Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology
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Sex-dimorphic landing mechanics and their role within the noncontact ACL injury mechanism: evidence, limitations and directions
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - - 2012
Bronchial hyperresponsiveness testing in athletes of the Swiss Paralympic team
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 5 - Trang 1-8 - 2013
The aim of this study was to assess airway hyperresponsiveness to eucapnic voluntary hyperventilation and dry powder mannitol challenge in athletes aiming to participate at the Paralympic Games 2008 in Beijing, especially in athletes with spinal cord injury. Forty-four athletes with a disability (27 with paraplegia (group 1), 3 with tetraplegia (group 2) and 14 with other disabilities such as blindness or single limb amputations (group 3) performed spirometry, skin prick testing, measurement of exhaled nitric oxide, eucapnic voluntary hyperventilation challenge test (EVH) and mannitol challenge test (MCT). A fall in FEV1 of ≥10% in either challenge test was deemed positive for exercise-induced bronchoconstriction. Fourteen (32%) athletes were atopic and 7 (16%) had a history of physician-diagnosed asthma. Absolute lung function values were significantly lower in patients of group 1 and 2 compared to group 3. Nine (20%) athletes were positive to EVH (8 paraplegics, 1 tetraplegic), and 8 (18%) athletes were positive to MCT (7 paraplegics, 1 tetraplegic). Fourteen (22.7%) subjects were positive to at least one challenge; only three athletes were positive to both tests. None of the athletes in group 3 had a positive test. Both challenge tests showed a significant association with physician-diagnosed asthma status (p = 0.0001). The positive and negative predictive value to diagnose physician-diagnosed asthma was 89% and 91% for EHV, and 75% and 86% for MCT, respectively. EVH and MCT can be used to identify, but especially exclude asthma in Paralympic athletes.
Clinical examination of the knee: know your tools for diagnosis of knee injuries
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 3 - Trang 1-10 - 2011
The clinical evaluation of the knee is a fundamental tool to correctly address diagnosis and treatment, and should never be replaced by the findings retrieved by the imaging studies carried on the patient. Every surgeon has his own series of exams with whom he is more confident and on whom he relies on for diagnosis. Usually, three sets of series are used: one for patello-femoral/extensor mechanism pathologies; one for meniscal and chondral (articular) lesions; and one for instability evaluation. This review analyses the most commonly used tests and signs for knee examination, outlining the correct way to perform the test, the correct interpretation of a positive test and the best management for evaluating an injured knee both in the acute and delayed timing.
Shoulder muscle endurance: the development of a standardized and reliable protocol
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 3 - Trang 1-14 - 2011
Shoulder muscle fatigue has been proposed as a possible link to explain the association between repetitive arm use and the development of rotator cuff disorders. To our knowledge, no standardized clinical endurance protocol has been developed to evaluate the effects of muscle fatigue on shoulder function. Such a test could improve clinical examination of individuals with shoulder disorders. Therefore, the purpose of this study was to establish a reliable protocol for objective assessment of shoulder muscle endurance. An endurance protocol was developed on a stationary dynamometer (Biodex System 3). The endurance protocol was performed in isotonic mode with the resistance set at 50% of each subject's peak torque as measured for shoulder external (ER) and internal rotation (IR). Each subject performed 60 continuous repetitions of IR/ER rotation. The endurance protocol was performed by 36 healthy individuals on two separate occasions at least two days apart. Maximal isometric shoulder strength tests were performed before and after the fatigue protocol to evaluate the effects of the endurance protocol and its reliability. Paired t-tests were used to evaluate the reduction in shoulder strength due to the protocol, while intraclass correlation coefficients (ICC) and minimal detectable change (MDC) were used to evaluate its reliability. Maximal isometric strength was significantly decreased after the endurance protocol (P < 0.001). The total work performed during the last third of the protocol was significantly less than the first third of the protocol (P < 0.05). The test-retest reliability of the post-fatigue strength measures was excellent (ICC >0.84). Changes in muscular performance observed during and after the muscular endurance protocol suggests that the protocol did result in muscular fatigue. Furthermore, this study established that the resultant effects of fatigue of the proposed isotonic protocol were reproducible over time. The protocol was performed without difficulty by all volunteers and took less than 10 minutes to perform, suggesting that it might be feasible for clinical practice. This protocol could be used to induce local muscular fatigue in order to evaluate the effects of fatigue on shoulder kinematics or to evaluate changes in shoulder muscle endurance following rehabilitation.
A tale of 10 European centres – 2010 APOSSM travelling fellowship review in ACL surgery
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 4 - Trang 1-11 - 2012
The purpose of ESSKA- APOSSM Travelling fellowship is to better understand the epidemiology, management and surgical techniques for sports across continents. There has been a progressive evolution in ACL reconstruction and there is variation in technique in ACL reconstruction amongst the most experienced surgeons in different continents. During this one month fellowship, we saw various ACL reconstruction techniques using different graft sources, with a variety of graft fixation methods, with the common aim of recreating an anatomical ACL reconstruction.
Biomechanical comparison between single-bundle and double-bundle anterior cruciate ligament reconstruction with hamstring tendon under cyclic loading conditionAbstract Purpose Methods Results Conclusions
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - - 2012
The purpose of this study was to compare the anterior tibial translation (ATT) of the anterior cruciate ligament (ACL) reconstructed-knee between single-bundle and double-bundle ACL reconstruction under cyclic loading.
Single-bundle and double-bundle reconstructions of the knee were performed sequentially in randomized order on the same side using eight human amputated knees. After each reconstruction, the reconstructed-knee was subjected to 500-cycles of 0 to 100-N anterior tibial loads using a material testing machine. The ATT before and after cyclic loading and “laxity increase”, which indicated a permanent elongation of the graft construct, was also determined.
The ATT after cyclic loading increased in both single-bundle and double-bundle reconstruction techniques compared to that without cyclic loading. Changes in ATT before and after cyclic loading were 3.9 ± 0.9 mm and 2.9 ± 0.6 mm respectively, and were significantly different. Laxity increase was also significantly different (4.3 ± 0.9 mm and 3.2 ± 0.8 mm respectively). Although no graft rupture or graft fixation failure was found during cyclic loading, the graft deviated into an eccentric position within the tunnel.
Although ATT was significantly increased in both single-bundle and double-bundle reconstruction with hamstring tendon after cyclic loading test, there was significant difference. Double-bundle reconstruction might be superior to prevent increasing ATT under cyclic loading. Deformation of hamstring tendon after cyclic loading might result in deterioration of knee stability after ACL reconstruction, and is one of disadvantages of soft tissue graft.
The possible benefits of reduced errors in the motor skills acquisition of children
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 4 - Trang 1-4 - 2012
An implicit approach to motor learning suggests that relatively complex movement skills may be better acquired in environments that constrain errors during the initial stages of practice. This current concept paper proposes that reducing the number of errors committed during motor learning leads to stable performance when attention demands are increased by concurrent cognitive tasks. While it appears that this approach to practice may be beneficial for motor learning, further studies are needed to both confirm this advantage and better understand the underlying mechanisms. An approach involving error minimization during early learning may have important applications in paediatric rehabilitation.
One strategy for arthroscopic suture fixation of tibial intercondylar eminence fractures using the Meniscal Viper Repair System
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 3 - Trang 1-5 - 2011
Principles for the treatment of tibial intercondylar eminence fracture are early reduction and stable fixation. Numerous ways to treatment of this fracture have been invented. We designed a simple, low-invasive, and arthroscopic surgical strategy for tibial intercondylar eminence fracture utilizing the Meniscal Viper Repair System used for arthroscopic meniscal suture. We studied 5 patients, who underwent arthroscopic suture fixation that we modified. The present technique utilized the Meniscal Viper Repair System for arthroscopic suture of the meniscus. With one handling, a high-strength ultra-high molecular weight polyethylene(UHMWPE) suture can be passed through the anterior cruciate ligament (ACL) and the loops for suture retrieval placed at both sides of ACL. Surgical results were evaluated by the presence or absence of bone union on plain radiographs, postoperative range of motion of the knee joint, the side-to-side differences measured by Telos SE, and Lysholm scores. The reduced position achieved after surgery was maintained and good function was obtained in all cases. The mean distance of tibia anterior displacement and assessment by Lysholm score showed good surgical results. This method simplified the conventional arthroscopic suture fixation and increased its precision, and was applicable to Type II fractures that could be reduced, as well as surgically indicated Types III and IV. The present series suggested that our surgical approach was a useful surgical intervention for tibial intercondylar eminence fracture.
A comparison land-water environment of maximal voluntary isometric contraction during manual muscle testing through surface electromyography
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 5 - Trang 1-6 - 2013
The aim of this study was to compare through surface electromyographic (sEMG) recordings of the maximum voluntary contraction (MVC) on dry land and in water by manual muscle test (MMT). Sixteen healthy right-handed subjects (8 males and 8 females) participated in measurement of muscle activation of the right shoulder. The selected muscles were the cervical erector spinae, trapezius, pectoralis, anterior deltoid, middle deltoid, infraspinatus and latissimus dorsi. The MVC test conditions were random with respect to the order on the land/in water. For each muscle, the MVC test was performed and measured through sEMG to determine differences in muscle activation in both conditions. For all muscles except the latissimus dorsi, no significant differences were observed between land and water MVC scores (p = 0.063–0.679) and precision (%Diff = 7–10%) were observed between MVC conditions in the muscles trapezius, anterior deltoid and middle deltoid. If the procedure for data collection is optimal, under MMT conditions it appears that comparable MVC sEMG values were achieved on land and in water and the integrity of the EMG recordings were maintained during wáter immersion.
Cố định bằng vít nội tuỷ kết hợp ghép xương tự thân để điều trị gãy xương đốt bàn chân thứ năm gần thân xương ở vận động viên: một loạt các trường hợp Dịch bởi AI Tóm tắt Đặt vấn đề Phương pháp
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology - Tập 4 Số 1 - 2012
Các trường hợp liền xương chậm hoặc gãy lại không phải là hiếm gặp sau khi điều trị phẫu thuật cho các bệnh nhân gãy xương đốt bàn chân thứ năm gần thân xương. Cố định bằng vít nội tuỷ kết hợp ghép xương tự thân có tiềm năng để giải quyết vấn đề này. Mục tiêu của nghiên cứu này là đánh giá kết quả của phương pháp này.
Tác giả đã tiến hành xem xét hồi cứu 15 vận động viên đã trải qua điều trị phẫu thuật cho gãy xương đốt bàn chân thứ năm gần thân xương. Phẫu thuật bao gồm việc cố định bằng vít xốp có ống nội tuỷ sau khi nạo ổ gãy, tiếp theo là ghép xương tự thân. Sau phẫu thuật, các bệnh nhân giữ chế độ không chịu lực trong bột hoặc nẹp trong hai tuần và không cần giữ cố định thêm hai tuần nữa. Tất cả bệnh nhân được phép chịu lực cách đầy đủ sau sáu tuần phẫu thuật. Chạy được cho phép sau khi có hình ảnh X-quang cho thấy xương đã liền, và việc trở lại thi đấu được chấp thuận sau khi tăng dần cường độ vận động.
#Gãy xương đốt bàn chân thứ năm #cố định nội tuỷ #ghép xương tự thân #thể thao #điều trị phẫu thuật
Tổng số: 73
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