Postoperative gait mechanics in persons with femoroacetabular impingement syndrome (FAIS) remain understudied as a treatment outcome despite observed, yet inconclusive, preoperative gait abnormalities. Females with FAIS demonstrate worse preoperative patient-reported hip function and altered hip mechanics when compared with males; it is unknown whether these sex differences persist postarthroscopy. The purpose of this study was to compare sex-specific gait kinematics between persons at least 1 year postarthroscopy for FAIS and healthy comparisons. General linear models with estimating equations were used to evaluate the effect of (a) limb and sex within each group, and (b) limb and group within each sex for peak sagittal and frontal plane trunk, pelvis, and hip kinematics during stance phase of gait. Analyses were covaried by gait speed. Seventeen females and eight males an average 2.5 years postarthroscopy (1.1-7.2 year) for FAIS were compared with healthy females (n = 7) and males (n = 5). Females in the FAIS group presented with an average of 4.6°more anterior pelvic tilt, and 4.8°less hip extension compared with healthy females (P ≤ .03) and 8.6°less trunk flexion, 4.8°more anterior pelvic tilt, 3.1°more pelvic drop, and 7.5°more hip flexion than males with FAIS (P ≤ .03). Males in the FAIS group presented with 2.9°less pelvic drop, and 3.2°less hip adduction than healthy males. Preoperative gait mechanics were not collected and thus changes in mechanics could not be evaluated. This study is significant to clinicians who treat patients postarthroscopy to consider sex-specific gait impairments.

Background. Massage therapy is a noninvasive treatment that many individuals with multiple sclerosis (MS) use to supplement their conventional treatment. Objective. We hypothesize that massage therapy will improve the leg function and overall quality of life (QoL) of MS patients. Design. A two-period (rest, massage) crossover design was used. Twenty-four individuals with MS ranging from 3.0 to 7.0 on the Expanded Disability Status Scale (EDSS) received Swedish massage treatments for four weeks. Exercise capacity and leg function as well as QoL were assessed using the Six-Minute Walk Test (6MWT) and the Hamburg Quality of Life in Multiple Sclerosis (HAQUAMS) instrument, respectively. Assessments were measured before and after a massage period and a rest period where no massages were employed. Results. The results displayed no significant changes in 6MWT distances or HAQUAMS scores. However, the participants perceived improvement in overall health as expressed in written comments. Conclusions. Massage is a safe, noninvasive treatment that may assist MS patients in managing the stress of their symptoms. Future studies with larger sample size and cortisol measures are warranted.

BackgroundIndividuals with neurological disorders often have difficulty negotiating stairs that can lead to injurious falls. Clinicians lack a clinical tool to identify impairments in stair negotiation and to assist their decision making regarding treatment plans to improve stair performance and safety. We developed a new tool called the Step Test Evaluation of Performance on Stairs (STEPS) that is designed to assess stair performance and safety in neurological populations.ObjectivesThis study aimed to determine interrater and intrarater reliability of STEPS and its concurrent content validity to various clinical balance and mobility measures using individuals with Huntington’s disease (HD) as the first test population.MethodsForty individuals with HD (mean age 50.35) participated. Three observers rated live performances of the STEPS (interrater reliability) and seven observers rated videotaped performances twice (intrarater reliability). STEPS scores correlated with clinical mobility and balance test scores.ResultsExcellent inter- and intrarater reliability (ICCs = 0.91 and 0.89 respectively) and good internal consistency (α = 0.83) were found. Better STEPS performance correlated with better performance on co-administered motor and mobility measures and Stair Self-Efficacy scores. Per multivariable regression analysis, the Unified Huntington’s Disease Rating Scale modified motor score and descent time were significant predictors of STEPS performance.ConclusionsThe STEPS tool is easy to administer, requires no special devices and can be completed in less than five minutes. In the HD test population, it shows high reliability and validity making it a potentially useful tool for assessing maneuverability and safety on stairs in HD. The results suggest that the STEPS tool warrants further study to determine STEPS cut-off values for fall prediction in HD and may prove useful as an assessment tool for other neurological disorders.

PurposeMobility difficulties are prevalent in patients with Multiple Sclerosis (MS) and often result in a loss of independence and a diminished quality of life. Massage therapy is a noninvasive supplemental treatment that many MS patients utilize to assist in their symptom management. We explored the effect of massage therapy on mobility and overall quality of life (QoL) of MS patients. MethodsTwenty-four MS patients with scores ranging from 3.0 to 7.0 on the Expanded Disability Status Scale (EDSS) received four weeks of Swedish massage treatments. The Six-Minute-Walk-Test (6MWT) was used to assess their exercise capacity and leg function and the Hamburg Quality of Life in MS (HAQUAMS) instrument was used to assess changes in client QoL. These assessments were measured before and after a massage period and a rest period where no massages were employed. ResultsThe results displayed no significant changes in 6MWT distances or HAQUAMS scores after massage or rest periods. However, clients' personal health rating improved after massage and deteriorated when massages were removed. Client comments collected at the end of the study supported this change. The improvement in patient perception could have been due to an analgesic effect of massage that decreases pain. In addition, the relaxation induced by massage is very beneficial in stress management and thus symptom management for MS individuals. ConclusionAlthough the results from this study display a limited significant change after massage treatments, it is important to note that no harm was being done. Thus, massage is a safe, non-invasive supplementary treatment option that may assist MS patients to manage the stress of their symptoms and improve quality of life.

Objective: The objective of this study is to assess the perceptions of Indigenous medical students on postgraduate admissions through an Indigenous admissions pathway (IAP), and to determine what factors may influence Indigenous medical students’ choice of residency training program.       Methods: We distributed a survey to self-identified Indigenous students at settler Canadian medical schools. The survey questioned the students’ acceptability of an IAP, and what factors would influence application through an IAP. Analysis included descriptive statistics and thematic analysis of open-ended questions. Results: Thirty-six participants responded to the survey. Location and proximity to family or support system were the most important factors in choosing a residency program. Participants identified mentorship from Indigenous physicians and community involvement as being important features of a residency program that has an IAP. Eighty-one percent of participants felt the availability of an IAP would influence their choice of residency program. Fear of judgement or stigma, concern about entrance requirements, and program logistics were identified as barriers to applying to residency through an IAP. All participants believed that an IAP would have a positive influence on the healthcare system more broadly. Conclusions: An IAP appears to be an acceptable residency application format to Indigenous students but cannot exist in isolation. It is important for programs to consider the needs and safety of Indigenous trainees within residency programs.