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What Is the Accuracy of Shoulder Range of Motion Measurements on Physical Exam?

Open Journal of Orthopedics 2015年第9期5卷 264-276页

作者： Yousef Shishani Janice Flocken reuben gobezie Shoulder and Elbow Surgery The Cleveland Shoulder Institute Beachwood USA

The purpose of this study is to investigate a new method for measuring shoulder range of motion (ROM) in an orthopedic practice utilizing a smartphone application to improve accuracy from physical exam typically used in research. Our aim is to evaluate the application, Physio2Go (P2G), which uses a virtual goniometer, assessing validity by comparing its measurements to those taken by a universal goniometer (UG). Two observers of varying clinical experience, a research assistant and research fellow, compared measurements. Statistically, we used the intra-class correlation coefficient (ICC), standard error of measurement (SEM), and the Pearson correlation coefficient (PCC). Following validation we tested P2G in symptomatic postoperative shoulder patients measuring forward flexion (FF) and external rotation (ER). We compared P2G measurements to visual estimation (VE) done by a fellowship trained orthopedic surgeon. Statistically we used ICC, Bland- Altman plots with 95% limits of agreement (LOA), and scatter plots. We examined the impact of the application using Welch’s t-test comparing pre-to-postoperative ROM improvements using the values obtained by P2G and VE. We found high intra-rater reliability of P2G for both observers, substantial correlation between UG and P2G measurements, highly correlated inter-observer reliability for UG and P2G, and statistically significant PCC values (p < 0.05). As expected, ROM measurements of symptomatic patients comparing P2G and VE measurements demonstrated lower correlation. Bland-Altman plots demonstrated wide confidence intervals;scatterplots and histograms confirmed low agreement among measurement methods. Clinical application demonstrated varying statistical significance depending on whether measurements were done by P2G or VE. Our study found that P2G provided superior reliability compared to the customary physical exam routinely used for orthopedic research. The value of using this application instead of a UG is the ease of

关键词： Shoulder Range of Motion Digital Assessment Goniometry Smartphone Application

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The Impact of Joint Replacement on Driver Function and Safety

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Open Journal of Orthopedics 2012年第3期2卷 121-125页

作者： Stephanie J. Muh Yousef Shishani Jonathan Streit Carissa Ann Lucas Vinod Sahgal Matthew Kraay reuben gobezie Case Shoulder and Elbow Service Case Western Reserve University School of Medicine University Hospitals of Cleveland Cleve- land USA Cleveland Shoulder Institute University Hospitals of Cleveland Cleveland USA Department of Hematology/Oncology—Solid Tumor Department The Cleveland Clinic Cleveland USA Department of Orthopaedics Case Western Reserve University School of Medicine University Hospitals of Cleveland Cleveland USA

Background: The timing of return-to-driving following total joint replacement has not been well-defined. The primary aim is to study the impact of joint replacement on driver safety. A secondary aim is to investigate the possible predictors for increased car accidents in patients undergoing total joint replacement surgery. This data will provide the background to support further prospective studies on the relationship of driver safety to joint replacement surgery. Methods: A retrospective analysis of driver safety in the postoperative period was performed by analyzing the self-reporting of 485 patients who had undergone a Total Hip Arthroplasty (n = 196), Total Knee Arthroplasty (n = 258) or Total Shoulder Arthroplasty (n = 31). The mean age was 70 (28 - 88) with 164 male (34%) and 319 female (66%). Patients were mailed a questionnaire and the responses were analyzed to determine what factors affect driving after joint replacement. Results: Overall, increased patient age and gender were associated with increased accidents following surgery. Our subgroup analysis demonstrated that in patients undergoing TSA, increased patient age was associated with increased accidents. TKA patients showed that older patient age predicted increased accidents following surgery. Conclusions: While age and gender are correlated with increased accidents after joint replacement in general, no factors specific to joint replacement surgery are related to increased incidence of accidents.

关键词： Total Hip Arthroplasty Total Knee Arthroplasty Total Shoulder Arthroplasty Driving Driver Safety Traffic Accidents

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Effect of exclosure on dryland woody species restoration in northeastern Amhara,Ethiopia

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Journal of Forestry Research 2021年第5期32卷 1953-1961页

作者： Mubarek Eshetie Tsegaye gobezie Seid Muhie Dawd Sekota Dryland Agricultural Research Center P.O.Box 62SekotaEthiopia Department of Forestry College of AgricultureWollo UniversityP.O.Box 1145DessieEthiopia

In Ethiopia,among many restoration efforts to reverse deforestation and land degradation,area exclosure is one of the most common practices to restore secondary forests with assisted natural *** present study in the S ekota district,northeastern Amhara region,Ethiopia evaluated the influence of areas exclosures on woody species diversity,population structure and regeneration status.A total of 36 and 27 quadrats,each 20 m×20 m,were used to collect data in exclosures and non-exclosures,*** quadrats,four 5 m×5 m and 2 m×2 m quadrats at the corners were used to sample saplings and seedlings,*** exclosures,35 woody species representing21 families and 29 genera were recorded;19 woody species representing 13 families and 13 genera were recorded in the *** etbaica was the most dominant species in the two *** Shannon diversity index was1.77±0.46 in exclosures and 1.39±0.46 in *** and Simpson diversity indices showed a significant difference between the two land-uses(p<0.01).The regeneration status of all wood species in exclosures was good,only fair in *** exclosures have thus played a great role in the restoration of degraded lands by improving vegetation diversity and regeneration *** least dominant woody species should be maintained through active *** follow-up,maintenance of soil water conservation structure to improve soil fertility will further help enhance the woody species diversity and abundance.

关键词： Restoration Diversity Regeneration status Exclosure

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