Does range of motion measurement and reference values differ?: a multi-centered study

This study is aimed to estimate and measure reference values in the normal range of motion of extremity joints in females and to provide a database for the assessment of impairments related to the mobility of the joints. This observational cross-sectional study was conducted at seven major educational institutes areas of Rawalpindi and Islamabad in Pakistan from January to June 2020 with a sample size of 600 healthy females aged 15 to 45 years and divided into three groups through non-probability sampling technique. In study Instruments, an electronic Goniometer was used for the measurement of the range of motions for different joints and then those ranges were recorded. The questionnaire had two sections demographic characteristics and ROM for both upper and lower limbs. Data was analyzed using SPSS V21. A p < 0.05 was considered statistically significant.In the result,Out of 600 participants,there was a statistically significant difference of (p < 0.001) in both upper and lower extremities motion between all the three groups for the measurements and noticeably no significant difference (p > 0.005) between group 1, 2 comparisons for the knee joint extension.To conclude, In most joints, the range of motion increases with age. The transition from group 1 to group 2 was aided by increased hormone participation in growth, an active lifestyle, and generally good health. Because of degenerative changes and joint stiffness, group 3's range of motion deteriorated, leading to a sedentary lifestyle and lack of physical activity. Standardized biomechanical measurements can help health practitioners, such as physiotherapists, choose appropriate therapy interventions to assess musculoskeletal disorders. To resolve the inconsistencies in the reliability and validity of goniometry values, more research is required.

Analysis of postural control and muscle function performance of older adults participating in a multicomponent exercise program in primary health care / Análise do desempenho do controle postural e da função muscular de idosos participantes de um programa de exercício multicomponente na Atenção Primária à Saúde

Objectives: This cross-sectional study aimed to investigate (1) postural control performance in different postural tasks and (2) muscle strength and power of the hip, knee, and ankle of active vs inactive older adults. Methods: The sample consisted of 61 healthy community-dwelling older adults, classified into 2 groups: active, consisting of participants of a multicomponent exercise program offered through the Exercise Orientation Service; and inactive. Participants were considered physically active/inactive in the past 3 months. Postural control was assessed using a force plate in 8 postural tasks. Muscle function was evaluated using an isokinetic dynamometer. T-tests were used to compare clinical characteristics between the groups. ANCOVA and MANCOVA were used to compare differences in variables of postural control and muscle function. Results: Active participants had higher levels of physical activity, clinical balance, and quality of life than inactive participants. The active group had lower values for area (center of pressure) than the inactive group under the following conditions: bipedal stance on an unstable surface with eyes open and with eyes closed, and semi-tandem stance on an unstable surface with eyes open. The active group showed greater muscle power, with higher mean power values for hip abduction and adduction, knee extension, and knee flexion and shorter time to peak torque for hip adduction and ankle dorsiflexion than the inactive group. Conclusions: Multicomponent exercise programs delivered in primary health care settings contributed to improving postural control and muscle power in this sample of older adults, which can potentially help prevent falls and improve quality of life.

Objetivo: Este estudo transversal visou investigar: (1) o desempenho no controle postural em diferentes tarefas e (2) a força e a potência musculares de quadril, joelho e tornozelo de idosos ativos vs. inativos. Metodologia: A amostra foi composta de 61 idosos comunitários saudáveis, classificados em dois grupos: os ativos, participantes do programa de exercício multicomponente ofertado pelo Serviço de Orientação ao Exercício, e os inativos. Os participantes foram considerados fisicamente ativos/inativos nos três meses anteriores. O controle postural foi avaliado em oito tarefas usando-se uma plataforma de força. A função muscular foi mensurada com um dinamômetro isocinético. Foram utilizados testes t para comparar as características clínicas entre os grupos. Análise de covariância e análise multivariada de covariância foram utilizadas para comparar diferenças nas variáveis de controle postural e função muscular. Resultados: Os participantes ativos apresentaram maiores níveis de atividade física, equilíbrio e qualidade de vida que os inativos. O grupo ativo apresentou menores valores de área (centro de pressão) que o inativo nas seguintes condições: base bipodal em superfície instável com olhos abertos e fechados e base semitandem em superfície instável com olhos abertos. O grupo ativo apresentou maior potência que o inativo, com maior valor de potência média para abdução e adução de quadril, extensão e flexão de joelho, e menor tempo de pico de torque para adução de quadril e dorsiflexão de tornozelo. Conclusão: Programas de exercício multicomponente ofertados na Atenção Primária à Saúde contribuíram para melhorar o controle postural e a potência muscular nesta a

Anatomical and physiological considerations in the 'hip rotators test' related to the stomatognathic system: a brief commentary / Consideraciones anatomofisiológicas en el "test de rotadores de cadera" relacionado con el sistema estomatognático: un breve comentario

Manual tests in clinical investigation must be supported by anatomical and physiological findings in order to obtain an objective information. The application of different mandibular positions in children obtains a variation in the 'hip rotators test' (p < 0.001). The possible relationships behind the muscle tone of the external rotators of the hips and the stomatognathic system are exposed, with special attention on the fascial tissue and its morphological characteristics. Despite these anatomical and physiological connections, there is no further evidence of a strong cause-effect relationship in this test.

Las pruebas manuales en la investigación clínica deben estar respaldadas por hallazgos anatómicos y fisiológicos para obtener una información objetiva. La aplicación de diferentes posiciones mandibulares en niños muestra una variación en la "prueba de rotadores de cadera" (p <0,001). Se exponen las posibles relaciones del tono muscular de los rotadores externos de las caderas y el sistema estomatognático, con especial atención en el tejido fascial y sus características morfológicas. A pesar de estas conexiones anatomofisiológicas, no existe una evidencia mayor de una relación importante causa-efecto en esta prueba.

Medo de quedas e força muscular do quadril em idosos independentes da comunidade / Miedo a caerse y fuerza muscular de cadera en ancianos independientes de la comunidad / Fear of falling and hip muscular strength in independent older adults of the community

RESUMO O medo de quedas pode fazer com que o idoso desenvolva estratégias que alteram o equilíbrio semiestático e dinâmico, predispondo-o a um risco aumentado de cair. A função muscular dos abdutores e adutores de quadril tem importante papel na manutenção da estabilidade postural. Entretanto, não se sabe se idosos com medo de cair apresentam maior comprometimento na função muscular do quadril. Assim, o objetivo foi comparar o pico de torque (PT) isométrico dos músculos abdutores e adutores de quadril entre idosos com e sem medo de quedas. Os participantes foram divididos em dois grupos: com (n=81) e sem (n=81) medo de quedas. O PT dos abdutores e adutores de quadril foi obtido com dinamômetro isocinético (System 4 Pro, Biodex, Nova York, EUA). A comparação do PT dos grupos foi realizada por meio de modelo linear geral univariado, ajustado pelas covariáveis idade, sexo, índice de massa corporal, nível de atividade física e histórico de quedas, utilizando o software SPSS 17.0, com nível de significância de 5%. Não houve diferença do PT abdutor e adutor do quadril entre os grupos após análise univariada com ajustamento. Observou-se que idosos com medo de quedas não apresentam prejuízos na função muscular dos estabilizadores de quadril quando comparados a idosos sem medo de quedas.

RESUMEN El miedo a caerse puede hacer que los ancianos desarrollen estrategias de alteración del equilibrio semiestático y dinámico, predisponiéndolos a un mayor riesgo de caídas. La función muscular de los abductores y de los aductores de cadera juega un papel importante en el mantenimiento de la estabilidad postural. Sin embargo, no se sabe si los ancianos con miedo a caerse tienen un mayor deterioro en la función muscular de la cadera. Por lo tanto, el objetivo fue comparar el torque máximo (TM) isométrico de los músculos abductores y aductores de cadera entre los ancianos con miedo y sin miedo a caerse. Los participantes se dividieron en dos grupos: con miedo a caerse (n=81) y sin (n=81) miedo a caerse. El TM de los abductores y aductores de cadera se obtuvo mediante la utilización del dinamómetro isocinético (System 4 Pro, Biodex, Nueva York, EE.UU.). La comparación del TM de los grupos se realizó mediante un modelo lineal general univariado, ajustado por covariables edad, género, índice de masa corporal, nivel de actividad física e historial de caídas, utilizando el software SPSS 17.0, con nivel de significancia del 5%. No hubo diferencias entre el TM del abductor y del aductor de cadera entre los grupos tras el análisis univariado con ajuste. Se observó que los ancianos con miedo a caerse no presentaron daños en la función muscular de los estabilizadores de la cadera en comparación con los ancianos sin miedo a caerse.

ABSTRACT The fear of falling can cause older adults to develop strategies that alter the semi-static and dynamic balance, predisposing them to increased risk of falling. The muscular function of abductors and adductors plays an important role in maintaining postural stability. However, it is unknown whether older people with fear of falling have greater impairment in hip muscular function. Thus, the objective was to compare the isometric peak torque (PT) of hip abductor and adductor muscles among older adults with and without fear of falling. Participants were divided into two groups: with (n=81) and without (n=81) fear of falling. The PT of hip abductors and adductors was obtained with isokinetic dynamometer (System 4 Pro, Biodex, New York, USA). The PT groups were compared using general linear model univariate, adjusted for covariates age, sex, body mass index, physical activity level and history of falls, using the SPSS 17.0 software, with a significance level of 5%. No difference was found between the PT of hip abductor and adductor and the groups after univariate analysis with adjustment. We observed that older people with fear of falling have no muscle function loss of the hip stabilizers when compared with subjects without fear of falling.

Characteristics and Trends of Published Adult Hip Research over the Last Decade

PURPOSE: We designed this study to demonstrate recent trends in the proportion of adult hip research in orthopedics, to identify countries leading the adult hip research, and to evaluate the relationship between the economic power of the countries and their contributions. MATERIALS AND METHODS: Studies published in seven select orthopedic journals were retrieved from PubMed. Among them, we determined the number of adult hip studies. The countries-of-origin of adult hip studies, and the economic power of the countries were investigated. RESULTS: A total of 7218 orthopedic publications and 1993 (27.6%) addressed adult hip research were identified. Adult hip studies increased from 313 (23.7%) in 2000 to 555 (27.9%) in 2011. Twenty-five countries accounted for 97.6% of the total number of adult hip studies, and gross domestic product correlated with publication volume (Spearman's rho, 0.723; p=0.000). CONCLUSION: Researchers from a limited number of developed countries have published their studies in the adult hip discipline.

Effects of Community-based Comprehensive Fall Prevention Program on Muscle Strength, Postural Balance and Fall Efficacy in Elderly People

PURPOSE: The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. METHODS: The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using chi2-test, independent t-test and paired t-test using the SPSS program. RESULTS: Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. CONCLUSION: These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

[Electromyographic activity of the vastus medialis obliques and vastus lateralis longus muscles during squat with isometric hip adduction in athletes with patellofemoral pain syndrome and healthy athletes]

Patellofemoral is a pain syndrome, common among athletes and the theraputic regiment based on the improvement of muscle involved in this disorder. This study was done to compare electromyography activity of the vastus medialis obliques and vastus lateralis longus during squat with isometric hip adduction in athletes with patellofemoral pain syndrome and healthy athletes. This case-control study was carried out on 16 national team male athletes [volleyball, handball and taekwondo] aged 30-18 years with patellofemoral pain syndrome and 16 healthy male athletes. Subjects were matched based on weight, height, age, dominant of lower extremity and voluntarily participated. Electromyography activity of vastus medialis obliques and vastus lateralis longus muscles recorded by surface electrodes at 15, 30 and 45 knee flexion degrees. Paired t test was used to compare electromyography activities in each group and One-way ANOVA and Tukey post hoc test was used to compare each muscle in different angles. There was significant differences in the activity of vastus medialis obliques and vastus lateralis longus muscles in athletes with patellofemoral pain syndrome at 45 knee flexion degree [P<0.05]. There were no significant differences between the muscle activities in healthy athletes at none of the knee flexion degrees. There were significant differences in the activity of vastus medialis obliques [P<0.05] and vastus lateralis longus [P<0.05] muscles at 45 degrees in comparison with muscle activities in each group in knee flexion degrees. Electromyography activity of the vastus medialis obliques in healthy athletes during squat with isometric hip adduction at 45 knee flextion is greater than other degrees and in athletes with patellofemoral pain syndrome is greater than healthy athletes

Ativação muscular estabilizadora da patela e do quadril durante exercícios de agachamento em indivíduos saudáveis / Muscular activity of patella and hip stabilizers of healthy subjects during squat exercises

CONTEXTUALIZAÇÃO: Atualmente relaciona-se a fraqueza dos músculos do quadril e da coxa ao surgimento da dor anterior no joelho (DAJ). Dessa maneira, compreender como os agachamentos devem ser realizados para melhorar a ativação elétrica desses músculos é importante para o tratamento fisioterapêutico. OBJETIVO: Comparar a ativação mioelétrica de estabilizadores da patela e pelve entre as posições de agachamentos convencional e associado à contração isométrica em adução e abdução da coxa em indivíduos sem queixa de DAJ. MÉTODOS: O sinal eletromiográfico foi captado a partir de eletrodos duplo-diferenciais posicionados nos músculos vasto medial oblíquo (VMO), vasto lateral oblíquo (VLO), vasto lateral longo (VLL) e glúteo médio (GMed) em 15 mulheres sedentárias e clinicamente saudáveis, durante a contração de agachamentos convencional e associados à adução e à abdução isométrica da coxa com carga de 25 por cento do peso corporal. A análise estatística empregada foi o modelo linear de efeitos mistos, com significância de 5 por cento. RESULTADOS: A associação da adução e abdução isométrica da coxa no agachamento produziu cerca de 0,47 (0,2) e 0,59 (0,22), respectivamente, de atividade elétrica do músculo GMed, enquanto o agachamento convencional (AGA) produziu 0,33 (0,27) de atividade elétrica. A maior ativação do VMO aconteceu na contração de agachamento associado à adução da coxa e foi de 0,59 (0,27); já o músculo VLL apresentou uma maior atividade elétrica durante o agachamento associado à abdução, sendo de 0,60 (0,32). CONCLUSÃO: O exercício de agachamento associado à adução da coxa promoveu uma maior ativação muscular do VMO, além de aumentar a atividade muscular do GMed.

BACKGROUND: Hip and knee muscle weaknesses have been associated with the onset of anterior knee pain (AKP). Therefore, the understanding of how squats exercises can be performed in order to optimize the electrical activity of these muscles is relevant for physical therapy treatments. OBJECTIVE: To compare the electromyographic activity of patella and pelvic stabilizers during traditional squat and squat associated with isometric hip adduction or abduction in subjects without AKP. METHODS: Electromyography signals were captured using double-differential electrodes at the vastus medialis obliquus (VMO), vastus lateralis obliquus (VLO), vastus lateralis longus (VLL) and gluteus medium (GMed) in 15 healthy and sedentary women during squats exercises: traditional and associated with hip adduction and hip abduction with load of 25 percent of body weight. Linear mixed models with significance level of 5 percent were used for data analysis. RESULTS: Squat associated with hip adduction and abduction produced electromyographic activity of GMed of 0.47 (0.2) and 0.59 (0.22) respectively, while conventional squat produced an electromyiographic activity of 0.33 (0.27). The higher VMO activity was 0.59 (0.27) during the isometric contraction in the squat associated with hip adduction. The higher VLO activity was 0.60 (0.32) during isometric contraction in the squat associated with hip abduction. CONCLUSION: Squat exercise associated with hip adduction increased VMO muscle activity as well as the activity of GMed activity.

Análise do torque de resistência e da força muscular resultante durante exercício de extensão de quadril no Pilates e suas implicações na prescrição e progressão / Assessment of resistance torque and resultant muscular force during Pilates hip extension exercise and its implications to prescription and progression

CONTEXTUALIZAÇÃO: A análise da mecânica externa dos exercícios de Pilates e da biomecânica das articulações pode subsidiar a prescrição de exercícios na reabilitação. OBJETIVOS: Avaliar o comportamento do torque de resistência (ΓR) do exercício de extensão de quadril (EQ) realizado no Cadillac; realizar uma análise biomecânica a partir do comportamento do ΓR e das distâncias perpendiculares médias ponderadas (DPMPs) para estimar a força muscular resultante (FM R) dos extensores e flexores e propor critérios mecânicos para progressão do exercício de EQ realizado no Cadillac. MÉTODOS: Catorze praticantes de Pilates realizaram EQ no aparelho Cadillac em quatro situações em ordem aleatorizada - usando duas molas (vermelha e azul) fixadas em duas posições (alta e baixa). As posições angulares foram coletadas por meio de eletrogoniometria. Para o cálculo do ΓR, torque muscular (ΓM) e da FM R foram usados diagramas de corpo livre e equações de movimento. Os valores de DPMP dos músculos flexores e extensores do quadril foram quantificados usando dados da literatura. RESULTADOS: O ΓR e a FM R apresentaram comportamentos semelhantes em todas as situações, entretanto os valores máximos de ΓR não ocorrem na mesma posição articular que a FM R máxima. A DPMP dos flexores de quadril apresentou um comportamento crescente-decrescente, com máximo próximo aos 55º de flexão, enquanto os extensores de quadril apresentaram comportamento semelhante, com máximo próximo aos 25º de flexão. CONCLUSÃO: A análise biomecânica do exercício e a avaliação das características mecânicas associadas à articulação do quadril podem ser usadas como critérios objetivos de prescrição e progressão do exercício de EQ no Pilates.

BACKGROUND: The understanding of the external mechanics of Pilates exercises and the biomechanics of the joints may guide the prescription of rehabilitation exercises. OBJECTIVES: To evaluate the resistance torque (ΓR) during hip extension (HE) exercises performed on the Pilates Cadillac. To perform a biomechanic analysis of the ΓR and the weighted mean moment arm (WMMA) in order to calculate the resultant muscle force (FM R) of the hip extensors and flexors. To present a mechanical criteria for progression of HE exercise on the Pilates Cadillac. METHODS: Fourteen participants performed HE exercises on the Cadillac in four randomly assigned situations - using two springs (blue and red), which were attached in two positions (high and low). Angular positions were measured using an electrogoniometer. In order to calculate ΓR, the muscle torque (ΓM) and FM R, free-body diagrams and movement equations were used. The WMMA of the hip extensors and flexors were estimated from the literature. RESULTS: The ΓR and FM R presented a similar behavior during all situations; however, the maximum ΓR values did not occur at the same joint position as the FM R maximum values. The WMMA of the hip flexors presented an increased- decreased behavior with greatest values around 55º of flexion, while the hip extensors presented a similar behavior with greatest values around 25º of flexion. CONCLUSION: Biomechanic analysis of HE exercises and the evaluation of mechanical features in relation to the hip joint may be used as an objective criteria for the prescription and progression of HE exercise in Pilates.

Estudo clínico do quadril não tratado na tetraparesia espástica / Clinical study of untreated hip in spastic tetraparesis

Objetivo: Avaliar quadris de pacientes com tetraparesia espástica considerando a gravidade das deformidades articulares, a idade e a escoliose. Métodos: Realizamos um estudo descritivo transversal de 40 pacientes (um a 17 anos); 21 (52,5 por cento) do sexo feminino e 19 (47,5 por cento) do masculino em pacientes da Associação Cruz Verde; 19 (47,5 por cento) apresentaram prematuridade, 26 (65,0 por cento) anóxia, quatro (10,0 por cento) meningite, 10 (25,0 por cento) hidrocefalia e 15 (37,5 por cento) microcefalia; 38 (95,0 por cento) apresentavam espasticidade, um (2,5 por cento) atetose e um (2,5 por cento) o padrão misto; 28 (70,0 por cento) apresentavam tetraparesia e 12 (30,0 por cento) dupla hemiparesia. Nenhum paciente deambulava, 38 (95,0 por cento) foram classificados como GFMCS V e dois (5,0 por cento) como IV. Consideramos dois grupos, conforme a necessidade ou não do tratamento cirúrgico dos quadris pelo risco de luxação e dor. Utilizamos os testes de Thomas, abdução brusca e Nelaton-Galeazzi. A escoliose foi avaliada pela simetria do tronco e gibosidade. Resultados: Observamos correlação entre a escoliose e a positividade do teste da abdução brusca. Não houve correlação entre a idade e a contratura dos quadris. Não houve diferença entre os tipos topográficos e a contratura do quadril. Conclusões: Não encontramos correlação entre a idade e o grau de contratura articular; pacientes com escoliose apresentaram maior comprometimento da abdução do quadril.

Objective: To evaluate CP patients considering the hip joint and analyzing the relation between severity, age and scoliosis. Methods: A transversal descriptive study was performed in 40 patients (1 to 17 y.o.), 21 (52,5 percent) female and 19 (47,5 percent) male from Cruz Verde Association; 19 (47,5 percent) had history of prematurity; 26 (65,0 percent) with anoxia; meningitis in 4 (10 percent), hydrocephalus in 10(25,0 percent); microcephalus in 15 (37,5 percent). From the total 38 (95,0 percent) presented spasticity, 1 (2,5 percent) athetoid and 1 (2,5 percent) mixed. According to topographic classification 28 (70,0 percent) presented tetraparesis and 12 (30,0 percent) double hemiparesis. All of them are non-ambulators and 38 (95,0 percent) were classified as GFMCS V and 2 (5,0 percent) were level IV. The patients were divided in two groups (with or without indications for hip surgical treatment). The hips were analysed by Thomas, abduction, and Nelaton-Galeazzi tests. The scoliosis was clinically analysed considering trunk symmetry and dorsal hump. Results: We observed positive correlation between the patients’ scoliosis and hip flexion contracture. There was no difference between the patients’ age and and hip flexion contracture. There was no difference between topographic types and hip contractures. Conclusions: We did not find positive correlation between patients’ age and hip contractures; patients with scoliosis present worse hip abduction compromise.

The value of calcaneal bone mass measurement using a dual X-ray laser calscan device in risk screening for osteoporosis

OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL) correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA). MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO), dual energy X-ray laser calcaneal measurements showed that 13 percent of the subjects had osteoporosis, while another 56 percent had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT), covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05). A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001), body mass index (BMI) (r=0.223, p=0.001), number of live births (r=-0.229, p=0.001), breast feeding time (r=-0.064, p=0.001), and age at menarche (r=-0.050, p=0.008). The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001) at the spine, and calcaneal DXL and DXA T- ...

Protein depletion in Thai patients with hip fractures.

OBJECTIVE: Study the prevalence of protein depletion and determine the effect of protein depletion on postoperative complications. MATERIAL AND METHOD: A retrospective study was performed in 255 Thai elderly patients who had been admitted to Siriraj Hospital because of a fracture of the hip. The level of albumin was the parameter used to determine the degree of protein depletion. The effects of protein depletion that were examined were the length of hospital stay and the development of complications. RESULTS: Ninety-seven patients (44.5%) in the study group were in a protein-depleted state during the period of hospitalization. The patients who were protein-depleted had a higher prevalence of complications and tended to stay in the hospital longer, compared with the nonprotein-depleted patients. CONCLUSION: Thai elderly patients who sustain the trauma of a fracture of the hip should be managed appropriately for the intake of nutrients during the hospitalized period to improve their health status.

Anteversão do colo do fêmur: avaliação clínica versus radiológica / Femoral neck anteversion: a clinical vs radiological evaluation

O objetivo deste trabalho foi o de verificar a correlação entre o ângulo de anteversão femoral medido radiograficamente e os valores das rotações dos quadris apresentados clinicamente. Para isso, foram estudados 64 quadris de 32 pessoas sem nenhuma patologia coxo-femoral prévia, avaliando-se suas rotações com o auxílio de um aparelho específico - o flexímetro - e radiografando os quadris dos pacientes de acordo com o método de Rippstein-Müller. Os resultados obtidos foram analisados estatisticamente, concluindo-se que não houve correlação estatisticamente significante e que, possivelmente, outros fatores, além da anteversão femoral, têm importância na determinação da amplitude das rotações do quadril.

Bone mineral parameters in healthy young Indian adults with optimal vitamin D availability.

BACKGROUND: Several recent studies indicate a marked prevalence of vitamin D deficiency in asymptomatic, apparently healthy urban subjects from different socioeconomic groups in north India. METHODS: To further examine this trend, we studied 40 men and 50 women, 20-30 years of age, from the Indian paramilitary forces. These individuals consume a nutritious, high-protein diet, have optimal exposure to sunlight and undertake strenuous outdoor physical exercise. RESULTS: The mean serum calcium, phosphorus and alkaline phosphatase levels were normal in both men and women. The mean (SD) serum intact parathyroid hormone and 25-hydroxyvitamin D3 levels were 19.3 (8.2) pg/ml and 18.4 (5.3) ng/ml in men, and 11.9 (6.6) pg/ml and 25.3 (7.4) ng/ml in women. Bone mineral density estimated in 20 men and 22 women revealed that in comparison with white Caucasians, 35%-50% of men and 14%-32% of women were osteopenic at different sites, while an additional 10% of men had osteoporosis of the lumbar spine. CONCLUSION: We found that with optimal nutrition, good sunlight exposure and regular physical exercise, healthy young individuals have normal bone and mineral biochemical values. The reasons for the abnormalities detected in bone mineral density in them needs further study. The impact of childhood nutrition on accumulation of peak bone mass may contribute to our findings. There is a need for establishing normative bone mineral density data for Indians.