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OBJECTIVE: To evaluate the characteristics of patients who visited the Polyclinic during the Tokyo 2020 Olympics and analyze geographical and economic correlations with the number of clinic visits. DESIGN: Cross-sectional study. SETTING: Polyclinic during the Tokyo 2020 Olympics. PARTICIPANTS: Patients who visited the Polyclinic. INTERVENTION: Data from the electronic medical record system of the Polyclinic were extracted. MAIN OUTCOME MEASURES: The number of visits for each athlete or team official was calculated by country. Relationship between number of visits per patient and total number of team members, total health expenditure per capita, density of medical doctors, life expectancy at birth, and education expenditure per gross domestic product (GDP) were investigated. Independent variables related to medal tables were also investigated. RESULTS: The average number of visits per athlete was 0.67, and it was higher in athletes from non-high-income countries compared with high-income countries for both male and female athletes. Number of visits per athlete was higher in countries with low life expectancy at birth (95% CI, -0.16 to -0.02, P = 0.012) and education expenditure per GDP (95% CI, -0.17 to -0.04, P = 0.003). CONCLUSIONS: During the Tokyo 2020 Olympics, the number of visits to the Polyclinic per athlete was higher in countries with low life expectancy at birth and education expenditure per GDP.
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The KOJI AWARENESS (KA) screening test assesses motor function in humans. We aimed to analyze the correlation between age and KA screening scores and to identify the specific age at which a significant decline occurs. A total of 793 healthy participants (234 females) were interviewed for basic information on age and sex and completed the KA screening test. In addition to calculating the total score from the KA test, the scores were calculated for the neck-scapula-upper extremity-complex (NSU), trunk, and lower extremity (LE) segments. Spearman's rank correlation coefficient was used to assess the validity of the test. Additionally, Bayesian linear regression was employed to estimate the change point in KA scores, facilitating the identification of a critical age associated with a notable decline in motor function. KA screening total and separate body segment scores were negatively correlated with age in both gender (for female and male, KA total score, ρ = - 0.443, ρ = - 0.344; NSU segment, ρ = - 0.431, ρ = - 0.427; trunk segment, ρ = - 0.210, ρ = - 0.473; LE segment: ρ = - 0.43, ρ = - 0.507). Furthermore, a change-point analysis using linear regression analysis showed that KA screening total scores declined sharply at the age of 49.1(95% credible interval: 37.503, 68.366). The result show that total KA scores decrease - 0.196 (95% credible interval: - 0.335, - 0.049) for every 1 year of age increase, and for ages over 49.1, total KA scores additionally decrease - 0.255 (95% credible interval: - 0.485, - 0.054) for every 1 year of age increase. In the NSU segment, females showed a more rapid decline than males from the age of 50 years. KA screening test total scores declined sharply at the age of 49.1. These results may be useful in setting treatment goals, exercise, and lifestyle programs for age-related decline in motor function.
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Envejecimiento , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Adulto Joven , Envejecimiento/fisiología , Factores de Edad , Actividad Motora/fisiología , Teorema de Bayes , Concienciación/fisiología , Extremidad Superior/fisiologíaRESUMEN
Background: The KOJI AWARENESS (KA) test is a practical self-evaluation tool that assesses body movements and may help develop individual conditioning plans to improve movement function. However, the association between preseason KA scores and in-season injury occurrence remains unexplored. Purpose: To investigate whether the KA self-screening test score can predict running-related injuries in elite long-distance runners. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 47 elite college male long-distance runners (age, 18-22 years) were enrolled in this study in June 2022. The participants underwent the KA self-screening test to assess preseason upper limb, core, and lower limb function. Running-related injuries with a training time loss of >3 weeks were tracked for 6 months during the season. The participants were divided into injury and noninjury groups, and between-group comparisons and receiver operating characteristic (ROC) curve analysis were used to determine the association between the KA scores and the injury incidence. Chi-square tests and risk ratios were calculated based on the cutoff value- and injury-based grouping. Results: Among the runners, 10 (21.3%) sustained an injury. There were no significant differences in the demographic characteristics between the injury and noninjury groups. The injury group had significantly lower KA scores than the noninjury group (median, 44.5 [interquartile range, 43-46.8] vs median, 48 [interquartile range, 46-50], respectively; P = .009). The ROC curve analysis determined a cutoff value of 46.5 points (sensitivity, 73%; specificity, 63.6%), indicating that the KA scores exhibited a relatively high predictive value for running-related injuries (area under the ROC curve, 0.764 [95% CI, 0.600-0.930]). The risk ratio for group division based on the cutoff value was 2.590 (95% CI, 1.329-5.047). Conclusion: These findings demonstrated that the KA test is an effective self-screening tool for predicting the risk of running-related injuries in elite male long-distance runners.
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Introduction: The safety of hyperbaric oxygen treatment (HBO2) in patients with cardiovascular implanted electronic devices (CIED) remains unclear. Methods: We conducted a retrospective analysis of seven CIED patients (median age 79 [73-83] years, five males [71.4%]), including five with pacemakers and two with implantable cardioverter defibrillators (ICD), who underwent HBO2 between June 2013 and April 2023. During the initial session, electrocardiogram monitoring was conducted, and CIED checks were performed before and after the treatment. In addition, the medical records were scrutinized to identify any abnormal CIED operations. Results: All seven CIED patients underwent HBO2 within the safety pressure range specified by the CIED manufacturers or general pressure test by the International Organization for Standardization (2.5 [2.5-2.5] atmosphere absolute × 18 [5-20] sessions). When comparing the CIED parameters before and after HBO2, no significant changes were observed in the waveform amplitudes, pacing thresholds, lead impedance of the atrial and ventricular leads, or battery levels. All seven patients, including two with the rate response function activated, exhibited no significant changes in the pacing rate or pacing failure. Two ICD patients did not deactivate the therapy, including the defibrillation; however, they did not experience any arrhythmia or inappropriate ICD therapy during the HBO2. Conclusion: CIED patients who underwent HBO2 within the safety pressure range exhibited no significant changes in the parameters immediately after the HBO2 and had no observable abnormal CIED operations during the treatment. The safety of defibrillation by an ICD during HBO2 should be clarified.
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This investigation evaluated the microvascular permeability and ultrastructure of skeletal muscle capillaries in skeletal muscle of diabetic (DIA) rats using two-photon laser scanning microscopy (TPLSM) and transmission electron microscopy (TEM). Microvascular permeability was assessed in the tibialis anterior muscle of control (CON) and DIA (streptozocin) male Wistar rats (n = 20, 10-14 wk) by in vivo imaging using TPLSM after fluorescent dye intravenous infusion. Fluorescent dye leakage was quantified to determine microvascular permeability. The ultrastructure was imaged by TEM ex vivo to calculate the size and number of intercellular clefts between capillary endothelial cells and also intracellular vesicles. Compared with control, the volumetrically determined interstitial fluorescent dye leakage, the endothelial cell thickness, and the number of intercellular clefts per capillary perimeter were significantly higher, and the cleft width was significantly narrower in TA of DIA (interstitial fluorescent dye leakage, 2.88 ± 1.40 vs. 10.95 ± 1.41 µm3 x min x 106; endothelial thickness 0.28 ± 0.02 vs. 0.45 ± 0.03 µm; number of intercellular clefts per capillary perimeter 6.3 ± 0.80 vs. 13.6 ± 1.7 /100 µm; cleft width 11.92 ± 0.95 vs. 8.40 ± 1.03 nm, CON vs. DIA respectively, all p <0.05). The size of intracellular vesicles in the vascular endothelium showed an increased proportion of large vesicles in the DIA group compared to the CON group (p < 0.05). Diabetes mellitus enhances the microvascular permeability of skeletal muscle microvessels, due, in part, to a higher density and narrowing of the endothelial intercellular clefts, and larger intracellular vesicles.
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There have been few investigations into the effectiveness of thoracic spine exercises for improving thoracic range of motion (ROM) in any plane. This study assessed the effectiveness of two thoracic spine exercises: one in the quadruped position and one in the thoracic standing position. We determined how these exercises affect thoracic spine mobility ROM over a 2-week intervention period. Thirty-nine healthy participants were enrolled and assigned to a Quadruped Thoracic Rotation group (n=17 participants: 9 females and 8 males) or Flamenco Thoracic Spine Rotation group (n=22: 14 females and 8 males). All participants were administered a KOJI AWARENESSTM screening test, and the initial thoracic spine ROM before intervention exercise was measured in a laboratory setting. Quadruped Thoracic Rotation was performed as the quadruped exercise and Flamenco Thoracic Spine Rotation as the standing exercise. The KOJI AWARENESSTM thoracic spine test and ROM were evaluated on the day after the first exercise session and again after the program. Despite their different approaches to thoracic mobility, the quadruped exercise and standing exercise achieved equivalent improvement in thoracic ROM after 2 weeks. Practitioners have a range of exercise options for enhancing thoracic mobility based on their environmental or task-specific needs.
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Terapia por Ejercicio , Rango del Movimiento Articular , Vértebras Torácicas , Humanos , Masculino , Femenino , Adulto , Vértebras Torácicas/fisiología , Rotación , Adulto Joven , Terapia por Ejercicio/métodosRESUMEN
This study aimed to determine differences in the hip abductor muscle activity during clam exercise at different hip flexion and femoral anteversion angles. Thirty healthy females were divided into two groups based on the femoral anteversion angle: the excessive femoral anteversion group and the normal group. Clam exercise was performed at three different hip flexion angles (60°, 45°, and 30°). Tensor fascia latae, gluteus medius, and superior portion of gluteus maximus activities were measured during the exercise, and the results were normalized to the activity during maximum voluntary isometric contraction to calculate the gluteal-to-tensor fascia latae muscle activation index. The superior portion of gluteus maximus activities at a hip flexion of 60° and 45° were greater than that at 30°. The excessive femoral anteversion group had a lower gluteal-to-tensor fascia latae muscle activation index than the normal group; the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° was higher than that at 45°, and the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° and 45° were higher than that at 30°. Therefore, the femoral anteversion angle and hip joint position were related to the activity of the hip abductor muscles during clam exercise. These findings may provide a rationale for instructing exercises to maximize the activity of the hip abductor muscles in individuals with an excessive femoral anteversion angle.
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Ejercicio Físico , Fémur , Articulación de la Cadera , Músculo Esquelético , Humanos , Femenino , Músculo Esquelético/fisiología , Articulación de la Cadera/fisiología , Fémur/fisiología , Fémur/diagnóstico por imagen , Fémur/anatomía & histología , Ejercicio Físico/fisiología , Rango del Movimiento Articular/fisiología , Adulto Joven , Adulto , Contracción Isométrica/fisiología , ElectromiografíaRESUMEN
BACKGROUND: Many middle-aged and older adults participate in running to maintain their health and fitness; however, some have to stop running due to osteoarthritis-attributed knee pain. It was unclear whether gait biomechanics and knee physical findings differ between those who can and cannot run. RESEARCH QUESTION: What are the gait and knee physical findings of patients with knee osteoarthritis who remain capable of running in comparison to those who are not capable of running? METHODS: This was a cross-sectional study, which recruited 23 patients over the age of 40 who had been diagnosed with knee osteoarthritis. Their knee joint ranges of motion and muscle strength, knee pain, and the maximum gait speed (walk as fast as possible) were measured. Knee alignment was calculated from X-ray images, and the knee joint extension angle and adduction moment during a self-selected gait speed were determined using motion analysis. Participants were divided into two groups-those able to run (n=11) and those unable to run (n=12). The measured and calculated outcomes were compared between groups, and logistic regression analyses of significantly different outcomes were performed. RESULTS: There were significant group differences in the maximum knee extension angle during stance phase (p = 0.027), maximum gait speed during the 10-m walk test (p = 0.014), knee pain during gait (p = 0.039) and medial proximal tibial angle by X-ray (p = 0.035). Logistic regression analyses revealed that the maximum knee extension angle during stance phase (OR: 1.44, 95%CI: 1.06¬1.94, p = 0.02) was a significant factor. SIGNIFICANCE: The ability to extend the knee during gait is an important contributing factor in whether participants with knee osteoarthritis are capable of running.
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Análisis de la Marcha , Osteoartritis de la Rodilla , Rango del Movimiento Articular , Carrera , Humanos , Osteoartritis de la Rodilla/fisiopatología , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Rango del Movimiento Articular/fisiología , Anciano , Carrera/fisiología , Fenómenos Biomecánicos , Articulación de la Rodilla/fisiopatología , Fuerza Muscular/fisiología , Velocidad al Caminar/fisiología , Marcha/fisiología , AdultoRESUMEN
Introduction: Core stability is crucial for preventing and rehabilitating lumbar spine injuries. An external focus instruction using a paper balloon is an effective way to activate the trunk muscles. However, the degree of trunk and lower extremity muscle activation during single leg stance with external focus instruction using a paper balloon is unknown. This study aimed to investigate the core muscle involving activity in the trunk and lower extremities on both the support and non-support sides with or without using external focus instruction using a paper balloon during isometric single-leg stance. Methods: Thirteen healthy males aged 20-28 years volunteered to take part in this study and performed a single leg stance task with and without an external focus instruction, pressing their non-supporting foot onto a paper balloon without crushing it. The participant's muscle electrical activity was recorded during the single leg task using surface EMG and intramuscular EMG for six trunk muscles (transversus abdominis, internal oblique, external oblique, rectus abdominis, multifidus, and lumbar erector spinae) and five lower extremity muscles (gluteus maximus, gluteus medius, adductor longus, rectus femoris, and biceps femoris). Results: Compared to the normal single leg stance, the external focus instruction task using a paper balloon showed significantly increased transversus abdominis (p < 0.001, p < 0.001), internal oblique (p = 0.001, p < 0.001), external oblique (p = 0.002, p = 0.001), rectus abdominal (p < 0.001, p < 0.001), lumbar multifidus (p = 0.001, p < 0.001), lumbar erector spinae (p < 0.001, p = 0.001), adductor longus (p < 0.001, p < 0.001), rectus femoris (p < 0.001, p < 0.001), and biceps femoris (p < 0.010, p < 0.001) muscle activity on the support and non-support sides. Conclusion: In conclusion, external focus instruction using a paper balloon significantly activates the trunk and lower extremities muscles on both the support and non-support sides. This finding provides insights for designing programs to improve coordination and balance. The benefits extend to diverse individuals, encompassing athletes, tactical professionals, and the general population, mitigating the risk of injury or falls linked to inadequate lower limb balance.
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Purpose: This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale among patients following ACL reconstruction. Methods: Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL-RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL-RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single-leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate <0.05 in simple linear regression analyses as independent variables and the ACL-RSI in each subcategory score as the dependent variable. Results: Multiple regression analysis showed that subjective running ability affected all subcategories (p ≤ 0.001), and that the limb symmetry index of medial SLH distance affected both the Emotions (p = 0.047) and Confidence (p = 0.009) subcategories. Higher subjective running ability and greater limb symmetry in the medial SLH were thus positively associated with each dimension of psychological readiness. Conclusions: This study highlights the differential impact of physical function factors on specific subcategories of the ACL-RSI scale, providing clinicians with insights for designing targeted rehabilitation strategies. This original paper suggests the importance of analysing factors related to subcategory scores in addition to total ACL-RSI score, and could contribute to the understanding of determinants for a successful return to sport following ACL reconstruction. Level of Evidence: Level IV.
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Aim: More than 15,000 elite athletes participated in the Tokyo 2020 Olympic and Paralympic Games. Providing adequate medical services to these elite athletes was a priority. Hence, a polyclinic was established in the Athletes' Village. Visitors were triaged at the emergency department of the polyclinic to enable early treatment of critical illnesses or injuries in the emergency room (ER) and to identify patients suspected of having coronavirus disease as early as possible. No reports of emergency department activities at large sporting events in the pandemic era are available. Here, we aim to summarize the activities at the emergency department of the polyclinic. Methods: Data were collected using an electronic medical record system, nursing records, and questionnaires administered during triage from July 13 to September 8, 2021. Polyclinic data involving accredited athletes and team members were summarized. Results: During the Olympic Games, 12,318 triage cases were reported, of which 75 were treated in the ER. During the Paralympic Games, 8398 triage cases were reported, of which 94 were treated in the ER. During the Olympic Games, musculoskeletal issues (26 patients) were the most common. During the Paralympic Games, ear, nose, and throat issues were the most common (21 patients). Two patients experienced cardiopulmonary arrest in the Athletes' Village and were transported to the hospital postresuscitation. Conclusion: During the study period, many critically ill patients were triaged and treated at the emergency department. Our data can be used to improve medical care and infection prevention at future international sporting events.
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BACKGROUND: The KOJI AWARENESS� screening test is a self-administered screening tool for assessment of mobility, stability, and strength. It provides corrective exercises corresponding to the individual's answers to the KOJI AWARENESS� test questions. However, there is no evidence of the effectiveness of corrective exercises in improving KOJI AWARENESS� screening test scores and activity-related pain. METHODS: Twenty-six healthy subjects (11 female and 15 male ; age 20?50 years) were selected for participation. In a controlled laboratory setting, subjects were administered the KOJI AWARENESS� test and were provided with individualized exercise programs based on the results of this first test. KOJI AWARENESS� results were checked on the first day immediately after the first exercise session, and then again after the two-week program. Pain intensity was also assessed during daily training using a numerical rating scale. RESULTS: Compared to pre-intervention, KOJI AWARENESS� scores were significantly higher immediately after the first corrective exercise session and after 2 weeks of intervention (p<0.001). Moreover, pain intensity was significantly lower after 2 weeks of intervention (p<0.001). CONCLUSIONS: Individualized KOJI AWARENESS� corrective exercises were effective immediately on the first day and also after the two-week program in improving the KOJI AWARENESS� score and reducing pain intensity during daily training. J. Med. Invest. 70 : 208-212, February, 2023.
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Terapia por Ejercicio , Ejercicio Físico , Humanos , Masculino , Femenino , Persona de Mediana Edad , Dimensión del Dolor , Terapia por Ejercicio/métodos , Dolor/prevención & controlRESUMEN
BACKGROUND: During the Tokyo 2020 Games, pharmacists were required to provide appropriate pharmacotherapeutic care to athletes and officials at the polyclinic. Owing to the worldwide COVID-19 pandemic that was prevalent at the Games, it was imperative to strengthen infection control measures in the setting of such a major sporting event and to prevent and minimize the spread of COVID-19. OBJECTIVE: This study reports on the COVID-19 infection control measures and services provided by the pharmacy at the Tokyo 2020 Games. By evaluating pharmacy operations that took place under the COVID-19 protocol, this study provides insights for the organization of future sporting events, specifically their medical facilities. METHODS: Infection control measures in the pharmacy were implemented in accordance with the manual for dealing with COVID-19 infections. The number and content of issued and dispensed prescriptions were obtained from the electronic medical records and pharmacy department systems. These data were compared with those of the London 2012 Games, which were used as a reference for the pharmacy operations at the Tokyo 2020 Games. RESULTS: The participating pharmacists were fully trained in infection control measures. The number of prescriptions issued during the Olympics and Paralympics were 1120 and 1022, respectively. Prescriptions issued at the fever clinic accounted for 4% of the total number (77/2142). No influenza antiviral medications were prescribed, though medications to alleviate cold-like symptoms were issued. Compared to the London 2012 Games, there was a decrease (-59%) in the number of prescriptions. CONCLUSION: The positive impact of COVID-19 infection control measures was evident. The volume of prescriptions at the Tokyo 2020 Games was lower than that at the London 2012 Games. It was inferred that this was due to thorough infection control measures as well as enhanced pre-entry medical checkups before entering Japan, which reduced the incidence of diseases.
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COVID-19 , Servicios Farmacéuticos , Humanos , Tokio , Pandemias , Instituciones de Atención AmbulatoriaRESUMEN
PURPOSE: To identify the factors associated with anterior cruciate ligament return to sport after injury (ACL-RSI) scores in patients awaiting ACL reconstruction (ACLR). METHODS: This was a retrospective cross-sectional observational study conducted at a single clinical center. We recruited patients scheduled for primary ACLR, aged 16-45 years, and with modified Tegner activity scale scores ≥5 before ACL injury. The main outcome was psychological readiness to return to sport (RTS), as measured using the ACL-RSI scale. Participants' personal and injury-related information were obtained, and their psychological status (Tampa Scale for Kinesiophobia [TSK] and athletic identity measurement scale) and knee functions (effusion, range of motion, joint stability, and knee flexion angle during a single-leg squat) were examined. All variables were assessed the day before the surgery. RESULTS: A total of 105 patients (median [interquartile range]: age, 20.0 [9.0] years; body mass index, 22.8 [4.3] kg/m2; days from injury to surgery, 63.0 [65.0] days; 44% female) were enrolled. Univariate analysis indicated that only the TSK score was associated with the ACL-RSI scores (r = -0.305; P = .02). Multiple regression analysis of factors, including sex, preinjury Tegner activity scale score, and days from injury to surgery, further showed that only the TSK score was associated with the ACL-RSI scores (P = .002; 95% confidence interval -1.738 to -0.394). CONCLUSIONS: In patients awaiting ACLR, kinesiophobia was moderately negatively associated with psychological readiness to RTS, while other factors were not. LEVEL OF EVIDENCE: Level III, retrospective cross-sectional observational study.
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Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Deportes , Humanos , Femenino , Adulto Joven , Adulto , Masculino , Volver al Deporte/psicología , Estudios Retrospectivos , Estudios Transversales , Kinesiofobia , Lesiones del Ligamento Cruzado Anterior/complicaciones , Lesiones del Ligamento Cruzado Anterior/cirugía , Lesiones del Ligamento Cruzado Anterior/psicología , Reconstrucción del Ligamento Cruzado Anterior/psicologíaRESUMEN
BACKGROUND: Medial tibial stress syndrome (MTSS) is a running-related injury of the lower extremities. After returning to competition, there are often recurring episodes of MTSS. Therefore, it is important to prevent the onset and recurrence of MTSS among long-distance runners. This case-control study aimed to compare the kinematics and kinetics of runners with and without previous MTSS during running to clarify the biomechanical characteristics of the lower extremity of runners with previous MTSS. METHODS: Thirteen male long-distance runners aged over 18 years and asymptomatic at the time of measurement were divided into an MTSS group and a non-MTSS group based on their history of MTSS as reported in a questionnaire. The kinetics and kinematics of running were analyzed when participants ran at a speed of 2.0 ± 0.2 m/s by a three-dimensional motion analysis system and two force plates. Data regarding the joint angles, moments, and powers of the ankle, knee, and hip during the stance phase while running were extracted and compared between the two groups using the Mann-Whitney U test. RESULTS: Of the 13 participants, 5 and 8 were included in the MTSS (10 legs) and non-MTSS (16 legs) groups, respectively. The ankle maximum eversion moment was significantly larger in the MTSS group than in the non-MTSS group (p = 0.04). There were no significant differences in other parameters. CONCLUSIONS: This study found that the ankle maximum eversion moment during the stance phase of running was larger in the MTSS group than in the non-MTSS group. Even after the disappearance of the symptoms of MTSS, the running biomechanics of participants with previous MTSS differed from those of participants without previous MTSS.
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Síndrome de Estrés Medial de la Tibia , Humanos , Masculino , Adulto , Persona de Mediana Edad , Síndrome de Estrés Medial de la Tibia/prevención & control , Estudios de Casos y Controles , Extremidad Inferior , Articulación del Tobillo , Pierna , Fenómenos Biomecánicos , Articulación de la RodillaRESUMEN
INTRODUCTION: Kinesiophobia is a fear of physical movement and activity and is known to affect return to sports and second injury after anterior cruciate ligament reconstruction. OBJECTIVE: To determine the association among landing biomechanics, knee pain, and kinesiophobia in athletes following anterior cruciate ligament reconstruction. DESIGN: A cross-sectional study. SETTING: Clinical center of sports medicine. PARTICIPANTS: This study included 31 athletes who participated in sports after primary, unilateral anterior cruciate ligament reconstruction (age, median [interquartile range]: 20.0 [7.0] years; body mass index: 22.2 [2.6] kg/m2 ; time from anterior cruciate ligament reconstruction: 24.0 [23.0] months). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Kinesiophobia was measured using the Tampa Scale for Kinesiophobia-11. Knee function included joint laxity, strength, and single-leg hop distance. Knee pain intensity during sports activities was measured using a numerical rating scale. Vertical ground reaction force was measured, and electromyography data for the vastus medialis and semitendinosus muscles during single-leg jump landing were collected. Univariate correlation analysis and multiple regression analysis were performed to identify the associations between the Tampa Scale for Kinesiophobia-11 score and outcome measures. RESULTS: There was no correlation between peak vertical ground reaction force and Tampa Scale for Kinesiophobia-11 score (Spearman's r = -0.17, p = .355). On multiple regression analyses, lower preparatory vastus medialis activity during landing (beta coefficient = -0.51, p < .001) and knee pain intensity (beta coefficient = 0.57, p < .001) were significantly associated with greater Tampa Scale for Kinesiophobia-11 scores. CONCLUSIONS: In athletes who have participated in sports following anterior cruciate ligament reconstruction, lower preparatory vastus medialis activity during landing and knee pain intensity are associated with greater kinesiophobia. These findings indicate that interventions to address the landing muscle activity pattern and pain control should be performed to decrease kinesiophobia after anterior cruciate ligament reconstruction.
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Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Humanos , Adulto Joven , Adulto , Estudios Transversales , Kinesiofobia , Fenómenos Biomecánicos , Lesiones del Ligamento Cruzado Anterior/cirugía , Articulación de la Rodilla , Atletas , Dolor , Reconstrucción del Ligamento Cruzado Anterior/efectos adversosRESUMEN
CONTEXT: Deficits in knee extension strength after anterior cruciate ligament reconstruction have been a major problem. The inadequate recovery of the knee extension strength of surgical limb reportedly delays return to sports and increases reinjury risk. Accordingly, the early detection of knee extension strength deficits after reconstruction may help plan early interventions to manage impairment. This study aimed to clarify the association between knee extension strength at 3 and 6 months after anterior cruciate ligament reconstruction. DESIGN: Retrospective study. METHODS: Fifty patients who underwent primary anterior cruciate ligament reconstruction using hamstring grafts were included. At 3 months postoperatively, the limb symmetry index (LSI) of isokinetic knee extension strength (IKE) at 60°/s, degree of swelling, passive range of motion of knee flexion and extension, and anterior leg reach distance were measured. At 6 months postoperatively, the LSI of IKE was measured at 60°/s, which was used as the main outcome. A correlation analysis was performed with the LSI of IKE at 6 months postoperatively as the dependent variable and the LSI of IKE at 3 months postoperatively as the independent variable. Subsequently, a multiple regression analysis was performed, with LSI of IKE at 6 months postoperatively as the dependent variable; LSI of IKE at 3 months postoperatively as the independent variable; and other variables, demographic information, and surgical data as covariates. RESULTS: The correlation analysis revealed that the LSIs of IKE at 3 and 6 months postoperatively were correlated (r = .535, P < .001). In the multiple regression analysis, the LSI of IKE at 3 months postoperatively was significantly associated with that at 6 months postoperatively, even when other variables were included as covariates (R2 = .349, P = .004). CONCLUSION: Asymmetry of knee extension strength at 3 months postoperatively could be more useful than other variables related to knee strength in predicting the asymmetry of knee extension strength at 6 months postoperatively.
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Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Humanos , Estudios Retrospectivos , Lesiones del Ligamento Cruzado Anterior/cirugía , Articulación de la Rodilla/cirugía , Extremidad Inferior , Fuerza Muscular , Músculo CuádricepsRESUMEN
BACKGROUND: As no previous study has directly compared the linear wear rate in two types of second-generation annealed highly cross-linked polyethylene, we performed a retrospective study with a minimum of 5-year follow-up to assess primary arthroplasties in the (1) wear rates and (2) incidence of osteolysis of the two types of HXLPE. HYPOTHESIS: There was no significant difference in the linear wear rate and the incidence of osteolysis between the two types of second-generation annealed highly cross-linked polyethylene. PATIENTS AND METHODS: In this single-center study, we reviewed 257 cases of primary cementless total hip arthroplasties between 2011 and 2015, which were performed with 32mm delta ceramic on second-generation annealed highly cross-linked polyethylene (X3 and E1 were used in 105 and 103 cases, respectively.). The mean wear rate was evaluated using a computer-assisted method, and the incidence of osteolysis was evaluated based on the appearance of a localized area with loss of trabecular bone or cortical erosion adjacent to the implants during the latest follow-up. RESULTS: In total, we evaluated 208 cases, followed postoperatively for over 5 years (mean, 6.1 years, range: 5.0-8.0). There were no significant differences between the two groups with respect to age (list in order of Group X, Group E, p value) (61.2±12.3, 62.7±12.1, p=0.36), sex (ratio of male: 17.1%, 14.6%, p=0.61), body mass index (22.9±3.7, 22.8±4.0, p=0.91), pre- (49.9±14.8, 48.5±13.8, p=0.49) and post-operative (91.3±9.1, 92.7±7.0, p=0.23) Japanese Orthopaedic Association Hip Score, cup size (50.8±3.0, 50.9±2.2, p=0.70), cup inclination (38.7±4.8, 37.6±4.8, p=0.10), and cup anteversion (18.7±6.9, 18.5±7.6, p=0.80). The mean linear wear rates of the X3 and E1 groups were 0.057±0.039 (range: 0-0.16) and 0.054±0.037mm/year (range: 0-0.15), respectively (p=0.61). No osteolysis was found on the final plain radiographs in both groups. DISCUSSION: This study revealed that both types of highly cross-linked polyethylene have excellent linear wear rates and were equally safe to use. However, the difference between the two materials in terms of the long-term wear rate should be further validated. LEVEL OF EVIDENCE: III; retrospective case control study.
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Artroplastia de Reemplazo de Cadera , Prótesis de Cadera , Osteólisis , Masculino , Humanos , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Estudios Retrospectivos , Polietileno , Estudios de Casos y Controles , Prótesis de Cadera/efectos adversos , Falla de Prótesis , Diseño de Prótesis , Osteólisis/diagnóstico por imagen , Osteólisis/epidemiología , Osteólisis/etiología , Estudios de SeguimientoRESUMEN
OBJECTIVE: This study aimed to validate the KOJI AWARENESS™, a self-screening movement test, and compare it with the Functional Movement Screen (FMS). METHODS: Fifty-seven healthy participants completed the KOJI AWARENESS™ and functional movement screening. Pearson's correlation coefficients were used to assess the validity of the test. Subsequently, partial correlation analysis was used to determine the associations between age, sex, body mass index, and sports level as control variables and motor function. RESULTS: Correlation and partial correlation analyses showed a strong positive correlation between the functional movement screening and the KOJI AWARENESS™ scores. CONCLUSION: This study found that the KOJI AWARENESS™ test is valid and comparable to functional movement screening. It can be used for self-screening of movement.
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Atletas , Deportes , Humanos , Prueba de Esfuerzo , Movimiento , Índice de Masa CorporalRESUMEN
PURPOSE: To determine characteristic changes in subjective knee function, kinesiophobia, and psychological readiness to return to sports between scores taken before anterior cruciate ligament reconstruction (ACLR) and those taken 6 months post-ACLR. METHODS: Thirty-two participants (median age, 20.0 years) were included. Subjective knee function was assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). The Tampa Scale for Kinesiophobia (TSK-11) and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale were used to evaluate kinesiophobia and psychological readiness to return to sport, respectively. Questionnaires were administered 1 day before surgery and at 6 months post-ACLR. A positive change was defined as an increase in IKDC-SKF and ACL-RSI scores and a decrease in TSK-11 score. The change in each score from pre-ACLR to 6 months post-ACLR was analyzed using a paired t-test. The percentage change in scores was calculated, and the correlations of the percentage change in the TSK-11 and ACL-RSI scores and that in the IKDC-SKF score were analyzed. RESULTS: All scores differed significantly positively from pre-ACLR to 6 months post-ACLR. The proportion of participants whose scores did not change positively from pre-ACLR to 6 months post-ACLR was higher for the TSK-11 (38.0%) and ACL-RSI (38.0%) than for the IKDC-SKF (6.3%). No correlation was observed between the percentage change in the IKDC-SKF score and that in the TSK-11 or ACL-RSI scores from pre-ACLR to 6 months post-ACLR. CONCLUSIONS: Changes in subjective knee function and psychological status from pre-ACLR and 6 months post-ACLR may not be interdependent.