Musculoskeletal System Commons^™

The Evolution Of Body Posture In The Sagittal Plane In The Sensitive Growth Period Of Children And Adolescents Undergoing Individual Scoliosis Therapy: A Pilot Study, Barbara Rosołek, Katarzyna Smółka, Diana Celebańska, Monika Szarajew, Anna Zwierzchowska

Baltic Journal of Health and Physical Activity

Introduction: The shape of the spine in the sagittal plane undergoes evolution, which occurs specifically in children and adolescents with idiopathic scoliosis (IS). The aim of the study was to verify the variability of body features and indicators in relation to the features and parameters of body posture in children and adolescents with IS. Materials and Methods: 61 measurements of children and adolescents (three age groups) with IS were collected. Body height, body weight, waist circumference, hip circumference, scoliosis major curve angle, thoracic kyphosis angle, lumbar lordosis angle, spine length, and pelvic tilt were measured. BMI and WHtR were calculated. …

Comparing Bilateral And Unilateral Metal Stabilizers: Incision Complications In Pectus Repair, Seth Saylors, Shawn D. St Peter, Tolulope A. Oyetunji Md Mph, Nelimar Cruz-Centeno, Nitin Nadella

Research Days

Introduction: The use of metal stabilizers in minimally invasive pectus excavatum repair (MIPER) has been previously associated with multiple postoperative complications. We aimed to identify if bilateral metal stabilizers increase the risk of incision complications when compared to unilateral stabilizers.

Methods: Institutional Review Board approval was obtained. Patients that underwent MIPER with metal stabilizers from 2019 to 2022 and currently had the bar in place, at a single tertiary care pediatric center, were included. A telephone survey evaluated if they had incision-associated symptoms, and if the location was congruent with the stabilizer site. A retrospective chart review was performed to …

Health Disparities In Slipped Capital Femoral Epiphysis (Scfe) Presentation, Rithika Ginjupalli, George Thomas, Rohit Siddabattula, Richard M. Schwend, Caleb Grote

Research Days

This study identifies various health disparities in SCFE presentations using neighborhood-level determinants COI and ICE in addition to sociodemographic determinants such as race and gender.

Sensory Dysfunction And The Role Of Nrf2 In The Production Of Pain In Chronic Hindlimb Ischemia, Oliver Kitzerow

Theses & Dissertations

Peripheral arterial disease (PAD) is a progressive and debilitating atherothrombotic disorder that is estimated to impact >200 million people worldwide. Higher physical activity levels are associated with better overall survival rates, slower decline of functional capability, and improved quality of life. However, intermittent claudication, pain produced by physical activity, severely limits functional capacity in PAD patients. Despite known sensory dysfunction and documented neuropathy in diseased patients, the neural mechanisms that produce pain in PAD are yet to be identified. Importantly, few animal models of hindlimb ischemia (HLI) successfully recapitulate chronic human PAD. We developed a chronic animal model of HLI …

Identifying Chewing Alterations In A Parkinsonian Model, Nicholas Zanghi, Taylor Good, Shivam Patel, Francois Gould

Rowan-Virtua Research Day

Patients suffering from Parkinson’s Disease will typically experience a range of motor and nonmotor symptoms. Characteristic signs of Parkinson’s include pill-rolling tremor, stooped posture, and shuffling gate. Patients with this disease can also develop oropharyngeal dysfunction, which can disable patients from meeting their physiologic needs. Understanding this disability and the changes in mastication kinematics can lead to potential future treatment. Our study induced Parkinson’s in rats with rotenone injections. Their jaw kinematics were identified through fluoroscopy of radio-opaque beads implanted into different areas of their jaws. The Parkinson’s induction altered mastication significantly with an increase in anterior/posterior range of motion …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Investigating The Factors That Lead To Sports Related Injuries In Children, Kinjal Shah, Shawna Rotoli

Rowan-Virtua Research Day

This project’s focus is to investigate if playing contact versus non-contact sports at a young age leads to more sports related injuries and to identify which factors correlate with increased injury rate in order to develop the most effective prevention and treatment methods. Data was collected through a survey including questions that delve deeper to quantify the amount of strain being put on the youth athlete’s body such as hours played a week, level of competitiveness, weeks played in a year, contact versus non-contact sport, and number of sports played. The following set of questions then addressed the actual injury …

Case Report: Hidden Posterior Dislocation Of The Clavicular Head, David F. Koziel

Rowan-Virtua Research Day

Reported is a case of a 24-year-old male who presented with left shoulder pain and decreased range of motion of the same shoulder upon awakening, diagnosed with a posterior dislocation of the proximal clavicle, with the clavicular head residing in the mediastinum. In the conscious, ambulatory, young adult it is arguably much more common for major bony trauma involving the upper extremity and shoulder to present with pain, deformity, and a known mechanism. This is an example that lacks all three of these characteristics and highlights the importance of details in the physical examination as well as clinical gestalt.

Evaluation Of Unexplained Bone Fractures In A 3-Month-Old Infant – A Case Report, Hannah Ngo, Rachel Silliman Cohen

Rowan-Virtua Research Day

Child physical abuse is a significant cause of injury in infants and young children and can present in a variety of ways. Failure to recognize abuse in infants and young children can be life-threatening and is often recurrent until safety interventions occur. Consequently, it is of paramount importance that providers strongly consider child physical abuse on the differential, along with metabolic bone disease and accidental traumatic injury, when evaluating fractures in young children and infants. This case report will focus on the evaluation of a 3-month-old male infant who was admitted to the hospital with irritability and decreased right arm …

Utilizing Microwave Ablation In Combination With Vertebroplasty Is An Effective Method In Reducing Cancer Related Back Pain, Disability, And Opioid Use: A Systematic Review And Meta-Analysis, Jonathan Elias, Lothar Vidal, Richard Jermyn

Rowan-Virtua Research Day

Background: It is estimated that metastases from primary malignant neoplasms affect the spine around 30%-70% of the time. Many times, these osteolytic tumors will cause the degradation of the vertebrae, leaving patients in a tremendous amount of pain, disability, and dependence on opioids as analgesics. Microwave ablation (MWA) followed by vertebroplasties (VP) has been a developing treatment for such a condition; however, there are no systematic reviews or meta-analyses examining the method’s effectiveness thus far.

Purpose: This systematic review and meta-analysis analyzes the 4-week and 12-week outcomes of patients with metastatic spinal cancer treated with the combinatorial treatment …

Complications Following Hemivertebrectomy For Congenital Scoliosis, Sanjana Davuluri, Taemin Oh, Kyrillos Akhnoukh, Zachary Weingrad, Michael Lesgart, Terrence Ishmael, Joshua Pahys, Amer Samdani, Steven Hwang

Rowan-Virtua Research Day

Introduction:

Hemivertebrae are rare congenital anomalies that can cause severe scoliosis requiring surgical correction. We aimed to determine whether severity of deformities is associated with more long-term surgical complications following surgical correction.

Methods:

We performed a retrospective, single-institution review on patients who underwent hemivertebrectomy and spinal fusion for congenital scoliosis between 2008-2020. We extracted pertinent data on demographics, radiographic parameters, operative details, and complication rates. Subgroup analyses were also done by complication severity, deformity complexity, and construct length.

Results:

In our series, 30 patients underwent hemivertebrectomy and fusion. Mean age was 9±4.2 years and there was 2:1 male preponderance, with …

Effect Of Exercise Intervention On Facioscapulohumeral Muscular Dystrophy (Fshd), John Desrochers

Rowan-Virtua Research Day

Facioscapulohumeral Muscular Dystrophy (FSHD) is a common muscular dystrophy. The facial muscles, shoulder girdles, and upper arms are notably affected.¹ A common presenting symptom is asymmetrical scapular winging and further symptoms may include but are not limited to: loss of pectoral muscles, fatigue, severe pain, pathologic spinal curvatures, and foot drop.² It is a particularly debilitating muscular dystrophy, with 20% of people >50 y.o. requiring a wheelchair.³ With no approved therapeutics, patients are managed symptomatically.³ This review sought to determine the effect of different exercise interventions on patients with FSHD. It is hypothesized that exercise may …

Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch

Student Scholar Symposium Abstracts and Posters

Retraining impaired gait is essential in post-stroke recovery. This project aims to determine between day variability of spatiotemporal gait measures in treadmill walking post-stroke to differentiate between changes due to the intervention and measurement errors due to between day test-retest variability. Six individuals post-stroke performed a two-minute walk test at a self-selected speed (SSS) for two consecutive days. SSS was assessed through the six-minute walk test. Reflective markers were placed on anatomical landmarks (van den Bogert et al. 2013). The heel markers were used for step detection. We calculated spatiotemporal parameters: stride length, stride time, step length, stance time, and …

Pain Management In Individuals With Flat Feet Using The Footcore Max, Avery G. Dilley

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Foot pain can significantly affect one’s quality of life and ability to perform activities of daily living. Current interventions for foot pathologies are often directed at externally supporting the foot, rather than training the small, intrinsic muscles to function as they are intended to. The FootCore MAX is an exercise device designed to strengthen and promote better activation of the intrinsic muscles of the foot in order to improve foot function.

Purpose: The purpose of this study was to determine the effectiveness of intrinsic foot strengthening exercises using the FootCore MAX on alleviating foot pain. It hypothesized that the …

Qualitative Vs. Quantitative Train Of Four, Caleb Culbreath

Doctor of Nursing Practice Projects

The growing body of evidence linking residual neuromuscular blockade (NMB) to postoperative complications has underscored the need to integrate quantitative neuromuscular monitoring techniques into anesthesia practice. This study, conducted at a tertiary care center in southern Illinois, investigates the gap between current clinical practices and the latest evidence advocating for objective monitoring. The study utilized a non-experimental pretest-posttest design to evaluate an educational intervention's effectiveness in increasing anesthesia providers' knowledge of quantitative neuromuscular monitoring techniques and enhancing their awareness of the incidence and clinical implications of postoperative residual neuromuscular blockade. Analysis of the pretest and post-test responses revealed significant improvements …

Numerical Variations In The Thoracic And Lumbar Vertebrae Within The John A. Williams Skeletal Collection, Western Carolina University, Cullowhee, Nc (Usa), Leanna Annette Sanford

Department of Anthropology: Theses and Student Research

This research is on how human variation can lead to the identification of remains based on skeletal variation. The data were collected by performing a morphoscopic trait study of the John A. Williams (J.A.W.) Documented Human Skeletal Collection at Western Carolina University in Cullowhee, NC (USA). Morphoscopic traits are nonmetric traits, visually identified using the knowledge of osteology. The study was performed to study variation of the vertebral column, specifically focusing on morphoscopic traits of the thoracic and lumbar vertebrae. The focus of this research is centralized on the presence of numerical variations in the vertebral column such as eleven …

The Osteobiography Of Human Remains From The Seaview And Indian Town Trail Archaeological Sites, Maggie M. Klemm

Department of Anthropology: Theses and Student Research

Extensive site surveys and excavations on the Island of Barbuda led by Sophia Perdikaris have identified over 62 sites spanning from the Archaic time period to Historic times. Over the last 18 years, these multidisciplinary teams have focused on mapping all sites and performing rescue excavations on sites threatened by sea level rise, erosion or development. Two such sites are the Saladoid site of Seaview (BA016) and the Troumassoid site of Indian Town Trail (BA01). The dunes surrounding the site of Seaview receive the brunt of storms and hurricanes. In 1998 hurricane Georges exposed skeletal material now part of the …

Blood Flow Restriction Therapy: A Review Of Physiology, Clinical Application, And Guidelines For Implementation, Nathan Schuliger

Senior Honors Theses

Blood flow restriction (BFR) therapy is an emerging clinical modality utilizing the metabolic stress of a hypoxic state to induce hypertrophic and strength adaptations in a manner allowing for reduced external loading. BFR has a variety of applications in rehabilitation settings, showing great potential for patients seeking the benefits of high intensity training without the associated degrees of mechanical stress. This literature review details the proposed mechanisms of BFR, along with various clinical applications of BFR including active and aerobic BFR. Concerns and contraindications for BFR usage are discussed regarding certain clinical populations, with risk stratification recommendations provided. Current BFR …

Idiopathic And Neuromuscular Scoliosis In A Female College Basketball Player Requiring Spinal Correction Surgery, Magan Kim

UNO Student Research and Creative Activity Fair

The purpose of this report is to present the case of a 20-year-old female collegiate basketball player who was diagnosed with a combination of idiopathic and neuromuscular scoliosis. Patient underwent thoracic spinal fusion surgery when she was 15 to resolve her extreme scoliosis. The uniqueness of this case stems from the athlete’s urgency to have to undergo a life-altering spine operation and still be able to successfully contribute to a collegiate basketball team. Athletic trainers should be knowledgeable and aware of how to maintain treatment/rehabilitation for athletes with scoliosis, operative or non-operative. Scoliosis should no longer be a reason to …

Acute Simultaneous Medial And Lateral Ankle Sprain In A Collegiate Football Player: A Case Report, Ian Matlack

UNO Student Research and Creative Activity Fair

The purpose of this case report is to present a twenty-year-old African American male with a complex ankle injury. During a collegiate football game, the athlete injured his left ankle, damaging his deltoid ligament complex, and lateral ankle complex, causing several bone bruises and tearing his peroneal retinaculum. With surgery being declined, standard rehabilitation protocols of POLICE for initial management of inflammation, strengthening, and ROM exercises were conducted. Manual therapies consisting of milking massage, scraping, and joint mobilizations were added to aid in pain and edema control. Comparative case studies suggest that the athlete may have experienced a subluxation of …

Anterior Cruciate Ligament Hybrid Remnant Preservation Reconstruction Demonstrates Similar Outcomes As Traditional Reconstruction After 6 Months: A Randomized Control Trial, Joshua P. Castle, Eleftherios L. Halkias, Brittaney Pratt, Ashley Frei, Matthew A. Gasparro, Vasilios Moutzouros

Medical Student Research Symposium

Background

The anterior cruciate ligament (ACL) is often debrided during reconstruction (ACLR) to improve visualization. However, remnant ACL tissue contains nerve fibers and including remnant tissue in ACLR could provide benefit. Therefore, a technique was developed that preserves the tibial remnant and incorporates it into ACLR: Hybrid Remnant Preservation Reconstruction (HRPR) ACLR. This study compares HRPR-ACLR to traditional reconstruction by comparing patient reported outcomes and complications.

Methods

Patients presenting to one surgeon's clinic with an ACL injury are screened. Exclusion criteria are patient age<14 years, multi-ligament injury, chronic tears, and revision ACLR. Patients are consented and randomized to HRPR or traditional ACLR. Demographics, patient-reported outcomes, range of motion (ROM) and complications were collected.

Results

Thirty-three patients were included, 20 HRPR and 13 controls. No demographic differences were noted. PROMIS-PF, …

An Emg Study To Evaluate Chewing Efficiency And Maximum Voluntary Clenching (Mvc) For Different Malocclusion Groups Before And During Orthodontic Treatment, Vivek Reddy

Annual Research Symposium

The purpose of this study was to investigate the efficacy of chewing and maximum voluntary clenching (MVC) of patients with different malocclusion types by measuring the EMG activity in the masseter and temporalis muscles before and during orthodontic treatment.

Overlooked Dental Disease In Cbct Imaging And The Impact Of Oral Radiologist Interpretation, Jared Fausnaught

Annual Research Symposium

This study aims to underscore the necessity for a comprehensive interpretation of Cone Beam Computed Tomography (CBCT) volume images obtained by dentists. The research demonstrates and quantifies potentially overlooked dental pathology, categorizing incidental findings into three groups: 1) requiring some form of treatment or follow-up, 2) necessitating follow-up (monitoring) only, and 3) demanding no further treatment or follow-up.

Macrocephaly And Digital Anomalies Expand The Phenotypic Spectrum Of Pgap2 Variants In Hyperphosphatasia With Impaired Intellectual Development Syndrome 3 (Hpmrs3), Seda Susgun, Afif Ben-Mahmoud, Franz Rüschendorf, Bonsu Ku, Syeda Iqra Hussain, Solveig Schulz, Oliver Puk, Saskia Biskup, Jonathan D.J. Labonne, Dilan Wellalage Don, Vijay Gupta, Tae Ik Choi, Saadullah Khan, Naveed Wasif, Yves Lacassie, Lawrence C. Layman, Sibel Aylin Ugur Iseri, Cheol Hee Kim, Hyung Goo Kim

School of Medicine Faculty Publications

Glycosylphosphatidylinositols (GPIs) anchor over 150 proteins as GPI-anchored proteins (GPI-APs) with crucial roles in diverse biological processes. The highly conserved biosynthesis of GPI-APs involves precise steps with at least 21 genes, categorized as PIG and PGAP genes. Pathogenic variants in these genes are linked to human diseases, highlighting the importance of each biosynthesis step. PGAP2 stands out among these genes due to its association with an expanded clinical spectrum of neurodevelopmental disorder (NDD) phenotypes with biallelic pathogenic variants. We present four patients from two families, one consanguineous and the other nonconsanguineous, each displaying distinct clinical presentations, including intellectual disability, hyperphosphatasia, …

Ultrasound-Guided Erector Spinae Plane Block: An Objective Structured Clinical Examination For First-Year Anesthesia Providers, Andrew Edwards, Jonathan Mardis

Doctoral Projects

The use of ultrasound-guided regional anesthesia (UGRA) in anesthetic practice is an invaluable tool for anesthesia providers to implement into their daily practice. One of these regional techniques is the erector spinae plane block (ESPB) which has anesthetic implications in numerous surgical procedures including cervical spine, thoracolumbar spine, thoracic wall, and chest wall procedures. Because of the novelty of this regional anesthetic technique, it is important to educate first-year anesthesia providers about the implications, skillset, and complications of the ESPB.

To bridge the gap between didactic knowledge and clinical practice in first-year anesthesia providers, an objective structured clinical examination (OSCE) …

Comparative Analysis Of Inpatient And Outpatient Total Hip Arthroplasty: Cost, Rehabilitation, And Complexity, Kam Maghazehe

MUSC Theses and Dissertations

Background: Osteoarthritis in the hip joint leads to worn or damaged cartilage, resulting in bones scraping against each other. This scraping creates rough surfaces, causing significant pain and limiting mobility in daily activities. THA becomes necessary when other less invasive options fail to alleviate symptoms such as pain, stiffness, swelling, and reduced range of motion. Due to high out-of-pocket costs and the rapid spread of COVID-19, CMS took a substantial stride in healthcare policy by introducing the CMS-1736-FC ruling in December 2020. This ruling, effective from January 2021, facilitated the reclassification of eleven procedures, including Total Hip Arthroplasties (THAs), from …

Assessments Used By Athletic Trainers To Decide Return-To-Activity Readiness In Patients With An Ankle Sprain, Ryan S. Mccann, Cailee E. Welch Bacon, Ashley M. B. Suttmiller, Phillip A. Gribble, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Athletic trainers (ATs) often care for patients with ankle sprains. Expert consensus has been established for rehabilitation-oriented assessments (ROASTs) that should be included in ankle-sprain evaluations. However, the methods ATs use to determine return-to-activity readiness after an ankle sprain are unknown.

Objectives: To identify ATs' methods for determining patients' return-to-activity readiness after an ankle sprain and demographic characteristics of the ATs and their methods.

Setting: Online survey.

Design: Cross-sectional study.

Patients or Other Participants: We recruited 10 000 clinically practicing ATs. A total of 676 accessed the survey, 574 submitted responses (85% completion rate), and 541 respondents met the …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Actin Depolymerization Of Tenocytes Promotes A Tendinosis-Like Gene Expression, Kameron Inguito, Ba, Valerie West, Karl Matthew Ebron, Justin Parreno, Phd

Alpha Omega Alpha Research Symposium Posters

Optimal cellular mechanotransduction is essential for tendon matrix homeostasis. We recently developed an in vivo rat model of tendinosis, where the plantaris tendon are overloaded through ablation of the synergistic Achilles tendon. Using this model we determined that tissue overload disrupts matrix-cell interactions, which results in under-stimulation of tendon cells (tenocytes) (Fig.1)

Using an ex vivo model of tendon stress deprivation by maintaining tail tendon fascicles in floating culture we showed that tenocyte under-stimulation results in destabilization of filamentous (F-)actin (Fig.2). F-actin destabilization coincides with tendinosis-like gene expression: downregulation of tenogenic genes (Col1, Tnc, asma, Scx), upregulation of chondrogenic (Acan, …

Hamstring And Quadriceps Activation During Single Leg Hopping At Varying Frequencies: Electromyography Analysis, Jemma Bosselman

Scripps Senior Theses

Identification of knee motor control strategy is salient both for biomechanical understanding of the lower limb and for medical applications. Integral to knee function are the quadriceps and hamstring, an antagonistic muscle pair. Sub-optimal relative activation of the pair can increase injury potential. Muscle activation patterns are largely activity specific, necessitating muscle control research across various tasks. Single leg hopping has been sparsely studied, particularly for muscle activation in relation to hopping frequency. This project thus aimed to determine the effect of single leg hopping frequency on quadriceps and hamstring activation using surface electromyography (EMG), with the vastus lateralis (VL) …