aspirations Under Ultrasound versus Landmark Guidance: A Systematic Review.","authors":"Donald Kasitinon, Reed Williams, Veena Peraka, Levent Özçakar, Nitin B Jain","doi":"10.1097/PHM.0000000000002803","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002803","url":null,"abstract":"<p><strong>Purpose: </strong>To review the current literature on the accuracy and efficacy of ultrasound (US)- and landmark (LM)-guided intra-articular knee injections.</p><p><strong>Methods: </strong>A systematic review was performed following the Cochrane process from April 2023 to August 2023 utilizing PubMed, Embase, Web of Science, and Scopus. Branched logic was used to include articles containing terms regarding the knee AND ultrasound AND injections. Two authors screened studies for eligibility, and any disagreement was resolved through discussion with a third reviewer. Risk-of-bias assessments were performed.</p><p><strong>Results: </strong>A total of 13 studies were included in the review. Cumulative accuracies amounted to 95.4% (356/373) versus 82.0% (268/327) for US-guided and LM-guided intra-articular knee injections/aspirations, respectively. All but one study looking at efficacy showed significantly improved outcomes in the US-guided injection/aspiration groups.</p><p><strong>Conclusions: </strong>This systematic review provides data to support that US-guided intra-articular knee injections/aspirations are more accurate and efficacious than LM-guided intra-articular knee injections/aspirations.</p><p><strong>Level of evidence: </strong>Level I - systematic review.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740994","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":"Peroneal Neuropathy from a Ganglion Cyst in the Proximal Tibiofibular Syndesmosis: A Visual Vignette.","authors":"John Defant, Michael Baria, Shelby Lewis","doi":"10.1097/PHM.0000000000002825","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002825","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740996","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":"Shoulder overuse injury history is associated with imbalanced strength functional ratio and bilateral asymmetry in overhead male Para athletes in resting and fatigued conditions.","authors":"Alexis Dupuy, Marine Sorg, Claire Morel, Audrey Rudewicz, Etienne Colin, Anthony J Blazevich, Mélanie Rance, Sébastien Ratel","doi":"10.1097/PHM.0000000000002818","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002818","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to compare shoulder functional ratio and bilateral strength asymmetry between overhead Para athletes and able-bodied peers, and ascertain whether those factors could be associated with shoulder injury history in Para athletes under resting and fatigued conditions.</p><p><strong>Design: </strong>Sixteen sitting volleyball Para athletes and 12 able-bodied volleyball players were evaluated. The shoulder functional ratio was measured at rest and after a fatiguing shoulder internal-external rotation exercise on dominant and non-dominant shoulders. Imbalanced muscle strength profiles were identified as a functional ratio < 0.7 and bilateral peak torque asymmetry either >10% or > 15%. All injuries incurred over the past 2-months prior testing were reported.</p><p><strong>Results: </strong>No injury was surveyed in able-bodied athletes while 9 dominant shoulder overuse injuries were reported in 9 Para athletes. Functional ratio and bilateral asymmetry were not significantly different between groups at rest or after exercise in either shoulder(p > 0.05). Functional ratio < 0.7 and bilateral asymmetry of either >10% or > 15% were statistically associated with shoulder overuse injury history in the dominant limb in Para athletes(p < 0.05), but with a higher relative risk under fatiguing-conditions(p < 0.01).</p><p><strong>Conclusion: </strong>External rotator muscle conditionning should be implemented in overhead Para athlete regular training to alleviate shoulder imbalance and bilateral asymmetry, especially in fatigued conditions.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740998","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}
Flynn McGuire, Andrea Carefoot, Skyler Blair, Daniel M Cushman
{"title":"Two Cases of Flexor Hallucis Longus Tenosynovitis with Highly Viscous Fluid Accumulation: the Role of Ultrasound Imaging.","authors":"Flynn McGuire, Andrea Carefoot, Skyler Blair, Daniel M Cushman","doi":"10.1097/PHM.0000000000002812","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002812","url":null,"abstract":"<p><strong>Abstract: </strong>Soft tissue injuries of the medial ankle including the Flexor Hallucis Longus (FHL) can be difficult to diagnose because of the complex functional regional anatomy. FHL tenosynovitis is a relatively uncommon but well-described phenomenon in sports that require repetitive forefoot push-off in extreme plantar flexion. Though more work needs to be done to differentiate subtleties in imaging, identifying if the fluid can be easily compressed by sonographic pressure may help differentiate a typical FHL tenosynovitis from one with viscous, ganglion-like fluid. Here we describe two cases of viscous FHL that were resistant to treatment with regular care.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726582","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}
Guilherme Cezário Felix, Elisa Pilarski, Rodrigo Ferla Martins, Alan Edmilson do Nascimento, Michel Milistetd, Rafael Lima Kons
{"title":"Performance Differences in Para Taekwondo by Impairment Profile and Sex: Implications for Evidence-Based Classification.","authors":"Guilherme Cezário Felix, Elisa Pilarski, Rodrigo Ferla Martins, Alan Edmilson do Nascimento, Michel Milistetd, Rafael Lima Kons","doi":"10.1097/PHM.0000000000002797","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002797","url":null,"abstract":"<p><strong>Abstract: </strong>Para Taekwondo has become a prominent sport within the adapted community, especially since its inclusion in the Tokyo 2020 + 1 Paralympic Games. This study aimed to explore the distribution of female and male Para taekwondo athletes across body region-specific impairments (wrist, elbow, shoulder impairment, and limbs without amputation) considering different performance outcomes (gold, silver, bronze, and non-medalists) in international competitions from 2021 to 2024. A total of 902 matches were analyzed, comprising 450 female and 452 male matches, with multiple combats per athlete across 11 World Para Taekwondo events, representing 902 individual Para athletes. Chi-square tests were used to assess associations between the body region-specific impairments and performance outcomes, with significance set at p < 0.05. The findings showed that Para taekwondo athletes with more body region-specific impairments had a significantly lower percentage of gold and silver medals compared to those with less body region-specific impairments (female: χ2 = 26.13; p = 0.002; male: χ2 = 36.04; p < 0.001). Additionally, a significant increase in participation was observed across both sexes over the past four years (χ2 = 172.25; p < 0.001). These results highlight the need to refine the Para Taekwondo classification system to ensure fairness, particularly concerning the impact of upper limb impairments on performance outcomes.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726581","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}
Nicole Whiston Andrejow, Teressa Garcia Reidy, Katlyn Billups, Ifigenia D Mougianis, Kathryn A Birnie, Danielle Ploetz, Joan Carney
{"title":"Adapting an Intensive Interdisciplinary Chronic Pain Rehabilitation Program to Address Long COVID in Youth: A Pilot Study.","authors":"Nicole Whiston Andrejow, Teressa Garcia Reidy, Katlyn Billups, Ifigenia D Mougianis, Kathryn A Birnie, Danielle Ploetz, Joan Carney","doi":"10.1097/PHM.0000000000002807","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002807","url":null,"abstract":"<p><strong>Abstract: </strong>During the COVID-19 pandemic, an established interdisciplinary pain program (IPP) pivoted to address the emerging needs of youth with Long COVID. The program used a rehabilitation model with an overarching goal of supporting youth in their return to school, activities of daily living, and social-emotional functioning by learning to cope with chronic pain and mitigate its impact on daily life. This paper describes that protocol and uses three patient cases to illustrate positive clinical changes in function and the lessons learned from adapting the IPP to pediatric patients with Long COVID.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726578","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":"Inter-limb strength asymmetry and risk of total knee replacement: a survival analysis.","authors":"Carson Halliwell, Sophie Rayner, Janie Astephen Wilson, Derek Rutherford, Brett Feltmate, Heather Neyedli, Rebecca Moyer","doi":"10.1097/PHM.0000000000002775","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002775","url":null,"abstract":"<p><strong>Objective: </strong>The current study explored the association between knee extensor strength asymmetry and the risk of total knee arthroplasty (TKA) in individuals with or at risk of knee osteoarthritis.</p><p><strong>Design: </strong>This longitudinal cohort study analyzed data from the Osteoarthritis Initiative, including 3,860 individuals with or at risk for knee osteoarthritis. Participants were categorized as having symmetrical or asymmetrical knee extensor strength based on a 10% difference between limbs. Kaplan-Meier curves and Cox regression assessed the risk of TKA over 10-years, adjusting for age, sex, body mass index (BMI), baseline Kellgren-Lawrence grade, absolute weakness, and baseline pain.</p><p><strong>Results: </strong>Participants with asymmetrical knee extensor strength had a 30% greater risk of undergoing TKA over 10-years compared to those with symmetrical strength (hazard-ratio: 1.30, 95%CI [1.05,1.62]). Limb-specific analyses revealed that a 10% reduction in right and left knee extensor strength were associated with a 40% and 80% increased risk of right and left TKA, respectively.</p><p><strong>Conclusion: </strong>Knee extensor strength asymmetry was associated with the risk of TKA in individuals with or at risk for knee osteoarthritis. Findings support the need to further examine if an intervention targeted at quadriceps strengthening aimed at achieving and maintaining strength symmetry can reduce TKA risk.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726580","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}
Susan M Linder, Ryan Rilinger, Ken Learman, Mandy Miller Koop, Matt Streicher, Sara Davidson, Courtney Miller, Donayja Harris, Patrick Corrigan, Francois Bethoux, Jay L Alberts
{"title":"Forced-rate aerobic cycling improves locomotor function and gait biomechanics in individuals with chronic stroke: A randomized controlled trial.","authors":"Susan M Linder, Ryan Rilinger, Ken Learman, Mandy Miller Koop, Matt Streicher, Sara Davidson, Courtney Miller, Donayja Harris, Patrick Corrigan, Francois Bethoux, Jay L Alberts","doi":"10.1097/PHM.0000000000002785","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002785","url":null,"abstract":"<p><strong>Objective: </strong>While cycling and walking are different motor tasks, both require the rapid reciprocal activation and relaxation of lower extremity muscles in a synergistic manner, promoting coordination patterns similar to walking. The aim of this secondary analysis was to examine the effects of forced-rate cycling on gait biomechanics post-stroke.</p><p><strong>Design: </strong>A randomized controlled trial was conducted investigating the neuroplastic effects of forced-rate cycling on upper extremity motor recovery in individuals (n = 60) post-stroke. In this secondary analysis, a subset of participants (n = 45) completed biomechanical gait assessment at baseline and post-intervention.</p><p><strong>Results: </strong>Gait velocity increased in the cycling group by 0.08 m/s and in the control group by 0.02 m/s, though a group difference was not observed (p = 0.195). Walking capacity (6-minute walk test) significantly improved by 53.3 m for the cycling group versus 15.6 m for the control group (p = 0.0036). Improvements in spatiotemporal characteristics in the cycling group included increased step length, cadence, and time spent in single-limb support, in addition to paretic limb kinetics.</p><p><strong>Conclusion: </strong>Improvements in gait velocity following forced-rate cycling were accompanied by normalization of gait biomechanics rather than exaggerated compensatory strategies, supporting the use of aerobic cycling as a viable and safe intervention to improve locomotor control post-stroke.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726579","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}