Background: Cervical proprioception plays an important role in the stability and optimal functional of the cervical spine and assessment of cervical proprioception is integral in the assessment and management of cervical spine dysfunction. Cervical range of motion (CROM) device is an effective tool, simple and cost effective tool to assess cervical proprioception. The objective of the study was to establish the test-retest reliability of a CROM in assessing cervical proprioception in asymptomatic individuals. Methods: Twenty healthy adults (mean age 37±8 years) were recruited and test retest reliability of CROM device in assessing cervical proprioception was assessed. Cervico-cephalic kinaesthetic sensibility tests - Neutral Head Positioning (NHP) and Target head Positioning (THP) tests were used to assess cervical proprioception. The test retest reliability was assessed in 2 sessions each session is separated with the other by 48 hours. Results: The test-retest reliability of measurements made with the CROM was verified with ICC values for all cervical measurements ranging between 0.66 (CI: 0.1, 0.8) for Target Head Position – rotation right to 0.93 (0.8, 0.9) (CI: 0.8-0.9) for THP – Rotation right. The correlation analysis found there are high and significant correlations between the test and retest results indicating that the reliability of the test can be established (positive correlation coefficients ranging from 0.524 – 0.863). Conclusion: CROM device can be used to quantify cervical proprioception errors with acceptable level of reliability in asymptomatic individuals.

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Avulsion fractures of cruciate ligament are relatively uncommon as most of them are intrasubstance tears. Primary surgical fixation of avulsion fractures is necessary to avoid residual laxity and preserve the native ligaments. Combined anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) avulsion fractures are even rare with very few articles being published in literature. We report a case of simultaneous traumatic avulsion of ACL and PCL from tibial eminence, which was managed by staged surgical fixation with good functional outcome.

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Background: There is a paucity of literature evaluating the use of intra-articular drains after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction and their effects on knee function. Objective: The aim of this study is to determine the effect of postoperative drain use on knee function after ACL reconstruction with quadrupled hamstring graft. Materials and Methods: In this study, 44 arthroscopic ACL reconstruction patients were randomized for either intra-articular suction drain group or nondrain group. Outcome assessment was done on postoperative day 4, day 10, 1 month, 3, 6, and 12 months after the surgery in which patients were asked to complete a visual analog pain scale. They were assessed for a range of motion (ROM) in flexion and extension with a universal goniometer, knee effusion, and knee stability by Lachman's test. Results: Both treatment and control groups showed no statistical significant difference in flexion of the knee through the ROM (P = 0.116). The percentage reduction in knee effusion was found to be statistically significant at 4 ^th (P < 0.001), 10 ^th (P < 0.001) 16, and 1 month (P = 0.012) in between treatment and control group. The overall pain difference between the two groups was not found to be statistically significant (P = 0.198). Conclusion: Clinically, the drain group showed faster pain relief, lesser effusion, and early return to motion compared to the no-drain group but was not statistically significant.

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There are several possible etiologies for rotator cuff pathology, which vary based on age and sports participation. We are reporting a case of complete supraspinatus tear with associated greater tuberosity fracture in a 14-year-old boy, and to the best of our knowledge, this is the first case of complete supraspinatus tear with greater tuberosity fracture in a boy younger than 15 years.

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Purpose of the Study: Delayed onset muscle soreness (DOMS) is defined as the sensation of discomfort or pain in the skeletal muscles following physical activity, usually eccentric, to which an individual is not accustomed. DOMS begins usually 8-24 h after exercise in which pain, soreness, swelling, and stiffness and muscle spasm and peaks after 24-72 h. Cryotherapy and pulsed ultrasound were common modalities used to treat the DOMS effectively. Hence, this study is intended to compare the effect of these modalities on DOMS. Materials and Methods: Normal healthy individuals (n = 32) of age group between 18 and 30 years was selected randomly and divided into two groups. Group A received pulsed ultrasound therapy and Group B received cryotherapy. The total duration of the study was three sessions for 3 consecutive days. Measurements are taken initially before receiving the interventions and at the end of every treatment session by using universal goniometer for measurement of range of motion (ROM) and visual analog scale for pain. Data thus collected were analyzed and recorded for the study. Results: Mean ROM in Group A who received pulsed ultrasound is 143.42 and Group B who received cryotherapy is 140.12 and showed that there is an induction of DOMS. When comparison of pulsed ultrasound over cryotherapy shown a significant P < 0.05. Conclusion: Both pulsed ultrasound and cryotherapy are almost equal with each other up to a period of 48 h. However, pulsed ultrasound has an additional effect of increasing the ROM on day 3 onward when compared to cryotherapy.

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Background and Purpose: Several changes have occurred in Olympic boxing in last few decades. In March 2013, the use of headgear was banned to reduce the incidence of cerebral concussion. This reduced the concussion rate to 0.17% but affected the boxer's psychology and also the way boxers and coaches prepare. The boxers feel safer to take the risk wearing headgear that they simply would not do if they are not wearing one. Furthermore, three fatal incidents of professional boxing make it important to find out the prevalence of injuries in competitive boxers. The aim of this study was to find out the prevalence of injuries in national level boxers of India that occurred during the bout or training. Materials and Methods: The study was conducted as a retrospective and was carried on 54 national level boxers ranging between 11 and 35 years. Results: Fifty-four boxers reported with 820 injuries in 2 years. Each boxer sustained 15.18 injuries in 2 years on an average, i.e., 7.59 injuries/year on an average. The injury rate per boxer was 9.64/1000 h of training. The injuries of head and face (42.92%) are more frequent followed by the injuries of upper limb (33.90%). Soft tissue lacerations and contusions are common. Furthermore, frequent low back pain (5%), calf cramp (3.41%), and high ankle sprain (4.4%) were reported because of training. Conclusions: The study suggests that the most common type of injuries in boxers is the soft tissue lacerations and contusions, and the most common site of injury is the head and face region. Common injuries due to training are low back pain, calf cramp, and high ankle sprain.

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Lipoma arborescens (LA) is a rare disorder characterized by villous lipomatous proliferation of the synovial tissue. Magnetic resonance imaging is the investigation of choice, with images clearest on fat-suppressed or STIR sequences. Synovectomy appears to be curative. We present a case of bilateral LA of knees and undertake a comprehensive review of the literature.

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Entheses are sites where tendons, ligaments, joint capsules, or fascia attach to bone providing a mechanism for reducing stress at the bony interface. Inflammation of the entheses is called enthesitis and enthesitis of the shoulder is a common finding, but it mostly involves rotator cuff tendon. In this case report, we are reporting a case of arthroscopically proven capsular enthesopathy of shoulder joint, and to the best of our knowledge, capsular enthesopathy of glenohumeral joint with arthroscopic proven inferior capsule calcification has yet not been reported in English literature.

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Infective nonunion of a long bone is very notorious to be treated and prone to limb shortening when treated by conventional methods. In this case report, we treated a patient having infected nonunion of tibia initially by complete excision of all devitalized tissue from site of nonunion causing bone gap of 7 cm, followed by application of Ilizarov ring fixator using bifocal osteosynthesis by single upper tibial osteotomy. Bone transportation done at a rate of 1 mm/day followed by compression-distraction at the nonunion site following accordion maneuver. Results showed satisfactory bony union by bifocal osteosynthesis with single osteotomy.

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Background: Personality traits do influence the type of games that professional athletes participate in. Specific studies on this phenomenon are scare in Nigeria. Purpose of Study: This study examined the personality characteristics that influence some Nigerian professional athletes in their choice of games as individual or team sportsmen. It also relates significant personality traits with participants' sociodemographic characteristics to identify any influence that may exist. Methods: Personality characteristics of 250 Kano-State professional athletes were assessed using the 100-item International Personality Item Pool. Information was also collected on participants' sociodemographics, psychoactive substance using status, and game types. Results: Significant differences (P < 0.05) were noted in some personality traits between individual sport athletes and team sportsmen. Specifically, individual athletes were more extraverted and lower in conscientiousness (CO) compared to team sportsmen. Sociodemographic distributions based on significant personality traits of extraversion (EX) and CO show female gender to significantly contribute more to EX and less to CO. Other demographics significantly influencing higher EX is playing as professionals for <6 years. That associated with higher CO is to have <13 years of Western education. Conclusion: The study indicated that professional athletes' choice of sports types were influenced by specific personality dimensions and that some demographic variables do play some roles in this.

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Introduction: Perceived stress negatively affects cardiorespiratory functions by altering cardiovascular reactivity. Aims: To evaluate the effect of Raj yoga on stress management in healthy young adults of an urban population of a developing country. Materials and Methods: The present study was conducted after taking Institutional Ethical clearance and informed consent of the subjects. Hundred healthy young adults in the age group of 18-35 years performing Raj yoga regularly were selected as study subjects, and hundred age- and sex-matched subjects from the local population were chosen as control. The group practicing Raj yoga was named as meditators and another not practicing the same as nonmeditators. Stress level in the subjects was assessed according to the presumptive life event stress scale (PSLES). The perceived stress scale of Sheldon Cohen was used to measure perceived stress scores. Anthropometric measurements, resting pulse rate, and blood pressure were recorded, followed by the orthostatic tolerance test (OTT), isometric hand grip test, 40 mm endurance test, and pulmonary function tests. Results: Both the groups were age-, sex- matched, and their food habits were same. Their PSLES showed no significant difference, but perceived stress score was significantly higher in the case of nonmeditators. Body mass index and waist/hip ratio were significantly more in nonmeditators. Resting pulse rate, systolic blood pressure, and diastolic blood pressure were significantly lower in meditators. Results of OTT and isometric hand grip test showed significantly lower values in meditators. Results of 40 mm endurance test were significantly raised in meditators. Conclusions: Cardiorespiratory fitness parameters in young adults are correlated with perceived stress. Perceived stress shifts autonomic balance toward sympathetic dominance, hampering cardiovascular and respiratory functions. Practice of Raj yoga meditation can help in overcoming these bouts of stress and thereby stress-related hazards.

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Background: Children with Down syndrome (CDS) have low health-related physical fitness levels. Since, bursts of high-intensity constitute a major part of children's daily activities, it is important to determine the levels of anaerobic fitness in CDS. Aim: The aim of this study was to estimate the differences in anaerobic performance between CDS and typically developing children (TDC). Methods: Anaerobic performance was assessed in a group of twelve 8-16 year old CDS and their performance was compared to thirteen age-matched typically developing peers. The anaerobic performance of all children was measured using a field test-muscle power sprint test where children were asked to run six- 15 m sprints. The outcome measure was mean power (MP) that represented the average power output of all sprints. Results: The MP for CDS was 50.1 (25.03-75.2) W in comparison to 145.6 (114.6-176.7) W in TDC. Conclusions: The levels of anaerobic fitness are lower in CDS than in TDC. Implications: The rehabilitation strategies should emphasize strength training in adjunct to aerobic training to improve physical fitness in CDS.

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Background: Traumatic cervical cord injury (CCI) management requires extended acute care and lifelong chronic care. Aims: The present study was aimed to find out that after traumatic CCI, if neurological recovery takes place, how early it starts, how long it continues, and after how many weeks we can safely prognosticate that no more recovery will take place. Materials and Methods: Different epidemiological factors, radiological evidence of trauma, types of injury, cause, mechanism of injury, and level were recorded. The patients were examined every week to record any neurological recovery, either as per Frankel's or ASIA grading. These recordings were done till 6 weeks of admission. Cervical fractures were usually treated by continuous skull traction either by Crutchfield tong traction or by head halter traction giving adequate weight according to the level of vertebral fracture. At the end of 2 years, we followed the recovery pattern in 126 CCI patients. Results: 20.00% of patients showed signs of recovery and 56.36% patients did not show any sign of recovery in complete lesion. 69.01% of patients showed sign of recovery and 25.35% patients did not show any sign of recovery in incomplete lesion. 53.84% of patients showed the first sign of neurological recovery within 1 ^st week, 32.30% in 2 ^nd week, 9.23% in 3 ^rd week, and 4.61% in 4 ^th week. In upper cervical spine lesion, 22.22% of patients showed first sign of neurological recovery within 1 ^st week, 55.55% in 2 ^nd week, 16.11% in 3 ^rd week, and 5.55% in 4 ^th week. In lower cervical spine lesion, 65.95% of patients showed the first sign of neurological recovery within 1 ^st week, 23.40% in 2 ^nd week, 8.51% in 3 ^rd week, and 2.12% in 4 ^th week. Conclusions: In traumatic CCI, patients' level of lesion, type of injury, and nature of injury may be helpful in the early prediction of recovery pattern of patients and careful monitoring of these patients may reduce the social burden in developing countries and reduce morbidity and mortality of these patients.

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Sport-related renal trauma among children is a type of injury results usually from a blunt abdominal trauma during nonorganized sport. It can happen during either individual sports such as cycling, skating, skiing, sledding, snowboarding, gymnastics, and horseback riding or in clash sports such as football, rugby, soccer, martial arts, and ice hockey. Trauma may lead to hematuria, hemorrhage, thrombosis, renal artery occlusion or destruction, and tissue disruption of parenchyma and collecting ducts. Children are more susceptible to renal trauma due to anatomical variations from adults. Most injuries are managed conservatively with renal preservation. It is estimated that Sport-related renal trauma was 1-3% among children between 5 and 15 years in age. This narrative review article presents an overview of the current knowledge of sport-related renal trauma among children after review of 56 research paper focusing on etiology, pathophysiology, diagnosis, safety measures, and treatment. This information should assist healthcare practitioners who treat patients with this type of injury. Safety measures help in avoidance of such trauma and protect from unpleasant squeal.

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