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BACKGROUD: The main function of the hamstring muscles is to bend the knee joint and support the function of the hip extensors. Their frequent injuries are the result of overload related to, among others, dynamic running or jumping, and inadequate preparation for athletics activities. The asymmetry of the work of individual flexor muscle groups is clearly marked in the case of valgus or varus of the knee joint, i.e., in different positions of the lower limb. The aim of the study was to determine the position and form of a rehabilitation exercise in which an isolated group of muscles flexing the knee joint will show the greatest bioelectrical activity. METHODS: The study involved 25 students of the Jagiellonian University Medical College. The students were aged 20-26. The average age was 22.9 (±1.4). The study participants included 17 women with an average age of 23.0 (±1.1) and 8 men with an average age of 22.6 (±1.9). Women constituted 68% and men 32% of all respondents. All participants agreed to participate in the study. Surface electromyography measurements in both lower limbs provided an initial number of 50 cases. The activity of the knee flexor muscles during isometric contraction with resistance was measured in correlation with three foot and lower leg settings: internal rotation, neutral position, and external rotation. The bioelectrical activity of the semitendinosus muscle is significantly higher (p < 0.01) in the internal rotation position than in the neutral position of the lower leg, while the bioelectrical activity of the biceps femoris muscle is inversely higher (p < 0.01) in the external rotation position than in the neutral position. RESULTS: The results are significant for both average and maximum values of muscle stimulation. During isometric contraction with resistance, the semitendinosus muscle shows the greatest bioelectrical activity in the internal rotation position of the lower leg and foot, and the biceps femoris muscle in the external rotation position of the lower leg and foot. CONCLUSIONS: The above information has important implicational applications when improving isolated groups of hamstrings. In the future, this may contribute to more effective rehabilitation of patients with injuries of the muscles described in the article.
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Despite the increase in research of hamstring stiffness through the use of ultrasound-based shear wave elastography, the active stiffness of biceps femoris long head (BFlh) and semitendinosus (ST) muscles under fatigue conditions at various contraction intensities has not been sufficiently explored. This study aimed to compare the effects of knee flexor's isometric contraction until exhaustion performed at 20% vs. 40% of maximal voluntary isometric contraction (MVIC), on the active stiffness responses of BFlh and ST. Eighteen recreationally active males performed two experimental sessions. The knee flexors' MVIC was assessed before the fatiguing task, which involved a submaximal isometric contraction until failure at 20% or 40% of MVIC. Active muscle stiffness of the BFlh and ST was assessed using shear wave elastography. BFlh active stiffness remained relatively unaltered at 20% of MVIC, while ST active stiffness decreased from â 91% contraction time (55.79 to 44.52 kPa; p < 0.001). No intramuscular stiffness changes were noted in BFlh (36.02 to 41.36 kPa; p > 0.05) or ST (63.62 to 53.54 kPa; p > 0.05) at 40% of MVIC session. Intermuscular active stiffness at 20% of MVIC differed until 64% contraction time (p < 0.05) whereas, at 40% of MVIC, differences were observed until 33% contraction time (p < 0.05). BFlh/ST ratios were not different between intensities (20%=0.75 ± 0.24 ratio vs. 40%=0.72 ± 0.32 ratio; p > 0.05), but a steeper increase in BFlh/ST ratio was found for 20% (0.004 ± 0.003 ratio/%) compared to 40% (0.001 ± 0.003 ratio/%) of MVIC (p = 0.003). These results suggest that contraction duration could play a major role in inducing changes in hamstrings' mechanical properties during fatigue tasks compared to contraction intensity.
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Diagnóstico por Imagen de Elasticidad , Músculos Isquiosurales , Contracción Isométrica , Fatiga Muscular , Humanos , Masculino , Músculos Isquiosurales/fisiología , Fatiga Muscular/fisiología , Contracción Isométrica/fisiología , Adulto Joven , Adulto , Contracción Muscular/fisiologíaRESUMEN
Anomalous muscles are rarely seen in the popliteal region of the lower limb. Some of them are harmless and go unnoticed and some create problems such as neuropathies. We report a novel case of an unusual additional muscle in this region. The additional muscle was closely associated with the short head of the biceps femoris muscle. It took its origin from the lower part of the lateral supracondylar line and the adjoining popliteal surface of the femur. The muscle was 10 cm in length, 1 cm in breadth and was fleshy throughout. It was oriented parallel to the medial side of the tendon of biceps femoris. It was inserted to the posterior aspect of the head of the fibula, medial to the insertion of the biceps femoris. The additional muscle derived its nerve supply from the sciatic nerve. The common peroneal nerve was closely related to the medial border of the additional muscle.
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Snapping of the biceps femoris tendon over the fibular head is a cause of symptomatic lateral knee pain. We presented the case of an active patient in his mid-20s who had bilateral snapping of his biceps femoris tendon, with no history of trauma. The pathophysiology in our case was thought to be secondary to prominent fibular heads. We review the literature and outline the anatomical abnormalities of the biceps femoris tendon's insertion and fibular head morphology that are thought to contribute to this condition. The pathophysiology of snapping biceps femoris tendon is likely multifactorial. Anatomical abnormalities of the biceps femoris tendon's insertion or the fibular head are thought to contribute, and correction of these abnormalities can alleviate patients' symptoms. We propose a classification system that can describe these anatomical abnormalities and guide management.
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Targeted resistance training stimulates hamstring muscle hypertrophy, but its effect on tendon-aponeurosis geometry is unknown. This study examined changes in hamstring muscle, free tendon, and aponeurosis geometry following a 10 week Nordic or hip extension exercise intervention. Thirty recreationally active males were randomly allocated (n = 10 per group) to a Nordic, hip extension, or control group. Magnetic resonance imaging of both thighs was acquired pre- and post-intervention. Changes in free tendon and aponeurosis volume for each hamstring muscle, biceps femoris long head (BFlh) aponeurosis interface area and muscle volume-to-interface area ratio were compared between groups. Regional changes in muscle CSA were examined via statistical parametric mapping. The change in semimembranosus free tendon volume was greater for the Nordic than control group (mean difference = 0.06 cm3, 95% CI = 0.02-0.11 cm3). No significant between-group differences existed for other hamstring free tendons or aponeuroses. There were no between-group differences in change in BFlh interface area. Change in BFlh muscle volume-to-interface area ratio was greater in the hip extension than Nordic (mean difference = 0.10, 95% CI = 0.007-0.19, p = 0.03) and control (mean difference = 0.12, 95% CI = 0.03-0.22, p = 0.009) groups. Change in muscle CSA following training was greatest in the mid-portion of semitendinosus for both intervention groups, and the mid-portion of BFlh for the hip extension group. There was limited evidence for tendon-aponeurosis hypertrophy after 10 weeks of training with the Nordic or hip extension exercises. For the BFlh, neither intervention altered the interface area although hip extension training stimulated an increase in the muscle volume-to-interface area ratio, which may have implications for localized tissue strains. Alternative muscle-tendon loading strategies appear necessary to stimulate hamstring tendon adaptations.
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Adaptación Fisiológica , Músculos Isquiosurales , Imagen por Resonancia Magnética , Entrenamiento de Fuerza , Adulto , Humanos , Masculino , Adulto Joven , Aponeurosis/fisiología , Músculos Isquiosurales/fisiología , Músculos Isquiosurales/diagnóstico por imagen , Tendones Isquiotibiales/diagnóstico por imagen , Tendones Isquiotibiales/fisiología , Cadera/fisiología , Entrenamiento de Fuerza/métodos , Tendones/fisiologíaRESUMEN
Using sous-vide technology in combination with essential oils offers the potential to extend the preservation of food items while preserving their original quality. This method aligns with the growing consumer demand for safer and healthier food production practices. This study aimed to assess the suitability of minimal processing of game meat and the effectiveness of vacuum packaging in combination with Piper nigrum essential oil (PNEO) treatment to preserve red deer meat samples inoculated with Listeria monocytogenes. Microbial analyses, including total viable count (TVC) for 48 h at 30 °C, coliform bacteria (CB) for 24 h at 37 °C, and L. monocytogenes count for 24 h at 37 °C, were conducted. The cooking temperature of the sous-vide was from 50 to 65 °C and the cooking time from 5 to 20 min. Additionally, the study monitored the representation of microorganism species identified through mass spectrometry. The microbiological quality of red deer meat processed using the sous-vide method was monitored over 14 days of storage at 4 °C. The results indicated that the TVC, CB, and L. monocytogenes counts decreased with the temperature and processing time of the sous-vide method. The lowest counts of individual microorganism groups were observed in samples treated with 1% PNEO. The analysis revealed that PNEO, in combination with the sous-vide method, effectively reduced L. monocytogenes counts and extended the shelf life of red deer meat. Kocuria salsicia, Pseudomonas taetrolens, and Pseudomonas fragi were the most frequently isolated microorganism species during the 14-day period of red deer meat storage prepared using the sous-vide method.
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Listeria monocytogenes , Aceites Volátiles , Piper nigrum , Listeria monocytogenes/efectos de los fármacos , Listeria monocytogenes/crecimiento & desarrollo , Aceites Volátiles/farmacología , Aceites Volátiles/química , Piper nigrum/química , Piper nigrum/microbiología , Animales , Ciervos/microbiología , Conservación de Alimentos/métodos , Microbiología de Alimentos , Almacenamiento de Alimentos/métodos , Embalaje de Alimentos/métodos , Carne Roja/microbiología , Culinaria , Antibacterianos/farmacología , Antibacterianos/químicaRESUMEN
This study aimed to assess acute and residual changes in sprint-related hamstring injury (HSI) risk factors after a football (soccer) match, focusing on recovery within the commonly observed 72-h timeframe between elite football matches. We used a multifactorial approach within a football context, incorporating optical and ultrastructural microscopic analysis of BFlh (biceps femoris long head) muscle fibres, along with an examination of BFlh fibre composition. Changes in sprint performance-related factors and HSI modifiable risk factors were examined until 3 days after the match (MD +3) in 20 football players. BFlh biopsy specimens were obtained before and at MD +3 in 10 players. The findings indicated that at MD +3, sprint-related performance and HSI risk factors had not fully recovered, with notable increases in localized BFlh fibre disruptions. Interestingly, match load (both external and internal) did not correlate with changes in sprint performance or HSI risk factors nor with BFlh fibre disruption. Furthermore, our study revealed a balanced distribution of ATPase-based fibre types in BFlh, with type-II fibres associated with sprint performance. Overall, the results suggest that a 72-h recovery period may not be adequate for hamstring muscles in terms of both HSI risk factors and BFlh fibre structure following a football match.
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Traumatismos en Atletas , Músculos Isquiosurales , Fútbol , Humanos , Fútbol/lesiones , Fútbol/fisiología , Músculos Isquiosurales/lesiones , Factores de Riesgo , Masculino , Adulto Joven , Factores de Tiempo , Fibras Musculares Esqueléticas/fisiología , Adulto , Rendimiento Atlético/fisiología , Recuperación de la Función , Carrera/fisiología , Carrera/lesionesRESUMEN
BACKGROUND: Injuries of the proximal attachment of the hamstring muscles are common. The present study aimed to investigate the relationship of the proximal attachment of the hamstring muscles with neighboring structures comprehensively. METHODS: A total of 97 hemipelvis from 66 cryopreserved specimens were evaluated via ultrasound, anatomical and histological samples. RESULTS: The proximal attachment of the hamstring muscles presents a hyperechogenic line surrounding the origin of the semimembranosus and the long head of the biceps femoris muscles, as well as another hyperechogenic line covering the sciatic nerve. The anatomical and histological study confirms the ultrasound results and shows different layers forming the sacrotuberous ligament. Furthermore, it shows that the proximal attachment of the semimembranosus muscle has a more proximal origin than the rest of the hamstring muscles. Moreover, this muscle shares fibers with the long head of the biceps femoris muscle and expands to the adductor magnus muscle. The histological analysis also shows the dense connective tissue of the retinaculum covering the long head of the biceps femoris and semimembranosus muscles, as well as the expansion covering the sciatic nerve. CONCLUSIONS: These anatomical relationships could explain injuries at the origin of the hamstring muscles.
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BACKGROUND: Preventing severe arthrogenic muscle inhibition (AMI) after knee injury is critical for better prognosis. The novel Sonnery-Cottet classification of AMI enables the evaluation of AMI severity but requires validation. This study aimed to investigate the electromyography (EMG) patterns of leg muscles in the examination position from the classification during isometric contraction to confirm its validity. We hypothesised that the AMI pattern, which is characterised by quadriceps inhibition and hamstring hypercontraction, would be detectable in the supine position during isometric contraction. METHODS: Patients with meniscal or knee ligament injuries were enrolled between August 2023 and May 2024. Surface EMG was assessed during submaximal voluntary isometric contractions (sMVIC) at 0° extension in the supine position for the vastus medialis (VM) and vastus lateralis (VL) muscles and at 20° flexion in the prone position for the semitendinosus (ST) and biceps femoris (BF) muscles. Reference values for normalisation were obtained from the EMG activity during the gait of the uninjured leg. The Kruskal-Wallis test was used to compare the activation patterns of the muscle groups within the same leg, and the post-hoc tests were conducted using the Mann-Whitney U test and Bonferroni correction. RESULTS: Electromyographic data of 40 patients with knee injuries were analyzed. During sMVIC, the extensor and flexor muscles of the injured leg showed distinct behaviours (P < 0.001), whereas the uninjured side did not (P = 0.144). In the injured leg, the VM differed significantly from the ST (P = 0.018), and the VL differed significantly from the ST and BF (P = 0.001 and P = 0.026, respectively). However, there were no statistically significant differences within the extensor muscle groups (VM and VL, P = 0.487) or flexor muscle groups (ST and BF, P = 0.377). CONCLUSION: AMI was detectable in the examination position suggested by the Sonnery-Cottet classification. The flexor and extensor muscles of the injured leg exhibited distinct activation behaviours, with inhibition predominantly occurring in the quadriceps muscles, whereas the hamstrings showed excitation.
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Electromiografía , Contracción Isométrica , Músculo Cuádriceps , Humanos , Electromiografía/métodos , Músculo Cuádriceps/fisiopatología , Músculo Cuádriceps/fisiología , Contracción Isométrica/fisiología , Masculino , Estudios Transversales , Adulto , Femenino , Posición Supina/fisiología , Traumatismos de la Rodilla/fisiopatología , Adulto Joven , Examen Físico/métodos , Persona de Mediana Edad , Estudios de FactibilidadRESUMEN
The objective of this study was to investigate the effect of verjuice on beef M. biceps femoris (BF). BF blocks were marinated with 30%, 70%, and 100% verjuice solutions containing 2% NaCl, for different marination times (12, 24, 48, and 72 h). Verjuice marination reduced the pH values of BF samples from 6.77 in control sample to 3.66 in 100% of verjuice for 72 h. The decreased values of water holding capacity (from 54.06% to 47.46%) with increasing verjuice concentration (from 30% to 100% for 72 h) confirmed the drop of proteins isoelectric point of the muscle due to salt presence preventing fibers swelling. Less cookout was observed with increasing acid concentration. Marination time had no significant effect on L* and a* coordinates of uncooked samples while acidification made the samples lighter and less red. Enzymatic proteolysis of myosin and troponin-T concomitant with increase in myofibrillar fragmentation index contributed to the decrease of shear force in a way dependent on verjuice concentration and marination time. Sensory panelists gave the highest score to cooked samples marinated with 70% verjuice solution.
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The purpose of this study was to examine the differences in thoracolumbar fascia (TLF) and lumbar muscle modulus in individuals with and without hamstring injury using shear wave elastography (SWE). Thirteen male soccer players without a previous hamstring injury and eleven players with a history of hamstring injury performed passive and active (submaximal) knee flexion efforts from 0°, 45° and 90° angle of knee flexion as well as an active prone trunk extension test. The elastic modulus of the TLF, the erector spinae (ES) and the multifidus (MF) was measured using ultrasound SWE simultaneously with the surface electromyography (EMG) signal of the ES and MF. The TLF SWE modulus was significantly (p < 0.05) higher in the injured group (range: 29.86 ± 8.58 to 66.57 ± 11.71 kPa) than in the uninjured group (range: 17.47 ± 9.37 to 47.03 ± 16.04 kPa). The ES and MF modulus ranged from 14.97 ± 4.10 to 66.57 ± 11.71 kPa in the injured group and it was significantly (p < .05) greater compared to the uninjured group (range: 11.65 ± 5.99 to 40.49 ± 12.35 kPa). TLF modulus was greater than ES and MF modulus (p < 0.05). Active modulus was greater during the prone trunk extension test compared to the knee flexion tests and it was greater in the knee flexion test at 0° than at 90° (p < 0.05). The muscle EMG was greater in the injured compared to the uninjured group in the passive tests only (p < 0.05). SWE modulus of the TLF and ES and MF was greater in soccer players with previous hamstring injury than uninjured players. Further research could establish whether exercises that target the paraspinal muscles and the lumbar fascia can assist in preventing individuals with a history of hamstring injury from sustaining a new injury.
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Diagnóstico por Imagen de Elasticidad , Electromiografía , Fascia , Músculos Isquiosurales , Fútbol , Humanos , Masculino , Fútbol/lesiones , Fútbol/fisiología , Adulto Joven , Músculos Isquiosurales/lesiones , Músculos Isquiosurales/fisiología , Músculos Isquiosurales/diagnóstico por imagen , Fascia/lesiones , Fascia/diagnóstico por imagen , Fascia/fisiología , Fascia/fisiopatología , Módulo de Elasticidad , Traumatismos en Atletas/fisiopatología , Traumatismos en Atletas/diagnóstico por imagen , Adulto , Región Lumbosacra/lesiones , Región Lumbosacra/diagnóstico por imagen , Músculos Paraespinales/diagnóstico por imagen , Músculos Paraespinales/fisiología , Músculos Paraespinales/fisiopatología , AdolescenteRESUMEN
Background: During sprinting, the biceps femoris long head predominantly gets injured, while hamstring strengthening exercises predominantly activate the semitendinosus more effectively. Understanding how joint dominance influences hamstring activity may offer clarity on appropriate exercise selection in strengthening programs. Purpose: This study compared three hip-dominant hamstring exercises: the rocker, perpetuum mobile fast and slow (PMfast and PMslow) and the Nordic Hamstring exercise (NHE) on their potential to simulate sprint-like activity and kinematics. Methods: Muscle activity of the posterior kinetic chain (biceps femoris, semitendinosus, gluteus maximus, and medial gastrocnemius) was measured with surface electromyography (sEMG) during the exercises and treadmill running at 75% of the individual maximal sprint velocity in male athletes. sEMG data were normalized to maximal sprinting. 3D-motion capture was employed to assess hip and knee angles. Results: Eight male athletes were included (age: 24.0 years ± SD 2.9; body mass: 76.8 kg ± 7.7; height: 1.79 m ± 0.08). Greater activity of the hamstrings occurred during the explosive exercises ranging from 63.9% [95%CI: 56.3-71.5%] (rocker) to 49.0% [95%CI: 40.4-57.6%] (PMfast) vs. 34.0% [95%CI: 29.1-38.9%] (NHE) to 32.1% [95%CI: 26.9-37.3%] (PMslow). The rocker showed greatest hamstring and gluteus maximus activity. Biceps femoris consistently showed greater activity than the semitendinosus across all exercises in peak (mean difference: 0.16, [95%CI: 0.07-0.26]) and average (mean difference: 0.06, [95%CI: 0.01-0.11]) activity. PMfast, PMslow and NHE demonstrated less hip flexion angle at peak hamstring activity than the rocker and high-speed running and every exercise showed less hamstring elongation stress than during high-speed running. Discussion: Hamstring activity is comparable to high-intensity treadmill running for NHE and PMslow, and greater for the rocker and PMfast. Gluteus maximus activity varied, with the rocker and PMfast showing greater activity than in sprinting. All examined exercises demonstrated their peak activity at short hamstring muscle length. Level of evidence: 3b.
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PURPOSE: The hamstrings muscles are innervated by sciatic nerve branches. However, previous studies assessing which and how many branches innervate each muscle have yielded discrepant results. This study investigated the innervation patterns of hamstrings. MATERIALS AND METHODS: Thirty-five cadaver limbs were investigated. The average age of subjects was 78.6 ± 17.2 years, with 48.6% male and 51.4% female, while 57.1% were right limbs and 42.9% left. The sciatic nerve, hamstrings and associated structures were dissected. The number of nerve branches for each muscle and the level where they penetrated the muscle were recorded. RESULTS: The sciatic nerve was connected by a fibrous band to the long head of the biceps femoris. This muscle was innervated by either one or two branches, which penetrated the muscle into its superior or middle third. The short head of the biceps femoris was innervated by a single nerve that usually penetrated its middle third, but sometimes inferiorly or, less commonly, superiorly. The semitendinosus was always innervated by two branches, the superior branch penetrating its upper third, the inferior mostly the middle third. The semimembranosus usually was innervated by a single nerve branch that penetrated the muscle at its middle or lower third. Four specimens revealed common nerves that innervated than one muscle. CONCLUSIONS: We have characterized hamstring innervation patterns, knowledge that is relevant to neurolysis, surgery of the thigh, and other procedures. Moreover, a mechanical connection between the sciatic nerve and biceps femoris long head was identified that could explain certain neuralgias.
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Cadáver , Músculos Isquiosurales , Nervio Ciático , Humanos , Músculos Isquiosurales/inervación , Músculos Isquiosurales/anatomía & histología , Femenino , Masculino , Anciano , Nervio Ciático/anatomía & histología , Anciano de 80 o más Años , Persona de Mediana Edad , DisecciónRESUMEN
Objective: The objective of this study was to investigate the impact of dietary deficiency and supplementation of calcium, zinc, copper, cobalt, manganese or selenium on minerals content in the longissimus dorsi (LD), biceps femoris (BF) and triceps brachii (TB) of grazing Mongolian sheep. Methods: We randomly divided 98 sheep into 7 treatment groups and fed them specific diets for 60 days: a total mineral nutrition diet (LCG), a calcium deficiency diet (LCa), a zinc deficiency diet (LZn), a copper deficiency diet (LCu), a cobalt deficiency diet (LCo), a manganese deficiency diet (LMn) and a selenium deficiency diet (LSe). Then 7 sheep from each group were slaughtered and samples of LD, BF and TB were collected for mineral content analysis. The remaining sheep in each group were subsequently fed specific diets for an additional 41 days: a total mineral nutrition diet (SCG), a calcium supplementation diet (SCa), a zinc supplementation diet (SZn), a copper supplementation diet (SCu), a cobalt supplementation diet (SCo), a manganese supplementation diet (SMn) and a selenium supplementation diet (SSe). Afterward, all sheep were slaughtered, and muscle samples were collected and analyzed. Results: Significant findings emerged that LCa decreased sulfur (S) content in BF and increased Ca content in LD and BF, while SCa increased S and Ca content in BF and TB, respectively (P < 0.05). LZn decreased Zn, S, and potassium (K) content in LD and BF, while SZn increased Zn and S content in LD and BF, respectively (P < 0.05). LCu decreased Cu and iron (Fe) content in LD and TB, while SCu increased Fe content in TB (P < 0.05). LCo decreased phosphorus, S, K, Ca, Mn, Fe, Cu, and Zn content in LD (P < 0.05). LMn decreased Mn content and increased K content in TB, while SMn decreased K content in BF and TB (P < 0.05). LSe and SSe decreased and increased Se content in LD, BF, and TB, respectively (P < 0.05). Conclusion: Dietary mineral levels have varying effects on lamb meat minerals content. It is important to ensure an adequate intake of minerals in the diet to enhance the mineral nutrition of lamb meat.
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PURPOSE: The purpose of this study is to compare the patient-reported outcomes and return to sports of the conservative and surgical treatment of distal hamstring tendon injuries. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers searched PubMed, Scopus and Virtual Health Library databases in January 2023. Clinical studies evaluating conservative or surgical management outcomes of distal hamstring tendon injuries were considered eligible for this systematic review if predefined criteria were fulfilled: (1) published in English or Spanish; (2) evaluated any of the following: patient-reported outcomes, return-to-sports rate (RTS-R) or return-to-sports time (RTS-T). Data were presented in tables using absolute values from individual studies and derived pooled percentages. RESULTS: Eighteen studies were included for 67 patients and 68 distal hamstring tendon injuries. Initially, 39 patients (58.2%) underwent surgical treatment, whereas 28 (41.8%) were treated conservatively. Among conservative treatment patients, 15 failed and had to be operated on (53.6%), all with distal semitendinosus tendon injuries. Anchor fixation was the technique of choice in 20 lesions (36.4%), tenodesis in 16 (29.1%), tenectomy in 14 (25.5%) and sutures were preferred in five (9%). Thirteen out of 28 patients (46.4%) undergoing initial conservative treatment returned to sports at a mean of 3.6 months (range 1 week to 12 months), in contrast to surgical treatment, in which 36 out of 39 patients (92.3%) returned at a mean of 4.2 months (range 6 weeks to 12 months). Additionally, 14 of 15 patients (93.3%) converted to surgical treatment after failed conservative treatment returned to sports at a mean of 7.6 months after injury. CONCLUSION: Initial surgical treatment of distal hamstring tendon injuries yields a high RTS-R (92.3%) at a mean of 4.2 months. Furthermore, 15 out of 28 patients (53.6%) initially treated conservatively had to be operated on, delaying the RTS-T (mean 7.6 months after injury) without affecting their RTS-R. LEVEL OF EVIDENCE: IV.
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Tendones Isquiotibiales , Volver al Deporte , Traumatismos de los Tendones , Humanos , Traumatismos en Atletas/cirugía , Tratamiento Conservador , Tendones Isquiotibiales/lesiones , Tendones Isquiotibiales/cirugía , Medición de Resultados Informados por el Paciente , Traumatismos de los Tendones/cirugíaRESUMEN
The popliteal fossa presents an extensive diamond-shaped topographical element on the posterior aspect of the knee. With the use of classical anatomical dissection, digital image analysis of NIS Elements AR 3.0 and statistics we morphometrically analyzed the size of the popliteal fossa in human fetuses aged 17-29 weeks of gestation. Morphometric parameters of the popliteal fossa increased logarithmically with fetal age: y = -44.421 + 24.301 × ln (Age) for length of superomedial boundary, y = -41.379 + 22.777 × ln (Age) for length of superolateral boundary, y = -39.019 + 20.981 × ln (Age) for inferomedial boundary, y = -37.547 + 20.319 × ln (Age), for length of inferolateral boundary, y = -28.915 + 15.822 × ln (Age) for transverse diameter, y = -69.790 + 38.73 × ln (Age) for vertical diameter and y = -485.631 + 240.844 × ln (Age) for projection surface area. Out of the four angles of the popliteal fossa the medial one was greatest, the inferior one the smallest, while the lateral one was somewhat smaller than the medial one and approximately three times greater than the superior one, with no difference with fetal age. In terms of morphometric parameters the popliteal fossa in the human fetus displays neither male-female nor right-left differences. In the popliteal fossa, growth patterns of its four boundaries, vertical and transverse diameters, and projection surface area all follow natural logarithmic functions. All the morphometric data is considered age-specific reference intervals, which may be conducive in the diagnostics of congenital abnormalities in the human fetus.
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Authors of previous studies of patients with acute hamstring strains have reported injury to the biceps femoris and semitendinosus (ST) in 50% to 100% and 0% to 30%, respectively. This retrospective case series of hamstring injuries in National Collegiate Athletic Association Division I collegiate athletes exhibited an injury pattern on ultrasound imaging that differed from what would be expected based on prior literature. We examined ultrasound images of 38 athletes with acute hamstring strains for injury location (proximal muscle, proximal myotendinous junction, midportion of muscle, distal muscle) and affected muscles (biceps femoris, ST, or semimembranosus). Twenty-six athletes (68.4%) injured the ST, and 9 athletes (23.7%) injured the biceps femoris long head. Most athletes (23, 60.5%) injured the proximal portion of the muscle or myotendinous junction. Though this study had many limitations, we demonstrated more frequent involvement of the ST and less frequent involvement of the biceps femoris than reported in the literature.
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Traumatismos en Atletas , Músculos Isquiosurales , Deportes , Humanos , Músculos Isquiosurales/diagnóstico por imagen , Músculos Isquiosurales/lesiones , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/lesiones , Estudios Retrospectivos , Atletas , Ultrasonografía , Traumatismos en Atletas/diagnóstico por imagenRESUMEN
INTRODUCTION: This study examined the effects of ultrasound transducer pressure and examiner experience on the biceps femoris long head and semitendinosus muscle active shear modulus in healthy individuals (n = 28). METHODS: Active shear modulus was assessed using shear wave elastography at 20% of knee flexor maximal voluntary isometric contraction. Examiners with different experience levels measured the muscles' shear modulus with three pressure levels: mild, moderate, and hard. RESULTS: A main effect of transducer pressure was found for both biceps femoris long head (p < 0.001; η2p = 0.314) and semitendinosus muscles (p < 0.001; η2p = 0.280), whereas differences were found between mild-moderate (biceps femoris long head: p = 0.013, d = 0.23; semitendinosus: p = 0.024, d = 0.25), and mild-hard pressures (biceps femoris long head: p = 0.001, d = 0.47; semitendinosus: p = 0.002, d = 0.47). Examiners performed similar shear modulus measurements in the biceps femoris long head (p = 0.299; η2p = 0.041) and semitendinosus (p = 0.177; η2p = 0.066), although the experienced examiner showed a higher measurement repeatability (biceps femoris long head: ICC = 0.86-0.95, semitendinosus: ICC = 0.89-0.96; vs. biceps femoris long head: ICC = 0.78-0.87, semitendinosus: ICC = 0.66-0.87). CONCLUSION: Transducer pressure influences the active shear modulus measurement between mild and moderate or hard pressures. Additionally, examiner experience seems to have no influence on muscle active shear modulus measurement when assessed at the same site (using casts). IMPLICATIONS FOR PRACTICE: Future studies assessing active muscle shear modulus should use mild transducer pressure and having experienced examiners in order to improve measurement reliability.
Asunto(s)
Diagnóstico por Imagen de Elasticidad , Humanos , Músculo Esquelético/diagnóstico por imagen , Reproducibilidad de los Resultados , Rango del Movimiento Articular/fisiología , Articulación de la RodillaRESUMEN
Key Clinical Message: We present a case of lateral knee pain from snapping of an accessory tendinous insertion of the biceps femoris. After failure of conservative treatment options, tenodesis of the accessory band to the direct arm insertion at the posterolateral edge of the fibular head effectively resolved symptoms. Abstract: There are several distinct causes of lateral knee pain including IT band syndrome, meniscus tears, or other soft tissue pathologies; however, a few case reports have shown the biceps femoris as a cause of lateral knee pain and snapping. Conservative treatment is of modest benefit to the patient in these scenarios, and an MRI is not always able to identify the accessory band, as in our case. Intraoperatively, we discovered an accessory band of the biceps femoris attaching to the anterolateral tibia, causing pain and snapping during knee flexion as the band passed over the fibular head. There have been various surgical attempts to address this pathology; however, we report a successful outcome after tenodesis of the accessory band to the direct insertion at the posterolateral fibular head.
RESUMEN
BACKGROUND: The effect of 10 × 30 m repeated sprints on passive and active stiffness of semitendinosus (ST) and biceps femoris long head (BFlh), and knee flexor maximal voluntary isometric contraction (MVIC) and rate of force development (RFD), and whether athletes with previous hamstring injury have a different response, is unknown. HYPOTHESIS: Repeated sprints would (1) increase BFlh stiffness and decrease ST stiffness and knee flexors MVIC and RFD in healthy participants; and (2) greater magnitude of response would be seen in athletes with previous hamstring injury. STUDY DESIGN: Case series (experiment I) and case control (experiment II) study designs. LEVEL OF EVIDENCE: Level 3. METHODS: Healthy nonathletes attended 2 replicated sessions (experiment I, n = 18), while soccer players with (n = 38) and without (n = 67) previous hamstring injury attended 1 testing session (experiment II). RESULTS: In both experiments, the knee flexors MVIC and RFD decreased after the sprints (P < 0.05). In experiment I, the ST and BFlh passive stiffness reduced after the sprints (P < 0.02), while a small BFlh active stiffness increase was noted (P = 0.02); however, no correlation was observed between the 2 testing sessions for the postsprint muscle stiffness responses (r = -0.07-0.44; P > 0.07). In experiment II, only an ST passive stiffness reduction was observed after the sprints (P < 0.01). No differences were noted between injured and noninjured lower limbs for any variable (P > 0.10). CONCLUSION: Repeated sprints are likely to decrease the knee flexor's maximal and rapid strength, and to alter the hamstring stiffness in the nonathlete population. Previous hamstring injury does not apparently affect the footballer's hamstring functional and mechanical responses to repeated sprints. CLINICAL RELEVANCE: The responses of hamstring stiffness and knee flexor strength to repeated sprints are unlikely to be associated with hamstring injury.