Objective outcome evaluation using inertial sensors in subacromial impingement syndrome: a five-year follow-up study.

Shoulder-related dysfunction is the second most common musculoskeletal disorder and is an increasing burden on health-care systems. Commonly used clinical questionnaires suffer from subjectivity, pain dominance and a ceiling effect. Objective functional measurement has been identified as a relevant issue in clinical rehabilitation. Inertia based motion analysis (IMA) is a new generation of objective outcome assessment tool; it can produce objective movement parameters while being fast, cheap and easy to operate. In this prospective study, an inertial sensor comprising a three-dimensional accelerometer and gyroscope is attached at the humerus to measure shoulder movements during two motion tasks in patients with subacromial impingement syndrome at baseline and at five-year after treatment. One hundred healthy subjects served as healthy reference database and 15 patients were measured pre- and post-treatment. IMA was better able to detect improvement in shoulder movements compared to the clinical questionnaires (Disability of Arm, Shoulder and Hand (DASH) and Simple Shoulder Test (SST); p < 0.05) and was hardly correlated with the clinical questionnaires (Pearson R = 0.39). It may therefore add an objective functional dimension to outcome assessment. The fast assessment (t < 5 min) of a simple motion test makes it suitable for routine clinical follow-up.

Inertia based functional scoring of the shoulder in clinical practice.

Shoulder-related dysfunction is the second most common musculoskeletal disorder and is responsible for an increasing burden on health-care systems. Commonly used clinical outcome scores suffer from subjectivity, pain dominance and a ceiling effect. Objective functional measurement has been identified as a relevant issue in clinical rehabilitation. In recognition of this goal simple techniques for routine clinical application have been investigated with some success. Inertia based motion analysis (IMA) is a new generation of objective outcome assessment tool; it can produce objective movement parameters while being fast, cheap and easy to operate. This study investigates if a simple IMA shoulder test is suitable as a functional outcome measure for routine clinical follow-up. We measured 100 healthy subjects and 50 patients with confirmed unilateral shoulder pathology. Two motion tasks were performed on both shoulders and two simple motion parameters based on angular rate and acceleration were calculated. Patients were also assessed by the disability of arm, shoulder and hand (DASH) and the simple shoulder test. IMA produced high intra- (ICC = 0.94) and inter-assessor reliability (ICC = 0.90). Asymmetry was >3 times higher in patients than in healthy controls (p < 0.01). Healthy and pathological subjects could be distinguished with high diagnostic sensitivity (>84.0%) and specificity (>81.0%). There was a weak correlation between the IMA shoulder score and the clinical questionnaires (Pearson R < 0.25), as it may add an objective functional dimension to outcome assessment. The fast assessment (t < 5 min) of a simple motion task makes it workable for routine clinical follow-up. The IMA shoulder test adds objective information on functional capacity to the clinical scores and may help the physician in his decision-making, follow-up of treatment, effect of training and possibly lead to the development of new therapeutic interventions.

Juxta-articular myxoma of the knee in a 5-year-old boy: a case report and review of the literature (2009: 12b).

Juxta-articular myxoma (JAM) is a relatively rare variant of myxoma that occurs in the vicinity of large joints. It is composed of fibroblast-like cells that produce an excessive amount of glycosaminoglycans rich in hyaluronic acid. The peak incidence is between the 3rd and 5th decades of life. In this report we describe an extremely rare case of JAM in the knee of a 5-year-old child. The clinical presentation, radiological features and histopathologic findings are described, and the relevant literature is reviewed.