Upper Extremity Three-Dimensional Reachable Workspace Analysis Using the Kinect Sensor in Hemiplegic Stroke Patients: A Cross-Sectional Observational Study Objective A reachable workspace evaluation using the Kinect sensor was previously introduced as a novel upper extremity outcome measure in neuromuscular and musculoskeletal conditions. This study investigated its usefulness in hemiplegic stroke patients. Design Forty-one patients with hemiplegic stroke were included. Kinect-based reachable workspace analysis was performed on both paretic and nonparetic sides. Upper extremity impairment was measured using the Fugl-Meyer Assessment and the Motricity Index on the paretic side. Disability was assessed using the shortened Disabilities of the Arm, Shoulder, and Hand questionnaire. Correlations between the relative surface areas, impairment scores, and disability were analyzed. Results Quadrants 1, 3, and 4 as well as the total relative surface area of the paretic side were significantly reduced compared to the non-paretic side. The total relative surface area of the paretic side correlated with the Fugl-Meyer Assessment scores, the Motricity Index for Upper Extremity, and the Disabilities of the Arm, Shoulder, and Hand questionnaire score. Furthermore, quadrant 3 was the most important determinant of upper extremity impairment and disability. Conclusion A reachable workspace (a sensor-based measure that can be obtained relatively quickly and unobtrusively) could be a useful and alternative outcome measure for upper extremity in hemiplegic stroke patients. Correspondence: Jongmin Lee, MD, PhD, Department of Rehabilitation Medicine, Konkuk University Medical Center, 120-1, Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, 05030, South Korea. Tel: +82-2-2030-5345, Fax:+82-2-2030-5379, e-mail: leej@kuh.ac.kr Author Disclosure Funding: Not applicable. Conflict of Interest: All authors declare that there are no conflicts of interest. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

EFFECTS OF DIFFERENT EXERCISE INTENSITIES ON HEADACHE: A SYSTEMATIC REVIEW The benefits of the regular exercise on quality of life of individuals living with a headache are well known. However, whether the benefits of the exercise training on headache parameters (i.e., intensity, frequency and pain duration) occur in an intensity-dependent fashion remains unknown. Objective To investigate the effects of different exercise intensities on headache parameters. Design A systematic review of clinical trials that analyzed the effect of physical exercise on headache, without time or language restriction. The TESTEX scale was used to evaluate the methodological quality of the articles. Results Sixteen (16) articles were included with interventions with aerobic training (AT) and resistance training (RT). Primary results are positive effects of exercise on migraine symptoms, tension-type headache among others, and a decrease in the use of headache-related medications. On the other hand, the studies did not provide information on exercise intensity, especially studies with aerobic exercises. The intensities used for AT was mostly controlled subjectively and the RT ranged from 10 to 80% of 1MR (Maximum Repetition). Conclusion Exercise had a positive influence on the frequency and severity of headache crises, although the studies presented inconclusive data regarding the exercise parameters. Adress correspondence to: Yumie Okuyama da Silva Gauto, Av. Brasil, 1247 AP 402 BL 102. Bairro Universitário – Caruaru/PE. Zip code: 55016-260. Phone number: +55 (81)995068736. Email address: yumie_okuyama@yahoo.com.br Competing interests: none of the authors has any competing interests. Funding source: The research had no specific support. Financial disclosure statement: The authors have no financial relationships to this article to disclosure. Conflict of Interest: Nothing to declare. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Conservative treatment of tendon injuries Tendon injuries or tendinopathy are common painful and disabling conditions resulting from overuse and aging. Tendinopathy remains a challenging clinical problem since response to different treatment modalities is usually unsatisfactory and recovery is slow. We performed an extensive literature review focusing on non-surgical treatment options for tendinopathies, including nonsteroidal anti-inflammatory drugs, corticosteroid, eccentric exercise, extracorporeal shock wave therapy, therapeutic ultrasound, hyaluronic acid, platelet-rich plasma, prolotherapy, polydeoxyribonucleotide and stem cells, aimed at providing the most updated evidence as a guideline for caregivers. Corresponding author: Wen-Shiang Chen, MD, PhD Author Disclosures: No conflicts of interest are reported by the authors or by any individuals in control of the content of this article. The authors received no financial support for the publication of this article. No financial benefits will be received. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Electrophysiological Changes Following Human Muscle Tear: A Potential Confounder The goal of this prospective electrophysiologic study is to describe the chronological electromyographic findings observed in a human gastrocnemius muscle following a traumatic tear. A 30-year-old man sustained a tear of the medial gastrocnemius. Needle electromyography was performed serially at 5, 15, and 26 weeks post-injury, with the contralateral gastrocnemius muscle serving as a control. Audiovisual recordings of the studies were analyzed in a blinded manner. Five weeks post-injury, the affected gastrocnemius displayed increased insertional activity on electromyography. By 15 weeks post-injury, insertional activity had diminished. However, motor unit action potentials showed chronic neurogenic morphological changes not previously observed. These changes persisted 26 weeks post-injury. The study findings reveal a chronological trajectory of increased insertional activity followed by reinnervation changes in a human muscle after local trauma, paralleling a course previously observed in a rat model. Electrodiagnosticians unaware of this phenomenon are at risk for making erroneous interpretations when examining patients with a history of muscle trauma. Corresponding Author: Sandra L Hearn, Burlington Office Center, 325 E. Eisenhower Parkway, Suite 100, Ann Arbor, MI 48108. Phone: 617-233-2578, Fax: 734-764-9439. SLHEARN@MED.UMICH.EDU No funding was received for this research. The authors each declare no competing interests and this work does not provide any financial benefits to the authors. This study involved use of a medical device: a diagnostic electromyograph (Carefusion Nicolet EDX with Viking 4 Software, FDA 510(K) #K112052), used on-label to conduct electromyography and nerve conduction studies on subjects. Part of this research has been presented as a poster at an American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Annual Assembly. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Can Pelvic Floor Muscle Training Versus No Treatment or Inactive Control Treatments Reduce or Cure Urinary Incontinence in Women?: A Cochrane Review Summary with Commentary No abstract available

Effects of elastic resistance exercise after total knee replacement on muscle mass and physical function in elderly women with osteoarthritis: A randomized controlled trial OBJECTIVE Knee osteoarthritis (KOA) and age are associated with high sarcopenia risk, especially in patients who have received total knee replacement (TKR). The purpose of this study was to identify the effects of elastic resistance exercise training (RET) after TKR on muscle mass and physical outcomes in older women with KOA. DESIGN Sixty older women who received unilateral primary TKR surgery were randomized to an experimental group (EG), which received 12 weeks of postoperative elastic RET, or a control group (CG), which received standard care. The outcome measures included physical function performance (i.e., Timed Up & Go [TUG], gait speed [GS], forward reach, single-leg stance, timed chair rise), appendicular lean mass (ALM), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The assessment time points were 2 weeks prior to surgery (T0), 1 month after surgery (T1; before RET), and 4 months after surgery (T2; upon completion of RET). RESULTS After 12 weeks of postoperative elastic RET, the EG exhibited a significantly greater change in ALM (mean difference [MD], 0.81 kg; P = .004) than the CG. Elastic RET also exerted significant effects on TUG and GS with MDs of 0.28 m/s (P < .001) and -2.66 s (P < .001), respectively. CONCLUSION A 12-week elastic RET program after TKR exerted benefits on muscle mass, mobility, and WOMAC functional outcomes in older women with KOA. Address correspondence: Tsan-Hon Liou, MD, PhD, Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan No. 250, Wu-Hsing Street, Taipei, Taiwan. Tel: 886-2-2249-0088 ext. 1600. Fax: 886-2-2248-0577. Email: peter_liou@s.tmu.edu.tw Shih-Wei Huang and Tsan-Hon Liou contributed equally to this study Funding: This study was funded by the Ministry of Science and Technology, Taiwan (grant number MOST 107-2314-B-038-28); Taipei Medical University (grant number IIT-1072-3); and Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, Taiwan (grant number W107HCP-04). The funding sources played no role in the design, implementation, data analysis, interpretation, or reporting of the study. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official view of the funding sources. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Disparities in Health Care for Hispanic Patients in Physical Medicine and Rehabilitation in the United States: A Narrative Review In the United States, the number of people with Hispanic backgrounds is rapidly increasing. This growth, along with other factors, may put them at increased risk for healthcare disparities. Thus, Physical Medicine and Rehabilitation (PM&R) should evaluate disparities in health services through the lens of the evidence base. To our knowledge, this is the first review describing the literature on healthcare disparities for Hispanic patients in the field of PM&R. This review explores healthcare utilization, risk factors, access, and health conditions specific to Hispanic populations. Articles used in this narrative review were collected over a 10-year span (2009-2018) from online databases. Our findings highlight disparities across common conditions and injuries in the PM&R literature, including post stroke rehabilitation, hip fracture treatment and rehabilitation, spinal cord injury, and traumatic brain injury. Our review suggests that Hispanic patients may be at risk for worse outcomes following these conditions, due to low access to rehabilitation services and disparities in the referral process. Similar results are reported for pain management and Parkinson’s disease. As we strive to provide optimal care to an increasingly diverse patient population, researchers and clinicians must consider effects of race and ethnicity on access to and utilization of rehabilitation services. Corresponding Author: Laura E. Flores, Address: University of Nebraska Medical Center, 984000 NE Medical Center, Omaha NE 68198-4000, Email: laura.flores@unmc.edu, Phone: 402-599-6923 Funding Source: This project received no funding, grants or equipment from any source. Disclosures: Julie K. Silver, MD reports no disclosures related to this work. Unrelated to this work, Dr. Silver discloses that she has personally funded the Be Ethical Campaign and proceeds from the campaign support disparities research. As an academic physician, Dr. Silver has published books and receives royalties from book publishers, and she gives professional talks such as Grand Rounds and medical conference plenary lectures and receives honoraria from conference organizers. Dr. Silver has grant funding from 1) Arnold P. Gold Foundation (physician and patient care disparities research) and 2) Binational Scientific Foundation (culinary telemedicine research). Monica Verduzco-Gutierrez, MD, Laura E. Flores and Diana Molinares, MD report no disclosures related to this work. Previous Presentation: This manuscript and the material contain herein have not been previously presented or published. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

A curious case of acute onset bilateral hand weakness in a youth hockey player: A case report No abstract available

Role of Instruction Adherence During Highly Structured Robotic Arm Training on Motor Outcomes for Individuals after Chronic Stroke The aim of this study was to examine the effects of instruction adherence on upper extremity motor outcomes after highly structured intervention. A secondary data analysis was completed using mixed linear modelling design. Thirty chronic stroke survivors with moderate-to-severe arm impairment were assigned explicit movement instructions and completed 12 robotic therapy sessions over four weeks. Instruction adherence was measured weekly using the Manipulation Check Questionnaire (MCQ). Motor outcomes were measured at baseline, discharge, and at 4-week follow-up using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Wolf Motor Function Test–Functional Ability Scale (WMFT-FAS). There were no effects of adherence-related variables on upper extremity motor outcomes (p values > .2). Participant scores improved for both FMA-UE and WMFT-FAS from baseline to follow-up (p values < .001). Participants improved motor function after 12 weeks of robotic training, however, instruction adherence did not affect motor improvement. Adherence to explicit information may play a limited role in motor learning for stroke survivors with moderate-to-severe arm impairment during highly structured training protocols. Corresponding author: Grace Kim OTR/L, PhD, 82 Washington Square East, Pless Hall, 6th Floor, New York, NY 10003. Phone: +1-212-998-5846. Email: gjk207@nyu.edu Funding: No funding was received for this study. Author Disclosures: Authors have no conflicting interests to declare. Clinical Trial Registration No (primary study): NCT02890446 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Multiple Accessory Lower Limb Muscles Identified Using Ultrasonography in An Asymptomatic Individual No abstract available