Background and Objectives: Hemiplegic shoulder pain (HSP) is a common and disabling complication in stroke patients, yet its pathogenesis remains unclear. This longitudinal study aimed to investigate the clinical and ultrasound characteristics of HSP emerging within the first 72 h (T0) post-stroke, with follow-ups at one month (T1) and three months (T2). Materials and Methods: A total of 28 stroke patients with hemiparesis were assessed for HSP. Evaluations included pain severity during passive shoulder mobilization, passive and active range of motion, muscle strength, spasticity, and functional disability. Ultrasound examinations were conducted to assess tendon disorders, bursitis, effusion, glenohumeral subluxation, and adhesive capsulitis. Results: HSP prevalence increased over time, affecting 11% of patients at T0, 32% at T1, and 57% at T2. Higher baseline scores on the National Institutes of Health Stroke Scale (NIHSS), an established marker of stroke severity, were significantly associated with HSP (p < 0.05). At T2, patients with HSP exhibited greater impairment, including restricted passive and active range of movement, pronounced muscle weakness, and increased spasticity (p < 0.05). Ultrasound findings at T2 revealed that adhesive capsulitis and glenohumeral subluxation were significantly more frequent in HSP patients (p < 0.05). Adhesive capsulitis showed a significant increase from 0% at T0 to 21% at T2 (p = 0.031), while glenohumeral subluxation exhibited a non-significant rise from 4% to 21% (p = 0.063). Patients with these conditions experienced significantly greater pain progression (p < 0.001). Conclusions: These findings suggest that capsular pathology plays a key role in the development of HSP within the first three months after stroke. The results highlight the need for targeted interventions addressing glenohumeral subluxation and adhesive capsulitis to alleviate pain and improve rehabilitation outcomes.

Groin pain syndrome (GPS) is a prevalent issue in soccer. This study assessed the effectiveness of a new preventive protocol on GPS for youth soccer players. The protocol included targeted stretching and strengthening exercises for the adductor and core muscles from preseason to midseason. A questionnaire and two pain provocation tests were used for the evaluation. Mild GPS required positive results in at least two evaluations, while severe GPS was associated with pain incompatible with engagement in any activity confirmed by diagnostic ultrasound. Forty-two elite male athletes (aged 16.9 ± 0.7 years) participated in the study, with half of them assigned to the usual training (control group) and the remaining athletes undergoing the preventive protocol (treatment group) for 24 weeks. GPS rates were 14.3% (three diagnoses: two mild, one severe) in the treatment group and 28.6% (six diagnoses: three mild, three severe) in the control group. Toward the end of the season, three players, one from the treatment group and two from the control group had to stop playing due to severe GPS problems. In addition, one player in the control group stopped midseason. Even though the reduction in the risk of developing GPS was not significant (relative risk of 0.50 ([95%CI 0.14 to 1.74], p = 0.2759), the halved incidence of severe GPS and the increased muscle strength related to the treatment (p = 0.0277) are encouraging data for future studies.

Background: Electromyography (EMG) is increasingly used to characterize neuromuscular alterations after total hip arthroplasty (THA), yet available evidence remains fragmented and inconsistent. This systematic review synthesizes postoperative EMG findings during gait, functional tasks, and static assessments, highlighting clinical implications and future research needs. Methods: Peer-reviewed studies employing surface, needle, or high-density EMG after THA were systematically examined. Extracted variables included activation amplitude, timing (onset, offset, burst duration), co-activation patterns, and the influence of surgical approach. Methodological rigor, normalization procedures, and the extractability of quantitative EMG metrics were also assessed. Results: Across studies, postoperative EMG consistently revealed non-physiological activation patterns, including delayed or prolonged gluteus medius activity and excessive recruitment of posterior chain muscles. These abnormalities persisted for up to 12 months and, in isolated cases, beyond a decade. Comparisons of surgical approaches demonstrated early denervation signs and impaired recruitment following lateral-based incisions, whereas later adaptations differed between lateral and posterior approaches but remained abnormal in both. Needle EMG studies confirmed transient involvement of muscles innervated by the superior gluteal nerve, while high-density EMG identified persistent deficits in spatial and temporal organization despite clinical improvement. Load-bearing and assisted-task studies showed that cane use and balance challenges modulate abductor demand yet continue to expose asymmetries and elevated stabilization requirements. Nonetheless, comparability across investigations remains limited because few studies adopted standardized normalization procedures or reproducible locomotor tasks. Conclusions: Neuromuscular recovery after THA appears incomplete and asymmetric, characterized by compensatory strategies not detectable through clinical or kinematic assessments alone. Improved diagnostic sensitivity and clinical applicability will require protocol standardization and the broader adoption of advanced EMG approaches.

Return to sport (RTS) is an important outcome after surgery for adolescent idiopathic scoliosis (AIS), yet postoperative clearance remains largely time-based and reported outcomes vary according to procedure, population, endpoint, and treating-center policy. This critical review integrates direct postoperative RTS cohorts with biomechanical, rehabilitation, psychological, safety, and clinical-guidance evidence. Most available data concern adolescents treated with posterior spinal fusion and rely on self-reported participation. Resumption of physical activity or sport is common within the first postoperative year, but return to the same discipline, previous competitive level, and objectively verified performance is less consistently demonstrated. Evidence for anterior fusion is sparse, whereas vertebral body tethering is supported by smaller, selected cohorts and should be interpreted separately. Associations between RTS and distal fusion level or construct characteristics remain inconsistent, and biomechanical studies suggest redistribution rather than normalization of movement. Reported sport-related complications are uncommon, but existing cohorts are too small and lack exposure denominators to quantify rare events. No universal safe date or validated AIS-specific readiness battery currently exists. The proposed Multidimensional Scoliosis Return-to-Sport Framework therefore uses elapsed time as safety context while integrating clinical recovery, physical and psychological readiness, graded sport-specific exposure, and distinct return outcomes. The framework is evidence-informed and requires prospective validation.

Background: Electromyography (EMG) is increasingly used to characterize neuro-muscular alterations after total hip arthroplasty (THA), yet available evidence remains fragmented and inconsistent. This review synthesizes postoperative EMG findings during gait, functional tasks, and static assessments, highlighting clinical implications and future research needs. Methods: Peer-reviewed studies employing surface, needle, or high-density EMG after THA were systematically examined. Extracted variables included activation amplitude, timing (onset, offset, burst duration), co-activation patterns, and the influence of surgical approach. Methodological rigor, normalization procedures, and the extractability of quantitative EMG metrics were also assessed. Results: Across studies, postoperative EMG consistently revealed non-physiological activation patterns, including delayed or prolonged gluteus medius activity and excessive recruitment of posterior chain muscles. These abnormalities persisted for up to 12 months and, in isolated cases, beyond a decade. Comparisons of surgical approaches demonstrated early denervation signs and impaired recruitment following lateral-based incisions, whereas later adaptations differed between lateral and posterior approaches but remained abnormal in both. Needle EMG studies confirmed transient involvement of muscles innervated by the superior gluteal nerve, while high-density EMG identified persistent deficits in spatial and temporal organization despite clinical improvement. Load-bearing and assisted-task studies showed that cane use and balance challenges modulate abductor demand yet continue to expose asymmetries and elevated stabilization requirements. Nonetheless, comparability across investigations remains limited because few studies adopted standardized normalization procedures or reproducible locomotor tasks. Conclusions: Neuromuscular recovery after THA appears incomplete and asymmetric, characterized by compensatory strategies not detectable through clinical or kinematic assessments alone. Improved diagnostic sensitivity and clinical applicability will require protocol standardization and the broader adoption of advanced EMG approaches.

Purpose: To characterize longitudinal changes in axillary-pouch capsular thickness and clinical outcomes after ultrasound-guided hydrodilation with corticosteroid injection in patients with post-stroke adhesive capsulitis, and to examine associations between structural and clinical changes. Methods: In this longitudinal observational study, 20 patients underwent clinical and ultrasonographic assessment before the first procedure (T0) and at follow-up (T1), separated by a median of 5.7 months. All participants also received conventional neurorehabilitation. Paired changes in pain measured using the Numeric Rating Scale (NRS), range of motion (ROM), strength, muscle tone, disability, quality of life, and capsular thickness were assessed using Wilcoxon signed-rank or exact McNemar tests. Associations between within-participant changes were explored using Spearman correlations. Results: Median movement-evoked pain decreased by 4 NRS points during flexion and abduction and by 5 points during external rotation (all p < 0.001). Active and passive ROM improved across all assessed movements (all p ≤ 0.001). Median affected-side capsular thickness decreased from 3.7 to 2.45 mm, with a median within-participant reduction of 1.4 mm ( p < 0.001). The proportion meeting the ultrasonographic criteria for adhesive capsulitis decreased from 20/20 at T0 to 4/20 at T1. Capsular-thickness changes were not significantly associated with changes in any clinical outcome (all |ρ|≤ 0.35; all p ≥ 0.13). Conclusion: In this uncontrolled cohort, hydrodilation with corticosteroid injection, delivered alongside neurorehabilitation, was followed by reduced movement-evoked pain, improved shoulder mobility, and axillary-pouch capsular thinning. Capsular thickness should be interpreted as a complementary structural marker rather than a surrogate for clinical recovery.