Range of motion measurements: reference values and a database for comparison studies
TL;DR: Female subjects had greater joint mobility in all age groups in nearly all joints and the gender difference was most obvious in measures of ankle plantarflexion, elbow pronation and supination.
Abstract: Many diseases and injuries can impair joint mobility Normal reference values are needed to determine extent of impairment to assess and monitor joint motion There is very little published data describing normal joint range of motion (ROM) for healthy men and women across a wide span of ages We enrolled male and female subjects aged between 2 and 69 years who were free from conditions that could potentially limit joint mobility for the study Nine licensed physical therapists used universal goniometers to determine passive joint motion bilaterally of elbow flexion, extension, supination and pronation, shoulder flexion, hip flexion and extension, knee flexion and extension, and ankle dorsiflexion and plantarflexion Descriptive statistics were calculated for male and female subjects in four age groups: 2-8, 9-19, 20-44 and 45-69 years Joint ROM measurements were obtained on a total of 674 (536% female) healthy, normal subjects aged 2-69 years Female subjects had greater joint mobility in all age groups in nearly all joints and the gender difference was most obvious in measures of ankle plantarflexion, elbow pronation and supination Range of motion average values for all joints decreased with advancing age for both men and women and, in most cases, were significantly different than most commonly used normative values Our study of ROM measurements taken by trained physical therapists on a large sample of healthy individuals revealed significant gender- and age-related variation that may be an important consideration in patient assessment
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01 Jan 2007
2,163 citations
Ghent University Hospital1, Johns Hopkins University2, Baylor College of Medicine3, Karolinska Institutet4, Johns Hopkins University School of Medicine5, National Health Service6, Royal National Orthopaedic Hospital7, University of Brescia8, Erasmus University Medical Center9, French Institute of Health and Medical Research10, Northwick Park Hospital11, Boston Children's Hospital12, University of Southern Denmark13, University College London14, Shinshu University15, Hospital for Sick Children16, St Thomas' Hospital17, Izaak Walton Killam Health Centre18, Radboud University Nijmegen19, Innsbruck Medical University20
TL;DR: The International EDS Consortium proposes a revised EDS classification, which recognizes 13 subtypes, and revised the clinical criteria for hypermobile EDS in order to allow for a better distinction from other joint hypermobility disorders.
Abstract: The Ehlers-Danlos syndromes (EDS) are a clinically and genetically heterogeneous group of heritable connective tissue disorders (HCTDs) characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Over the past two decades, the Villefranche Nosology, which delineated six subtypes, has been widely used as the standard for clinical diagnosis of EDS. For most of these subtypes, mutations had been identified in collagen-encoding genes, or in genes encoding collagen-modifying enzymes. Since its publication in 1998, a whole spectrum of novel EDS subtypes has been described, and mutations have been identified in an array of novel genes. The International EDS Consortium proposes a revised EDS classification, which recognizes 13 subtypes. For each of the subtypes, we propose a set of clinical criteria that are suggestive for the diagnosis. However, in view of the vast genetic heterogeneity and phenotypic variability of the EDS subtypes, and the clinical overlap between EDS subtypes, but also with other HCTDs, the definite diagnosis of all EDS subtypes, except for the hypermobile type, relies on molecular confirmation with identification of (a) causative genetic variant(s). We also revised the clinical criteria for hypermobile EDS in order to allow for a better distinction from other joint hypermobility disorders. To satisfy research needs, we also propose a pathogenetic scheme, that regroups EDS subtypes for which the causative proteins function within the same pathway. We hope that the revised International EDS Classification will serve as a new standard for the diagnosis of EDS and will provide a framework for future research purposes. © 2017 Wiley Periodicals, Inc.
1,075 citations
Cites background from "Range of motion measurements: refer..."
...However, joint range of motion decreases with age [Soucie et al., 2011;McKay et al., 2016] and there is an inverse relationship between age at ascertainment and the Beighton score [Remvig et al., 2007], so the cut-off of five may prompt an over-diagnosis in children and an under-diagnosis among…...
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TL;DR: Most children with neurofibromatosis type 1 and inoperable plexiform neurof Bibromas had durable tumor shrinkage and clinical benefit from selumetinib, and clinically meaningful improvements were seen in child-reported and parent-reported interference of pain and overall health-related quality of life.
Abstract: Background No approved therapies exist for inoperable plexiform neurofibromas in patients with neurofibromatosis type 1. Methods We conducted an open-label, phase 2 trial of selumetinib to...
304 citations
TL;DR: Current literature is not sufficient enough to draw firm statistically based conclusions, however, as the amount of complications seems to rise with the extent of the surgical procedure, it is advised to treat as less invasive as possible (grade C).
126 citations
Cites background from "Range of motion measurements: refer..."
...The range of motion (ROM) of the elbow joint in healthy people varies considerably and decreases during life; extension varies from 21 to 12 and flexion varies from 122 to 164 .(36) However, Morrey et al have shown that a functional arc of motion of 100 for both...
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TL;DR: The results of this study suggest that three bouts of 2-min SS of the plantar flexors is useful for preventing muscle injury, improving muscle condition, and maintaining muscle strength, and that the acute effects of SS on the muscle hardness of MG and LG are of the same degree.
Abstract: AB Purpose: The objective of this study is to investigate the acute effects of static stretching (SS) on muscle hardness of the gastrocnemius medialis (MG) and gastrocnemius lateralis (LG). Methods: Twenty young men participated in this study. MG and LG hardness was measured using shear wave ultrasound elastography before and after three bouts of 2-min SS. The measurement site of muscle hardness was at 30% of the lower leg length from the popliteal crease to the lateral malleolus. Similarly, the passive range of motion (ROM) of dorsiflexion, musculotendinous unit (MTU) stiffness determined by the slope of the portion of the passive torque-angle curve from 15[degrees] to 25[degrees], and joint torque developed during isometric maximal voluntary plantarflexion at 0[degrees] of ankle joint angle were also measured before and after SS. Results: SS increased ROM and decreased MTU stiffness significantly but did not change joint torque. The main effects of test time and muscle group on muscle hardness were significant without a significant interaction of these variables. Both differences between the relative changes in the MG and LG hardness and between the muscle hardness ratios before and after SS were not significant. A significant correlation between the muscle hardness ratios before and after SS was found. Conclusion: The results of this study suggest that three bouts of 2-min SS of the plantar flexors is useful for preventing muscle injury, improving muscle condition, and maintaining muscle strength, and that the acute effects of SS on the muscle hardness of MG and LG are of the same degree
113 citations
References
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01 Jan 2007
2,163 citations
TL;DR: These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.
Abstract: During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States. In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.
1,494 citations
TL;DR: It is likely that a gene-environment interaction, in which genetically susceptible individuals respond to an environment with increased availability of palatable energy-dense foods and reduced opportunities for energy expenditure, contributes to the current high prevalence of obesity.
1,431 citations
10 Jan 2002
TL;DR: It can be tentatively concluded that obesity is particularly common in women living in relatively poor conditions.
Abstract: The epidemiology of obesity has for many years been difficult to study because many countries had their own specific criteria for the classification of different degrees of overweight. Gradually during the 1990s, however, the body mass index (BMI; weight/height ) became a universally accepted measure of the degree of overweight and now identical cut-points are recommended. This most recent classification of overweight in adults by the World Health Organization is shown in Table 2.1 (1). In many community studies in affluent societies this scheme has been simplified and cut-off points of 25 and 30 kg/m are used for descriptive purposes. The prevalence of very low BMI ( 18.5 kg/m ) and very high BMI (40 kg/m or higher) is usually low, in the order of 1—2% or less. Already researchers in Asian countries have criticized these cut-points. The absolute health risks seem to be higher at any level of the BMI in Chinese and South Asian people, which is probably also true for Asians living elsewhere. There are some developments that indicate that the cut-points to designate obesity or overweight may be lowered by several units of BMI. This would of course greatly affect the estimates of the prevalence of obesity in these populations. For instance, the prevalence of overweight measured as BMI 27 kg/m in the 1989 China Health and Nutrition Survey (2) was 6% in the North, 3% in Central China and 1% in the South. If the cut-off point was lowered to 25 kg/m the prevalence would be increased to, respectively, 15%, 9% and 6%. In countries such as China and India, each with over a billion inhabitants, small changes in the criteria for overweight or obesity potentially increase the world estimate of obesity by several hundred million (currently estimates are about 250 million worldwide). Much research over the last decade has suggested that for an accurate classification of overweight and obesity with respect to the health risks one needs to factor in abdominal fat distribution. Traditionally this has been indicated by a relatively high waist-tohip circumference ratio. Recently it has been accepted that the waist circumference alone may be a better and simpler measure of abdominal fatness (3,4). Table 2.2 gives some tentative cut-points for the waist circumference. These are again based on data in white populations. In June 1998 the National Institutes of Health (National Heart, Lung and Blood Institute) adopted the BMI classification and combined this with waist cut-off points (6). In this classification the combination of overweight (BMI between 25 and 30kg/m ) and moderate obesity (BMI between 30 and 35kg/m ) with a large waist circumference ( 102 cm inmen or 88 cm in women) is proposed to carry additional risk.
1,275 citations
TL;DR: The data constitute a more detailed set of measurements, based on a sample described according to height and age, than has been available hitherto.
Abstract: With a clinical goniometer, we measured the arcs of active motion of the shoulder, elbow, forearm, wrist, hip, knee, ankle, and foot in 109 normal male subjects ranging in age from eighteen months to fifty-four years old. The normal limits were determined for subjects who were one to nineteen years old and for those who were twenty to fifty-four years old. Significant differences were found between the two age groups for most motions. The data were compared with estimations in the handbook of The American Academy of Orthopaedic Surgeons as the standard reference. The data constitute a more detailed set of measurements, based on a sample described according to height and age, than has been available hitherto.
670 citations