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1.
J Strength Cond Res ; 37(12): 2417-2422, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37815243

RESUMO

ABSTRACT: Lunn, DE, Nicholson, G, Cooke, M, Crespo, R, Robinson, T, Price, RJ, and Walker, J. Discrete hamstring: quadriceps strength ratios do not represent angle-specific ratios in Premier League soccer players. J Strength Cond Res 37(12): 2417-2422, 2023-This study compared angle-specific hamstring:quadriceps (H:Q) ratios with their discrete counterparts during strength testing in professional male soccer players. Twenty-seven professional English Premier League soccer players were recruited for this study (age: 22 ± 4 years; stature: 1.81 ± 0.08 m; body mass: 74.7 ± 6.5 kg). Isokinetic testing of the knee flexors and extensors was conducted concentrically at two angular velocities (60° and 240°·s -1 ) and eccentrically (for the knee flexors only) at 30°·s -1 . Conventional H:Q ratio was calculated as the ratio between peak joint moment in the flexors and extensors at 60°·s -1 . Functional H:Q ratio was calculated as the peak joint moment in the flexors during the eccentric condition and the extensors at 240°·s -1 . Discrete conventional and functional H:Q ratios were 0.56 ± 0.06 and 1.28 ± 0.22, respectively. The residual differences between discrete values and angle-specific residual values were 13.60 ± 6.56% when normalized to the magnitude of the discrete value. For the functional ratios, the normalized residual was 21.72 ± 5.61%. Therefore, neither discrete ratio was representative of angle-specific ratios, although the conventional ratio had lower error overall. Therefore, practitioners should consider H:Q ratio throughout the full isokinetic range of motion, not just the discrete ratio calculated from peak joint moments, when designing and implementing training programs or monitoring injury risk, recovery from injury, and readiness to return to play.


Assuntos
Músculos Isquiossurais , Futebol , Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Torque , Músculo Quadríceps , Articulação do Joelho , Força Muscular
2.
Am J Pathol ; 191(1): 157-167, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33129760

RESUMO

Colorectal cancer (CRC) is a leading nonfamilial cause of cancer mortality among men and women. Although various genetic and epigenetic mechanisms have been identified, the full molecular mechanisms deriving CRC tumorigenesis are not fully understood. This study demonstrates that cell adhesion molecule transmembrane and immunoglobulin domain containing 1 (TMIGD1) are highly expressed in mouse and human normal intestinal epithelial cells. TMIGD1 knockout mice were developed, and the loss of TMIGD1 in mice was shown to result in the development of adenomas in small intestine and colon. In addition, the loss of TMIGD1 significantly impaired intestinal epithelium brush border membrane, junctional polarity, and maturation. Mechanistically, TMIGD1 inhibits tumor cell proliferation and cell migration, arrests cell cycle at the G2/M phase, and induces expression of p21CIP1 (cyclin-dependent kinase inhibitor 1), and p27KIP1 (cyclin-dependent kinase inhibitor 1B) expression, key cell cycle inhibitor proteins involved in the regulation of the cell cycle. Moreover, TMIGD1 is shown to be progressively down-regulated in sporadic human CRC, and its downregulation correlates with poor overall survival. The findings herein identify TMIGD1 as a novel tumor suppressor gene and provide new insights into the pathogenesis of colorectal cancer and a novel potential therapeutic target.


Assuntos
Pontos de Checagem do Ciclo Celular/fisiologia , Neoplasias do Colo/metabolismo , Glicoproteínas de Membrana/metabolismo , Adenoma/genética , Adenoma/metabolismo , Adenoma/patologia , Animais , Movimento Celular/genética , Proliferação de Células/genética , Transformação Celular Neoplásica/metabolismo , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Pontos de Checagem da Fase G2 do Ciclo Celular/fisiologia , Genes Supressores de Tumor/fisiologia , Humanos , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Knockout , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo
3.
Scand J Med Sci Sports ; 32(1): 83-93, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34606650

RESUMO

Measurements of muscle-tendon unit passive mechanical properties are often used to illustrate acute and chronic responses to a training stimulus. The purpose of this study was to quantify the inter-session repeatability of triceps surae passive stiffness measurements in athletic and non-athletic populations, with the view to discussing its usefulness both as a muscle-tendon profiling tool and a control measure for studies with multiple data collection sessions. The study also aimed to observe the effects of quiet standing on passive stiffness parameters. Twenty-nine men (10 cyclists, nine triathletes, 10 controls) visited the laboratory on three separate occasions, where passive stiffness tests were carried out using an isokinetic dynamometer and B-mode ultrasound. Participants were fully rested on two of the sessions and subjected to 20 min of quiet standing in the other. The passive stiffness assessment generally showed only moderate inter-session repeatability but was still able to detect inter-group differences, with triathletes showing higher passive stiffness than cyclists (p < 0.05). Furthermore, quiet standing impacted passive stiffness by causing a reduction in ankle joint range of motion, although mechanical resistance to stretch in the muscle-tendon unit at a given joint angle was relatively unaffected. These findings show that passive stiffness assessment is appropriate for detecting inter-group differences in the triceps surae and even the effects of a low-intensity task such as quiet standing, despite showing some inter-session variation. However, the inter-session variation suggests that passive stiffness testing might not be suitable as a control measure when testing participants on multiple sessions.


Assuntos
Tendão do Calcâneo , Articulação do Tornozelo , Eletromiografia , Humanos , Masculino , Músculo Esquelético , Amplitude de Movimento Articular
4.
Scand J Med Sci Sports ; 32(1): 69-82, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34587293

RESUMO

We assessed sprint mechanical asymmetry in world-class competitors and evaluated whether inter-limb sex-based differences in sprinting mechanics exist. The eight finalists in the men's and women's 100 m events at the 2017 IAAF World Championships were studied. Five high-speed cameras (150 Hz) were used to capture two consecutive steps of the whole body between 47.0 m and 55.5 m from the start, while four additional cameras (250 Hz) focussed on the lower extremities. A total of 33 spatio-temporal, touchdown and toe-off joint angles, and horizontal and vertical foot velocity parameters were extracted through three-dimensional analysis. Group mean asymmetry scores were assessed using the symmetry angle (SA) where scores of 0% and 100% represent perfect symmetry and perfect asymmetry, respectively. Although considered generally low (SA <3% for 22 out of 33 parameters), the magnitude of mechanical asymmetry varied widely between sprinters of the same sex. However, there was no mean SA scores difference between men and women for any stride mechanical parameters (all p ≥ 0.064). Asymmetry scores were inconsistent between parameters and phases (touchdown vs toe-off instants), and sprinting mechanics were generally not related to asymmetry magnitudes. In summary, low to moderate asymmetry is a natural phenomenon in elite sprinting. Asymmetry was inconsistent between parameters and competitors during near maximum velocity running, yet mean values for a given parameter generally did not differ between sexes. Sprinters' performances were not related to their SA scores.


Assuntos
Desempenho Atlético , Corrida , Fenômenos Biomecânicos , Feminino , Humanos , Extremidade Inferior , Masculino
5.
J Strength Cond Res ; 36(1): 90-98, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32032229

RESUMO

ABSTRACT: Bissas, A, Paradisis, GP, Nicholson, G, Walker, J, Hanley, B, Havenetidis, K, and Cooke, CB. Development and maintenance of sprint training adaptations: an uphill-downhill study. J Strength Cond Res 36(1): 90-98, 2022-We examined the development of performance adaptations resulting from an uphill-downhill training program and monitored the decline of adaptations during detraining. Twenty-eight men were randomly assigned to 1 of 2 sprint training groups who trained 3 times per week for 6 weeks and a control group (C). The uphill-downhill group (U+D) trained on an 80-m platform with 3° slopes, whereas the horizontal (H) group trained on flat track. Subjects were tested for maximal running speed (MRS), associated kinematics, and leg strength before and after training, with U+D subjects also tested after weeks 2 and 4 of training, and after a 3-week detraining period. The U+D group increased their MRS by 3.7% (from 8.75 ± 0.72 to 9.07 ± 0.64 m·s-1, p < 0.05), their stride rate by 3.1% (from 4.21 ± 0.21 to 4.34 ± 0.18 Hz, p < 0.05), and their knee extensors' maximum isometric force by 21% (from 2,242 ± 489 to 2,712 ± 498 N, p < 0.05) after training. The time course of changes showed declines for weeks 1-4 (1.4-5.1%), but an ascending trend of improvement compensated all losses by the end of week 6 (p < 0.05). During detraining, no decreases occurred. No changes were observed for the H and C groups. The minimum period to produce positive effects was 6 weeks, with a very good standard of performance maintained 3 weeks after training. U+D training will prove useful for all athletes requiring fast adaptations, and it can fit into training mesocycles because of its low time demands.


Assuntos
Adaptação Fisiológica , Corrida , Atletas , Fenômenos Biomecânicos , Humanos , Joelho , Masculino
6.
Scand J Med Sci Sports ; 30(7): 1151-1162, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32246562

RESUMO

We mapped structural and functional characteristics of muscle-tendon units in a population exposed to very long-term routine overloading. Twenty-eight military academy cadets (age = 21.00 ± 1.1 years; height = 176.1 ± 4.8 cm; mass = 73.8 ± 7.0 kg) exposed for over 24 months to repetitive overloading were profiled via ultrasonography with a senior subgroup of them (n = 11; age = 21.4 ± 1.0 years; height = 176.5 ± 4.8 cm; mass = 71.4 ± 6.6 kg) also tested while walking and marching on a treadmill. A group of eleven ethnicity- and age-matched civilians (age = 21.6 ± 0.7 years; height = 176.8 ± 4.3 cm; mass = 74.6 ± 5.6 kg) was also profiled and tested. Cadets and civilians exhibited similar morphology (muscle and tendon thickness and cross-sectional area, pennation angle, fascicle length) in 26 out of 29 sites including the Achilles tendon. However, patellar tendon thickness along the entire tendon was greater (P < .05) by a mean of 16% for the senior cadets compared with civilians. Dynamically, cadets showed significantly smaller ranges of fascicle length change and lower shortening velocity in medial gastrocnemius during walking (44.0% and 47.6%, P < .05-.01) and marching (27.5% and 34.3%, P < .05-.01) than civilians. Furthermore, cadets showed lower normalized soleus electrical activity during walking (22.7%, P < .05) and marching (27.0%, P < .05). Therefore, 24-36 months of continuous overloading, primarily occurring under aerobic conditions, leads to more efficient neural and mechanical behavior in the triceps surae complex, without any major macroscopic alterations in key anatomical structures.


Assuntos
Militares , Músculo Esquelético/fisiologia , Tendões/fisiologia , Caminhada , Fenômenos Biomecânicos , Humanos , Masculino , Ultrassonografia , Adulto Jovem
7.
Front Sports Act Living ; 6: 1352725, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38380076

RESUMO

Studies previously conducted on high jump have yielded important information regarding successful performance. However, analyses in competitive scenarios have often disregarded athletes' unsuccessful attempts. This study aimed to investigate the biomechanical differences between successful and unsuccessful jumps during competition. High-speed video footage (200 Hz) was obtained from 11 athletes during the 2018 Men's World Athletics Indoor Championship Final. From each athlete, one successful (SU) and one unsuccessful (UN) jump at the same bar height were included in the analysis, leaving seven athletes in total. Following whole-body 3D manual digitization, several temporal and kinematic variables were calculated for the run-up, take-off, and flight phases of each jump. During SU jumps, athletes raised the center of mass to a greater extent (p < 0.01) from take-off. Touchdown in SU jumps was characterized by a faster anteroposterior velocity (p < 0.05), lower backward lean (p < 0.05), and changes in joint angles for the stance and trail limbs (p < 0.05). Athletes also shortened the final contact time during SU jumps (p < 0.01) after producing a longer flight time in the final step of the run-up (p < 0.05). Elite-level high jumpers undertake a series of adjustments to successfully clear the bar after UN jumps. These adjustments reinforce the importance of the run-up in setting the foundations for take-off and bar clearance. Furthermore, the findings demonstrate the need for coaches to be mindful of the adjustments required in stance and trail limbs when looking to optimize feedback to athletes during training and competition.

8.
J Biomech ; 176: 112327, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39288508

RESUMO

Research investigating ankle function during walking in a controlled ankle motion (CAM) boot has either placed markers on the outside of the boot or made major alterations to the structure of the CAM boot to uncover key landmarks. The aim of this study was to quantify joint kinematics and kinetics using "in-boot" skin markers whilst making only minimal structural alterations. Seventeen healthy participants walked at their preferred walking speed in two conditions: (1) in standard athletic trainers (ASICS patriot 8, ASICS Oceania Pty Ltd, USA), and (2) using a hard-cased CAM boot (Rebound® Air Walker, Össur, Iceland) fitted on the right foot. Kinematic measurements revealed that CAM boots restrict sagittal plane ankle range of motion to less than 5°, and to ∼3° in the frontal plane, which is a reduction of 85% and 73% compared to standard footwear, respectively (p < 0.001). This ankle restriction resulted in a reduction of ankle joint total limb work contribution from 38 ± 5% in normal footwear to 13 ± 4% in the CAM boot (p < 0.001). This study suggests that CAM boots do restrict the ankle joint's ability to effectively perform work during walking, which leads to compensatory mechanisms at the ipsilateral and contralateral hip and knee joints. Our findings align with previous research that employed "on-boot" kinematic measurements, so we conclude that in-boot approaches do not offer any benefit to the researcher and instead, on-boot measurements are suitable.

9.
Gait Posture ; 108: 208-214, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38118224

RESUMO

BACKGROUND: Controlled ankle motion (CAM) boots are often prescribed during the rehabilitation of lower limb injuries and pathologies to reduce foot and ankle movement and loading whilst allowing the patient to maintain normal daily function. RESEARCH QUESTION: The aim of this study was to quantify the compensatory biomechanical mechanisms undergone by the ipsilateral hip and knee joints during walking. In addition, the compensatory mechanisms displayed by the contralateral limb were also considered. METHODS: Twelve healthy participants walked on an instrumented treadmill at their preferred walking speed. They underwent kinematic and kinetic analysis during four footwear conditions: normal shoes (NORM), a Malleo Immobil Air Walker on the right leg (OTTO), a Rebound® Air Walker on the right leg with (EVEN) and without (OSS) an Evenup Shoelift™ on the contralateral leg. RESULTS: CAM boot wear increased the relative joint contribution to total mechanical work from the ipsilateral hip and knee joints (p < 0.05), which was characterised by increased hip and knee abduction during the swing phase of the gait cycle. EVEN increased the absolute work done and relative contribution of the contralateral limb. CAM boot wear reduced walking speed (p < 0.05), which was partially compensated for during EVEN. SIGNIFICANCE: The increased hip abduction in the ipsilateral leg was likely caused by the increase in effective leg length and limb mass, which could lead to secondary site complications following prolonged CAM boot wear. Although prescribing an even-up walker partially mitigates these compensatory mechanisms, adverse effects to contralateral limb kinematics and kinetics (e.g., elevated knee joint work) should be considered.


Assuntos
Tornozelo , Caminhada , Humanos , Cinética , Caminhada/fisiologia , Marcha/fisiologia , Extremidade Inferior , Articulação do Tornozelo/fisiologia , Articulação do Joelho , Fenômenos Biomecânicos
10.
J Foot Ankle Res ; 17(3): e12044, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39020474

RESUMO

INTRODUCTION: Controlled ankle motion (CAM) boots are a below-knee orthotic device prescribed for the management of foot and ankle injuries to reduce ankle range of motion (RoM) and offload the foot and ankle whilst allowing continued ambulation during recovery. There is a lack of clarity within the current literature surrounding the biomechanical understanding and effectiveness of CAM boots. AIMS: To summarise the biomechanical effects of CAM boot wear as an orthotic for restricting ankle RoM and offloading the foot. METHODS: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. All papers were independently screened by two authors for inclusion. Methodological quality was appraised using Joanna Briggs Critical Appraisal checklists. A narrative synthesis of all eligible papers was produced. RESULTS: Thirteen studies involving 197 participants (113 male and 84 female) were included. All studies were quasi-randomised and employed a within-study design, of which 12 studies included a control group and a range of CAM boots were investigated. CAM boots can be seen to restrict ankle RoM, however, neighboring joints such as the knee and hip do have kinetic and kinematic compensatory alterations. Plantar pressure of the forefoot is effectively redistributed to the hindfoot by CAM boots. CONCLUSION: The compensatory mechanisms at the hip and knee joint during CAM boot wear could explain the secondary site pain often reported in patients, specifically at the ipsilateral knee and contralateral hip. Although CAM boots can be used to restrict ankle motion, this review has highlighted a lack of in-boot kinematic analyses during CAM boot use, where tracking markers are placed on the anatomical structure rather than on the boot, or through video fluoroscopy, urging the need for a more robust methodological approach to achieve this. There is a need for studies to assess the biomechanical alterations caused by CAM boots in populations living with foot and ankle pathologies. Future research, adopting a longitudinal study design, is required to fully understand the effectiveness of CAM boots for rehabilitation.


Assuntos
Articulação do Tornozelo , Amplitude de Movimento Articular , Sapatos , Humanos , Amplitude de Movimento Articular/fisiologia , Fenômenos Biomecânicos/fisiologia , Articulação do Tornozelo/fisiologia , Feminino , Masculino , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/reabilitação , Órtoses do Pé , Adulto
11.
Front Sports Act Living ; 5: 1298003, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38250008

RESUMO

This study tested the performance of OpenPose on footage collected by two cameras at 200 Hz from a real-life competitive setting by comparing it with manually analyzed data in SIMI motion. The same take-off recording from the men's Long Jump finals at the 2017 World Athletics Championships was used for both approaches (markerless and manual) to reconstruct the 3D coordinates from each of the camera's 2D coordinates. Joint angle and Centre of Mass (COM) variables during the final step and take-off phase of the jump were determined. Coefficients of Multiple Determinations (CMD) for joint angle waveforms showed large variation between athletes with the knee angle values typically being higher (take-off leg: 0.727 ± 0.242; swing leg: 0.729 ± 0.190) than those for hip (take-off leg: 0.388 ± 0.193; swing leg: 0.370 ± 0.227) and ankle angle (take-off leg: 0.247 ± 0.172; swing leg: 0.155 ± 0.228). COM data also showed considerable variation between athletes and parameters, with position (0.600 ± 0.322) and projection angle (0.658 ± 0.273) waveforms generally showing better agreement than COM velocity (0.217 ± 0.241). Agreement for discrete data was generally poor with high random error for joint kinematics and COM parameters at take-off and an average ICC across variables of 0.17. The poor agreement statistics and a range of unrealistic values returned by the pose estimation underline that OpenPose is not suitable for in-competition performance analysis in events such as the long jump, something that manual analysis still achieves with high levels of accuracy and reliability.

12.
Front Sports Act Living ; 4: 873547, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35571744

RESUMO

This study aimed to compare joint kinematics and center of mass parameters throughout hurdle clearance between world-class men and women sprint hurdlers, who were competing in a World Championships final. This was the first study to present time-series kinematic data around hurdle clearance, and given the technical ability of the athletes analyzed, it can be used as a template when analyzing the technique of other athletes in similar competitions and training. Video data were collected of the 16 finalists at the 2017 IAAF World Championships using four high-speed cameras (150 Hz). Video files were continuously digitized manually from touchdown before hurdle clearance to toe-off after landing around the sixth hurdle for men and the fifth hurdle for women, and sex-based comparisons were made at key discrete time points using independent t-tests, and throughout the entire hurdle phase using statistical parametric mapping. When calculated relative to hurdle height, the women's center of mass height was significantly greater than the men's throughout the full analyzed sequence (p < 0.001). Men also displayed more hip flexion in the lead leg at take-off before hurdle clearance (p = 0.029) as well as a more extended knee joint at intervals during flight and upon landing (p ≤ 0.037). Women completed the hurdle phase in a significantly shorter time than men (~11% difference, p < 0.001). Finally, women seemed to be more efficient by maintaining and even exceeding their entry velocity for the first 40% of the hurdle phase. These results show a lower technical demand for the women to successfully negotiate hurdle clearance, thus providing further evidence to support the argument that the women's hurdle height is too low for their performance capabilities and should be raised in senior competition.

13.
J Biomech ; 129: 110802, 2021 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-34662758

RESUMO

Racewalking is an unconventional form of competitive gait that elicits a unique loading profile on lower limb muscles and tendons. This study mapped the structural and mechanical properties of lower limbs in competitive racewalkers and made associations with World Athletics competition performance points. Fourteen international racewalkers (seven men, seven women) were recruited for this study. Static ultrasonography was used to quantify muscle and tendon morphological characteristics. An isokinetic dynamometer was used to measure passive musculotendinous stiffness of the triceps surae, isometric (seven knee/ankle angle combinations) and isokinetic (four angular velocities) strength parameters in the plantarflexors and dorsiflexors, and isokinetic knee flexion and extension strength at five angular velocities. Correlations were found between performance and fascicle length of gastrocnemius medialis (r = -0.569, p = 0.034), dorsiflexor strength at 120°/s (r = 0.649, p = 0.016) and knee flexor strength at 30°/s (r = 0.632, p = 0.020). No associations were found for isometric plantarflexion or passive stiffness properties. Overall, the study showed various morphological and mechanical properties are associated with performance in competitive racewalkers. These associations seem to be related to the specific and unique biomechanical characteristics of racewalking.


Assuntos
Músculo Esquelético , Tendões , Tornozelo , Articulação do Tornozelo/diagnóstico por imagem , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Tendões/diagnóstico por imagem
14.
Front Sports Act Living ; 3: 704308, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34308350

RESUMO

The sprint hurdle events require athletes to cross ten hurdles between the start and finish line. The height of the hurdles, and the distances between them, differ for men and women, possibly resulting in technical differences. The aim of this study was to provide a kinematic comparison of in-competition hurdle technique for world-class men and women hurdlers. Video data were collected for the 16 finalists in the 100 m and 110 m hurdles events at the 2017 IAAF World Championships using four high-speed cameras (150 Hz), focusing on the sixth hurdle for the men and fifth for the women. Center of mass (CM) position, joint angles, step lengths and clearance times were compared between sexes at key events before, during and after hurdle clearance. The hurdle height was ~7% higher for men when calculated as a proportion of stature (p < 0.001). This discrepancy in relative hurdle height provided women with a kinematic and mechanical advantage over men as they took off farther from the hurdle (relative to hurdle height) (p < 0.001), leading to a lower and more efficient flight parabola. Women were also able to maintain longer relative step lengths after hurdle clearance and showed minimal vertical oscillation of the CM in the stance phases before and after the hurdle compared with men. The lower relative hurdle heights in the women's event provide a less demanding task, and thus these findings present preliminary evidence to those coaches who advocate revising the women's hurdle heights in competition.

15.
Ulster Med J ; 90(3): 157-161, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34815594

RESUMO

BACKGROUND: During the COVID-19 pandemic of Spring 2020, Belfast City Hospital functioned as Belfast's Nightingale facility. Evidence published during this time focused mainly on the acute management of the condition. Guidance on follow up and long-term management for patients recovering from COVID-19 was sparse. A specialist COVID-19 follow up service was devised in Belfast City Hospital led by a respiratory physician with physiotherapy and psychology input. METHODS: Data was collected on all patients admitted to Belfast Nightingale unit. Patients admitted to Intensive Care at any stage in their admission were followed up separately by Intensive Care. Initial consultation was via telephone call for all eligible patients six weeks post discharge, followed by face-to-face consultation for those with symptoms at next available appointment, and a further face-to-face consultation at twelve weeks post hospital discharge. Patients were seen by respiratory physician, physiotherapy and psychology at each appointment. All patients who had initial changes on chest radiograph had 12 week follow up radiograph requested as per British Thoracic Society guidelines. RESULTS: 29 patients were followed up after hospitalisation with COVID-19. Of these, 10 were brought for face-to-face consultations. Patients at clinic were all functionally independent with a median Medical Research Council dyspnoea score of 2 and a subjective assessment of their current health of median 50, on a visual analogue scale 0-100. Fatigue was common with all patients. Depression, anxiety and post-traumatic stress disorder were all reported from psychological review. Chest radiograph showed signs of improvement in 100% of clinic attendees. 90% of patients seen in clinic had normal or chronic obstructive patterns on spirometry, with one patient having a reduced transfer factor. CONCLUSION: Majority of patients did not require face-to-face review and were recovering well. Of the 10 patients seen in the respiratory led clinic, the main issues reported were fatigue and psychological issues. Respiratory symptoms were significantly improving in 9 out of the 10 patients seen. All patients have been introduced to psychology service whilst at clinic and will continue to receive necessary support.


Assuntos
COVID-19 , Pandemias , Assistência ao Convalescente , Seguimentos , Hospitais Urbanos , Humanos , Alta do Paciente , SARS-CoV-2
16.
J Biomech ; 124: 110554, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34157480

RESUMO

The aim was to investigate the kinematic factors associated with successful performance in the initial acceleration phase of a sprint in the best male athletes in the World at the 2018 World Indoor Athletics Championships. High speed video (150 Hz) was captured for eight sprinters in the men's 60 m final. Spatio-temporal and joint kinematic variables were calculated from the set position to the end of the first ground contact post-block exit (GC1). Normalised average horizontal external power (NAHEP) defined performance and was the dependent variable for a series of regression analyses. Clear relationships were found between GC1 NAHEP and 10-m time, 60-m time, change in velocity, acceleration and contact time in the first ground contact (r = -0.74, -0.64, 0.96, 0.91 and -0.56, respectively). Stepwise multiple linear regression of joint kinematic variables in the first ground contact revealed that trunk angle at take-off and thigh separation angle at take-off explained nearly 90% of variation in GC1 NAHEP (R2 = 0.89). The athletes' projection at take-off with a forward leaning trunk and large thigh separation is characteristic therefore of excellent initial acceleration performance and this will be a good visual guide for technical coaching instruction. This was the first study of its kind to adopt such a research design in a World-class sample in a representative environment. Future studies that combine detailed kinematic and kinetic data capture and analysis in such a setting will add further insight to the findings of this investigation.


Assuntos
Desempenho Atlético , Corrida , Aceleração , Atletas , Fenômenos Biomecânicos , Humanos , Masculino
17.
Phys Sportsmed ; 48(3): 290-297, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31662010

RESUMO

Objectives: Achilles tendon rupture leads to functional impairments and these may be underpinned by morphological changes in the muscle-tendon unit. The functional performance of the injured limb will be impaired regardless of time since surgery and these impairments occur alongside changes in muscle-tendon morphology. Methods: Following operative treatment of Achilles tendon rupture and short-term immobilization, 12 patients completed a battery of tests during a single visit to the laboratory (performed an average of 4.4 ± 2.6 years post-surgery). Patients completed the Achilles' tendon rupture score (ATRS), tests of the ankle and hip range of motion (ROM) and ultrasound measurements of muscle-tendon architecture. Data on isokinetic (30°/s, 60°/s) plantar flexion strength, jumping performance and walking-running were also collected on the same visit. Percentage deficits were expressed relative to the non-injured limb and determined for statistical significance (p < 0.05). Relationships between outcome measures and time since surgery were tested using Pearson's correlation coefficients (p < 0.05). Results: The repaired limb showed a shorter muscle fascicle length (12.1-19.6%), increased fascicle pennation (18.0 ± 22.14%) and reduced muscle thickness (9.1-20.1%) in the gastrocnemius and/or soleus along with greater tendon cross-sectional area (46.7 ± 34.47%). Functionally, the repaired limb displayed lower countermovement jump height (-12.6 ± 15.68%) and longer drop jump contact times (5.5 ± 5.7%). Also, the repaired limb showed reduced hip internal-external ROM (6.3 ± 8.2%) but no differences existed between limbs for plantar flexion ROM and strength or gait characteristics. Good ATRS outcomes were reported (mean: 87.9 ± 16.2, range: 43-100) which related to time since surgery (r = 0.79) but individual ATRS items did not correlate with corresponding objective measures. Conclusion: Plantar flexor atrophy following surgically treated Achilles tendon rupture is partially compensated for by remodeling of the fascicles; however, impairments may still persist many years into the postoperative period although these may be more pronounced in high-velocity activities.


Assuntos
Tendão do Calcâneo/lesões , Tendão do Calcâneo/cirurgia , Ruptura/cirurgia , Tendão do Calcâneo/patologia , Tendão do Calcâneo/fisiopatologia , Adulto , Articulação do Tornozelo/fisiopatologia , Teste de Esforço/métodos , Feminino , Análise da Marcha , Articulação do Quadril/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Atrofia Muscular/patologia , Amplitude de Movimento Articular , Corrida/fisiologia , Ruptura/diagnóstico por imagem , Ruptura/patologia , Ruptura/fisiopatologia , Ultrassonografia , Caminhada
18.
J Biomech ; 101: 109630, 2020 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-31983406

RESUMO

Isokinetic strength assessments are common outcome measures following operatively treated Achilles tendon (AT) ruptures. However, there is a lack of clarity on whether commonly reported outcome measures (such as peak joint moment) are sufficient to describe the extent of long-term functional deficits following AT rupture and repair. The present study conducted a comprehensive isokinetic evaluation of the Triceps surae complex in 12 participants who previously underwent AT rupture and repair. Testing occurred 4.4 (±2.6) years following surgery, and consisted of maximal isokinetic strength assessments of the plantarflexors at two angular velocities (30 and 60°âˆ™s-1) with the knee in flexed and straight positions. Differences between injured and non-injured limbs were tested through discrete and statistical parametric mapping analysis. Average joint moment showed significant main effects between injured and non-injured limbs, but common isokinetic parameters such as peak moment and angle of peak moment did not. The normalised moment curves showed a significant main effect of limb, angular velocity and knee joint position on joint moment throughout different portions of the range of motion. Temporal analysis revealed a significantly greater ability of the non-injured limb to sustain plantarflexor moments across a range of testing conditions. Participants who had undergone operative treatment of AT ruptures did not display inter-limb differences in discrete isokinetic strength outcomes that are often used in the literature. Instead, temporal analyses were required to highlight the reduced capacity of the injured limb to generate end-range joint moments and to sustain higher levels of joint moment for longer periods.


Assuntos
Tendão do Calcâneo/lesões , Fenômenos Mecânicos , Força Muscular , Músculo Esquelético/fisiopatologia , Ruptura/complicações , Traumatismos dos Tendões/fisiopatologia , Traumatismos dos Tendões/cirurgia , Tendão do Calcâneo/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Traumatismos dos Tendões/complicações
19.
Artigo em Inglês | MEDLINE | ID: mdl-33344947

RESUMO

The effect of the inclusion of a high hurdle 13.72 m after the start line on elite sprint start and initial acceleration technique has yet to be investigated or understood. This highly novel study addresses that lack of information in an exceptional manner, through detailed biomechanical analysis of the world's best sprint and hurdle athletes, with data collected in situ at the 2018 IAAF World Indoor Championships, held in Birmingham, UK. High speed videos (150 Hz) were compared for eight sprinters and seven hurdlers for the start and initial acceleration phase of the finals of the men's 60 m and 60 m hurdles. Temporal and kinematic data were supplemented by vector coding analysis to investigate mechanisms by which these world-class athletes translate their centres of mass (CM) up to the fourth touchdown post-block exit. The sprinters and hurdlers coordinated their lower limb and trunk movement in a similar manner throughout the start and initial acceleration phases, which contributes new conceptual understanding of the mechanisms that underpin start and initial acceleration performance. Differences between groups were initiated from block set-up, with the hurdlers utilising a larger block spacing, but with the front block nearer to the start line than sprinters. Even after accounting for stature, the biggest differences in the raising of the CM occurred during the block phase, with hurdlers greater than sprinters (difference in vertical CM displacement scaled to stature = -0.037, very large effect size). Subsequent flight phases showed the biggest differences in the translation of the CM, in part due to longer flight times in the hurdlers, whilst the techniques of the two groups generally converged during the ground contact phases of initial acceleration. In highlighting that similar techniques are used by world-class sprinters and hurdlers, despite differing task constraints, this study has provided invaluable insights for scientists, coaches, and athletes, that will inform further developments in understanding and practice across both sprints and hurdles.

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