BackgroundPatients with frozen shoulder show limited shoulder mobility often accompanied by pain. Common treatment methods include physiotherapy, pain medication, administration of corticosteroids, and surgical capsulotomy. Frozen shoulder often lasts from months to years and mostly affects persons in the age group of 40 to 70 years. It severely reduces the quality of life and the ability to work.ObjectiveThe objective of this study was to evaluate the feasibility of a mobile health (mHealth) intervention that supports patients affected by “stage two” frozen shoulder. Patients were supported with app-based exercise instructions and tools to monitor their training compliance and progress. These training compliance and progress data supplement the patients’ oral reports to the physiotherapists and physicians and can assist them in therapy adjustment.MethodsIn order to assess the feasibility of the mHealth intervention, a pilot study of a newly developed app for frozen shoulder patients was conducted with 5 patients for 3 weeks. The main function of the app was the instruction for exercising at home. Standardized questionnaires on usability such as System Usability Scale (SUS) and USE (Usefulness, Satisfaction, and Ease of use), and Technology Acceptance Model-2 (TAM-2) were completed by the study participants at the end of the study. Additionally, a nonstandardized questionnaire was completed by all patients. The correctness of the exercises as conducted by the patients was assessed by a physiotherapist at the end of the study. The mobility of the shoulder and pain in shoulder movement was assessed by a physiotherapist at the start and the end of the study.ResultsThe pilot study was successfully conducted, and the app was evaluated by the patients after 3 weeks. The results of the standardized questionnaires showed high acceptance (TAM-2) and high usability (SUS) of the developed app. The overall usability of the system as assessed by the SUS questionnaire was very good (an average score of 88 out of 100). The average score of the TAM-2 questionnaire on the intention to further use the app was 4.2 out of 5, which indicated that most patients would use the app if further available. The results of the USE questionnaires highlighted that the patients learned how to use the app easily (an average score of 4.2 out of 5) and were satisfied with the app (an average score of 4.7 out of 5). The frequency of app usage and training was very high based on patient reports and verified by analysis of the usage data. The patients conducted the exercises almost flawlessly.ConclusionsOur results indicate the feasibility of the mHealth intervention, as the app was easy to use and frequently used by the patients. The app supported the patients’ physiotherapy by providing clear exercising instructions.

Visual perceptual decisions can be altered by recent experience. In the “serial dependence” effect, participants’ responses to visual stimuli appear to be biased toward (i.e., attracted to) recently encountered stimuli. Fischer and Whitney (2014) proposed that serial dependence reflects a “continuity field” that promotes visual stability by biasing perception toward the recent past. However, when participants are relatively accurate on the prior trial, there is no discernible difference between attraction to the prior stimulus and attraction to the prior response. To tease apart these alternative explanations of the attraction effect, we developed two complementary analysis techniques that rely on participants’ naturally occurring errors on a trial-by-trial basis, identifying any effect of the prior stimulus and, separately, any effect of the prior response (i.e., each effect could be attractive, repulsive, or absent). Applying these techniques to serial dependence data from a new experiment and four previously published studies, including Fischer and Whitney’s, we found that serial dependencies reflect an attraction to the previous response and repulsion from the previous stimulus, with these effects cancelling each other to different degrees for different experiments. In no case did we find evidence of an attraction to the prior stimulus. These results are consistent with literatures that predate the serial dependence effect: Attraction to prior responses is routinely observed in a wide variety of paradigms and repulsion from prior stimuli is ubiquitous, such as in the tilt aftereffect.

Background Non-specific chronic low back pain (nscLBP) has a high socio-economic relevance due to its high incidence, prevalence and associated costs. Therefore, it is essential to evaluate effective therapeutic strategies. This study examines the effects of moderate mountain exercise and spa therapy on orthopedic and psychophysiological parameters. Based on a three-armed randomized controlled trial, guided mountain hiking tours and balneotherapy in thermal water were compared to a control group. Methods Eighty patients with diagnosed nscLBP were separated into three groups: The two intervention groups GE (green exercise) and GEBT (green exercise and balneotherapy) undertook daily mountain hiking tours, whereas the GEBT group got an additional treatment with baths in Mg-Ca-SO 4 thermal water. The third group (CO) received no intervention. GE and GEBT group were treated for 6 days; all groups were followed up for 120 days. Results Compared to GE and CO group, the GEBT treatment showed significant improvements of pain, some orthopedic parameters, health-related quality of life and mental well-being in patients with nscLBP. Conclusions The results of this study confirmed a benefit of mountain hiking combined with Mg-Ca-SO 4 spa therapy as a multimodal treatment of patients with nscLBP. Further studies should focus on long-term-effects of this therapeutic approach. Trial registration ISRCTN, ISRCTN99926592 . Registered 06. July 2018 - Retrospectively registered.

Introduction Intravenous leiomyomatosis (ILV) is a rare pathology, part of leiomyoma beyond the uterus (LBU), characterized by benign smooth muscle cell tumor outside of the uterus and mainly affecting premenopausal woman with a medical history of leiomyoma or gynecologic surgical treatment. The treatment depends on the localization of the tumor, age of the patient, initial size, symptoms and the suitability for surgery but should always aims in toto surgical resection. Case presentation Retrospective case series and review of literature. Clinical discussion Symptoms presented by the patient were aspecific and only localized in the pelvic area. All cases were fortuitous histopathological diagnosis. No relapse was. Two out of 5 patients have pulmonary nodules, only one was biopsied and diagnosed with PBML (pulmonary benign metastasizing leiomyoma). Conclusion IVL and BML are rare disease that can co-exist. Because of tumoral hormonal receptors, hormonotherapy could be an optional treatment but to date no clear efficacy is demonstrated. In case of high recurrence risk such as voluminous initial mass, impairment of broad ligament, failure of total surgical resection, adjuvant hormonotherapy could be useful. Recurrence rate is about 16.6-30% and can occur even dozen years later and even after radical surgery, justifying a regular follow up.