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1.
Knee Surg Sports Traumatol Arthrosc ; 32(4): 889-895, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38454787

RESUMEN

PURPOSE: Females with above-average anterior knee laxity values are at increased risk of anterior cruciate ligament (ACL) injury. The purpose of this study was to examine the effects of menarche age (MA) and menarche offset on anterior knee laxity in young, physically active women. METHODS: Anterior knee laxity (KT-2000) and menstrual characteristics (per self-report) were recorded in 686 Slovenian sportswomen from team handball, volleyball and basketball club sports (average years sport participation: 7.3 ± 3.6 years). Females were stratified into four groups based on their self-reported age at menarche: 9-11, 12, 13 and 14+ years. Anterior knee laxity was compared across MA groups using a univariate analysis of variance (ANOVA) with Bonferroni correction, with and without controlling for factors that could potentially differ between groups and influence anterior knee laxity. Females were then stratified into four groups based on the number of years they were away from their age at onset of menarche. Groups were compared using a univariate ANOVA with Bonferroni correction, with and without controlling for factors that differed between groups and could influence anterior knee laxity. RESULTS: Anterior knee laxity was greater in females who attained menarche at 12 years of age (6.4 ± 1.5 mm) or younger (6.6 ± 1.6 mm) compared to 14 years of age or older (5.8 ± 1.2 mm) (p < 0.001; partial η2 = 0.032). Anterior knee laxity was 0.7-1.4 mm greater in females who were 5 or more years away from menarche compared to those who were within 2 years of menarche (5.8 ± 1.3 mm; p < 0.001). CONCLUSION: Anterior knee laxity is greater in females who attained menarche at a younger age and in females who are 5 or more years postmenarche. Age of menarche represents a critical pubertal event that is easy for women to recall and may provide important insights into factors that moderate anterior knee laxity, a risk factor for ACL injury in women. LEVEL OF EVIDENCE: Level IV.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Baloncesto , Inestabilidad de la Articulación , Traumatismos de la Rodilla , Femenino , Humanos , Menarquia , Traumatismos de la Rodilla/complicaciones , Articulación de la Rodilla , Lesiones del Ligamento Cruzado Anterior/complicaciones , Inestabilidad de la Articulación/etiología
2.
Dermatol Online J ; 29(4)2023 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-37921814

RESUMEN

Sickle cell disease is a monogenic hemoglobinopathy that results in the abnormal production of hemoglobin S, which yields the characteristic sickle-shaped red blood cells. Sickle cell vaso-occlusive crisis is a painful complication of sickle cell disease caused by red blood cell entrapment within the microcirculation. The resulting tissue ischemia triggers a secondary inflammatory process involved in the pathogenesis of varying inflammatory skin conditions. Chronic leg ulcers are the most common skin presentation in sickle cell disease. A 58-year-old woman with sickle cell disease presented with systemic edematous plaques with the most notable involvement of her bilateral legs, which exhibited reticulated purpuric patches with central pallor. We report a case highlighting an unusual presentation of livedo racemosa as the presenting sign in a patient with sickle cell disease in vaso-occlusive crisis.


Asunto(s)
Anemia de Células Falciformes , Livedo Reticularis , Humanos , Femenino , Persona de Mediana Edad , Livedo Reticularis/etiología , Anemia de Células Falciformes/complicaciones , Dolor/etiología
3.
J Clin Nurs ; 25(11-12): 1501-14, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27108662

RESUMEN

AIM: To determine which factors relate to the development of post-traumatic stress disorder, in adult patients who are admitted to critical care units. BACKGROUND: Patient survival rates from critical care areas are improving each year and this has led to interest in the long-term outcomes for patients who have been discharged from such environments. Patients typically require invasive and extensive treatment, which places a stress on physical and mental health. Prevalence estimates of post-traumatic stress disorder in the critical care discharge population vary from 5-63%, yet it remains unclear what the predisposing factors are. DESIGN: A systematised review. METHOD: Subject heading and keyword searches were conducted in MEDLINE, CINAHL, PsycINFO and ScienceDirect, with 23 articles identified that examined the relationship between critical care and the development of post-traumatic stress disorder. RESULTS: Three main themes were identified; Critical Care Factors, Patient Factors and Experience Factors. Eight key and three potential causative factors were found: younger age, female, previous psychiatric history, length of ICU stay, benzodiazepine sedation, use of stress hormones, delusional memory and traumatic memory, delirium, GCS score of ≤9 on admission & use of mechanical restraint. CONCLUSIONS: Post-traumatic stress reactions can be strongly related to the development and presence of traumatic and delusional memories. Younger patients may exclude themselves from research to avoid their traumatic thoughts. The role of prior psychiatric illness is unknown. Distinction between 'factual' and 'false' or delusional memory as occurs in the literature maybe unhelpful in understanding trauma reactions. RELEVANCE TO CLINICAL PRACTICE: There are around 38,000 occupied critical care beds each year in England. The scale of the issue is therefore substantial. Risk factors can be isolated from available evidence and provide a rudimentary risk assessment tool to inform practice development in this area.


Asunto(s)
Cuidados Críticos , Trastornos por Estrés Postraumático/epidemiología , Adulto , Inglaterra , Femenino , Humanos , Masculino
4.
Knee Surg Sports Traumatol Arthrosc ; 23(11): 3168-77, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24934926

RESUMEN

PURPOSE: To investigate the effect of different loads of knee extensor open kinetic chain resistance training on anterior knee laxity and function in the ACL-injured (ACLI) knee. METHODS: Fifty-eight ACLI subjects were randomised to one of three (12-week duration) training groups. The STAND group trained according to a standardised rehabilitation protocol. Subjects in the LOW and HIGH group trained as did the STAND group but with the addition of seated knee extensor open kinetic chain resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Anterior knee laxity and measurements of physical and subjective function were performed at baseline, 6 and 12 weeks. Thirty-six subjects were tested at both baseline and 12 weeks (STAND n = 13, LOW n = 11, HIGH n = 12). RESULTS: The LOW group demonstrated a reduction in 133 N anterior knee laxity between baseline and 12 weeks testing when compared to the HIGH and the STAND groups (p = 0.009). Specifically, the trained-untrained knee laxity decreased an average of approximately 5 mm in the LOW group while remaining the same in the other two groups. CONCLUSION: Twelve weeks of knee extensor open kinetic chain resistance training at loads of 2 sets of 20RM led to a reduction in anterior knee laxity in the ACLI knee. This reduction in laxity does not appear to offer any significant short-term functional advantages when compared to a standard rehabilitation protocol. These results indicate that knee laxity can be decreased with resistance training of the thigh muscles. LEVEL OF EVIDENCE: Randomised controlled trial, Level II.


Asunto(s)
Ligamento Cruzado Anterior/fisiopatología , Inestabilidad de la Articulación/rehabilitación , Traumatismos de la Rodilla/rehabilitación , Entrenamiento de Fuerza/métodos , Adulto , Lesiones del Ligamento Cruzado Anterior , Femenino , Humanos , Inestabilidad de la Articulación/fisiopatología , Cinética , Traumatismos de la Rodilla/fisiopatología , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiología , Adulto Joven
5.
Int J Biometeorol ; 58(7): 1673-82, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24357489

RESUMEN

Regional sweating patterns and body surface temperature differences exist between genders. Traditional sportswear made from one material and/or one fabric structure has a limited ability to provide athletes sufficient local wear comfort. Body mapping sportswear consists of one piece of multiple knit structure fabric or of different fabric pieces that may provide athletes better wear comfort. In this study, the 'modular' body mapping sportswear was designed and subsequently assessed on a 'Newton' type sweating manikin that operated in both constant temperature mode and thermophysiological model control mode. The performance of the modular body mapping sportswear kit and commercial products were also compared. The results demonstrated that such a modular body mapping sportswear kit can meet multiple wear/thermal comfort requirements in various environmental conditions. All body mapping clothing (BMC) presented limited global thermophysiological benefits for the wearers. Nevertheless, BMC showed evident improvements in adjusting local body heat exchanges and local thermal sensations.


Asunto(s)
Regulación de la Temperatura Corporal , Vestuario , Maniquíes , Animales , Superficie Corporal , Fibra de Algodón , Humedad , Microclima , Poliésteres , Poliuretanos , Temperatura Cutánea , Temperatura , Lana
6.
Knee Surg Sports Traumatol Arthrosc ; 22(11): 2821-9, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24114352

RESUMEN

PURPOSE: The main purpose of this study was to describe the nature of the relationship between hamstring muscle activity and anterior knee laxity. METHODS: This was a cross-sectional study. Anterior knee laxity was measured at 133N and manual maximal forces using the KT2000 knee arthrometer, in 8 ACL-injured and 13 uninjured individuals. Electromyographic activity of the lateral hamstrings was measured during laxity testing. Subjects contracted the hamstrings during anterior knee laxity testing at eight predetermined levels of maximal voluntary isometric contraction. RESULTS: Volitional contraction of the lateral hamstrings reduced anterior knee laxity logarithmically for both the 133N and manual maximal tests in both the ACL-injured and uninjured knees. A simple linear regression model, with the log of percentage of maximum lateral hamstrings activity as the sole predictor, explained approximately 70-80% of the variation in anterior knee laxity. Both ACL-injured and uninjured subjects reduced anterior knee laxity at the same rate with increases in muscle activity. However, initial lateral hamstrings muscle activity had a greater effect on percentage anterior knee laxity scores in the ACL-injured as compared to the uninjured knee. CONCLUSIONS: Lateral hamstrings activity reduces anterior knee laxity in a nonlinear manner, whereby the initial lower level of activation produces the greatest change in anterior knee laxity. Therefore, hamstrings muscle activity must be monitored during anterior knee laxity testing.


Asunto(s)
Inestabilidad de la Articulación/fisiopatología , Traumatismos de la Rodilla/fisiopatología , Rodilla/fisiopatología , Músculo Esquelético/fisiopatología , Adulto , Ligamento Cruzado Anterior/fisiopatología , Lesiones del Ligamento Cruzado Anterior , Estudios Transversales , Electromiografía , Femenino , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiología , Muslo , Adulto Joven
7.
Qual Life Res ; 20(9): 1437-46, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21547357

RESUMEN

PURPOSE: To compare the psychometric properties of the Hughston Clinic Questionnaire (HCQ), EQ-5D and SF-6D in patients following arthroscopic partial meniscectomy surgery. METHODS: A total of 84 participants (86% men; mean age 40) were recruited. The questionnaires were completed on average 5 days, 6 weeks and 6 months after surgery and compared for internal consistency, convergent validity, sensitivity to change and floor and ceiling effects. RESULTS: Internally, the HCQ was the most consistent instrument (α = 0.923) followed by the SF-6D and EQ-5D. The EQ-5D and SF-6D were moderately correlated with the HCQ (ρ = 0.499 and 0.394, respectively). Six weeks after surgery, the most sensitive measures were the HCQ and EQ-5D (effect size: 2.04 and 0.99, respectively), at 6 months, with a smaller cohort (n = 42), again it was the HCQ and EQ-5D (effect size: 2.03 and 1.04, respectively). The SF-6D demonstrated no ceiling or floor effect during the study; the HCQ demonstrated a ceiling affect for 5% of respondents at 6 months after surgery compared to 26% of respondents for the EQ-5D. CONCLUSION: For this patient population, our findings indicated that the EQ-5D was more consistently responsive to change over time, as a utility index was better at distinguishing differences between groups and reflected the results of the joint-specific HCQ for knee recovery better than the SF-6D. It is therefore recommended that for similar populations, the EQ-5D is preferable to the SF-6D for utilisation alongside the HCQ.


Asunto(s)
Artroscopía , Traumatismos de la Rodilla/cirugía , Meniscos Tibiales/cirugía , Adulto , Artroscopía/psicología , Femenino , Humanos , Traumatismos de la Rodilla/fisiopatología , Traumatismos de la Rodilla/psicología , Masculino , Persona de Mediana Edad , Psicometría , Estudios Retrospectivos , Encuestas y Cuestionarios , Reino Unido , Adulto Joven
8.
J Pediatr Gastroenterol Nutr ; 49(2): 237-42, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19525868

RESUMEN

BACKGROUND: Growth failure and undernutrition complicate the clinical course of girls with Rett syndrome (RTT). These abnormalities are, in part, the consequence of oral motor dysfunction and inadequate dietary intake. OBJECTIVE: To determine whether gastrostomy placement for nutritional therapy alters the natural history of growth failure and undernutrition in RTT. HYPOTHESIS: We hypothesized that gastrostomy placement for nutritional therapy reverses the decline in height, weight, and body mass index (BMI) z scores in RTT. METHODS: Standard stadiometric and anthropometric measures were obtained to derive height, weight, and BMI z scores and estimates of fat-free mass (FFM) and body fat in a cohort of girls (n = 92) with RTT before and after gastrostomy placement. Methyl-CpG-binding protein 2 (MECP2) mutations and the presence or absence of a fundoplication were recorded. RESULTS: The differences in height (n = 73), weight (n = 81), and BMI (n = 81) z score slopes before and after gastrostomy placement were 1.31 + 2.06 (P < 0.001), 2.38 +/- 3.18 (P < 0.001), and 3.25 +/- 3.32 (P < 0.001), respectively. FFM and body fat (n = 43) increased after gastrostomy by 41 +/- 27 g/cm height (P < 0.001) and 7.5% +/- 5.7% body weight (P < 0.001), respectively. The differences in height, weight, and BMI z score slopes were similar regardless of the age at which the gastrostomy was placed. The differences in height, weight, and BMI z score slopes, as well as the change in FFM and body fat deposition after gastrostomy placement, did not differ between those who did or did not have a fundoplication and among the classes of MECP2 mutations. CONCLUSION: Gastrostomy placement for aggressive nutritional therapy favorably altered the natural history of growth failure and undernutrition in RTT, but did not restore height and weight z scores to birth values, regardless of the age at which surgery occurred and in the presence or absence of a fundoplication.


Asunto(s)
Tamaño Corporal , Gastrostomía/métodos , Trastornos del Crecimiento/terapia , Crecimiento , Apoyo Nutricional/métodos , Síndrome de Rett/terapia , Tejido Adiposo , Adolescente , Compartimentos de Líquidos Corporales , Estatura , Índice de Masa Corporal , Peso Corporal , Niño , Preescolar , Femenino , Fundoplicación/estadística & datos numéricos , Trastornos del Crecimiento/etiología , Humanos , Proteína 2 de Unión a Metil-CpG/genética , Mutación , Síndrome de Rett/complicaciones
9.
Orthopedics ; 31(8): 752, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19292423

RESUMEN

A main role of clinicians treating patients after orthopedic surgery is to inform patients about their anticipated recovery rate and recovery endpoint. In estimating recovery rate, clinicians consider a series of potentially influencing factors, including the type and severity of injury and the characteristics of the patient. Unfortunately, this is done largely without evidence to support factors believed to be important in recovery rate. To our knowledge, no studies exist where factors that might influence recovery rate after arthroscopic partial meniscectomy have been evaluated. Eighty-three patients (11 women and 72 men) were evaluated 4 days after and then again 6 weeks after knee arthroscopic partial meniscectomy surgery. Recovery rate was calculated by dividing the change in a patient's Hughston Clinic knee self-assessment questionnaire during this period by his or her baseline Hughston score and relationships to independent variables (gender, age, body mass index [BMI], injury chronicity, affected meniscus, Hughston Clinic knee self-assessment score at baseline, knee flexion passive range of motion, and knee circumference). These were evaluated using backward stepwise regression analysis. The relationship between recovery rate and the independent variables was statistically significant (P,.05) for the following variables: injury chronicity, gender, and gender/injury type combination. The most unexpected finding in this study was the statistically nonsignificant relationship between recovery rate and the following variables: age, Hughston score, BMI, knee swelling, and knee flexion passive range of motion loss.


Asunto(s)
Artroscopía/estadística & datos numéricos , Traumatismos de la Rodilla/epidemiología , Traumatismos de la Rodilla/cirugía , Meniscos Tibiales/cirugía , Evaluación de Resultado en la Atención de Salud/métodos , Recuperación de la Función , Medición de Riesgo/métodos , Lesiones de Menisco Tibial , Adolescente , Adulto , Femenino , Humanos , Londres/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Resultado del Tratamiento , Adulto Joven
10.
Phys Ther ; 87(1): 53-65, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17179442

RESUMEN

BACKGROUND AND PURPOSE: Neuromuscular electrical stimulation (NMES) is frequently used to decrease swelling in the early period after ankle sprain. The purpose of this study was to evaluate its effectiveness in this treatment. SUBJECTS: Thirty-four subjects (11 female, 23 male; mean age=30.2 years) who were recovering from ankle sprain participated. METHODS: Outcome measures were ankle-foot volume, ankle girth, and self-assessed ankle function. Three testing raining sessions occurred within 5 days of injury. Subjects were randomly assigned to 1 of 3 groups: a group that received NMES treatment, a group that received submotor ES treatment (designed to act as a control group), and a group that received sham treatment. RESULTS: There were no statistically significant differences among the groups for ankle-foot volume and self-assessed ankle function. The statistically significant differences for ankle girth may have been compromised due to the significantly different values among groups at baseline. Ankle girth measurements were shown to be statistically significant from session 1 to session 3 for the NMES group but not for the other 2 groups. DISCUSSION AND CONCLUSION: The results indicate that NMES, as designed and used in this study, is not effective in decreasing ankle-foot volume or increasing self-assessed ankle function in the early period after ankle sprain.


Asunto(s)
Articulación del Tobillo , Edema/terapia , Terapia por Estimulación Eléctrica/métodos , Esguinces y Distensiones/terapia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
11.
J Strength Cond Res ; 21(4): 1050-2, 2007 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18076254

RESUMEN

Resistance training is one of the major components of rehabilitation after musculoskeletal injury and surgery. Despite the importance of resistance training and the frequency of its use in rehabilitation, little is known about factors that are related to training load that might be useful in devising and monitoring training in a patient and comparing training intensities between individuals and groups. We hypothesized that the following would show a statistically significant relationship to training load: injury chronicity, self-assessed knee function (Hughston Clinic questionnaire), knee swelling (injured-uninjured midpatellar knee girth), uninjured knee girth, and body mass. The purpose of this study was to evaluate whether factors such as body mass are related to the load used in training the knee extensors in rehabilitation after knee surgery. Thirty-six individuals undergoing early-phase rehabilitation after knee arthroscopic meniscectomy surgery participated in this study. Subjects were tested 5 days after surgery, just prior to commencing a 6-week outpatient rehabilitation program, and again soon after the end of this rehabilitation program. The independent variables evaluated were age, gender, body mass, meniscus injured, injury chronicity, knee function self-assessment, knee swelling (injured-uninjured midpatellar girth), uninjured knee girth, and knee flexion and extension passive range of motion (difference between injured and uninjured side). The dependent variable was the load used for training the knee extensors on the knee extension machine in the final training session prior to the posttest. The only variable exhibiting a statistically significant (p = 0.001) relationship to knee extensor final training was age (r = -0.529). This finding, that age was the only variable to have a significant relationship with training load, suggests that clinicians' expectation of training intensity should decrease with an increase in the patient's age in the range studied (20-58 years) for patients recovering from knee arthroscopic meniscectomy.


Asunto(s)
Terapia por Ejercicio/métodos , Traumatismos de la Rodilla/fisiopatología , Traumatismos de la Rodilla/rehabilitación , Cuidados Posoperatorios/métodos , Soporte de Peso , Adulto , Factores de Edad , Peso Corporal , Femenino , Humanos , Traumatismos de la Rodilla/cirugía , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Movimiento , Rango del Movimiento Articular , Levantamiento de Peso
12.
Man Ther ; 11(1): 54-60, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16009592

RESUMEN

The purpose of this study was to consider how the deep abdominal muscles responded to alterations in seated stability. The thickness of the right transverse abdominis (TrA) and internal oblique (IO) muscles were measured with ultrasound imaging in 30 healthy human subjects (mean age 27.7, years 22 females) in supine lying, relaxed sitting on a chair with both feet on the ground, relaxed sitting on a gym ball with both feet on the ground and sitting on a gym ball lifting the left foot off the floor. Measurements were taken at the end of both inspiration and expiration. The results showed that muscle thickness expressed as a percentage of the actual muscle thickness in supine lying did not differ between relaxed sitting on a chair and sitting on a gym ball for either muscle (P=0.012-0.054) where Bonferroni corrected P-value for significance=0.002. Raising the foot off the floor produced a significant increase in thickness for TrA and IO, when compared with the other seated postures (P<0.001). It was also found that both muscles were thicker at the end of expiration (P<0.001) which has also been established by other authors. These findings suggest that both deep abdominal muscles respond in the same way to postural changes. It also demonstrates that these muscles are automatically targeted by significantly decreasing the base of support, but in normal subjects sitting on a gym ball is not sufficient to increase their activity.


Asunto(s)
Músculos Abdominales/fisiología , Contracción Muscular/fisiología , Músculo Esquelético/fisiología , Postura/fisiología , Músculos Abdominales/diagnóstico por imagen , Adulto , Ejercicio Físico/fisiología , Femenino , Humanos , Masculino , Músculo Esquelético/diagnóstico por imagen , Recto del Abdomen/diagnóstico por imagen , Recto del Abdomen/fisiología , Valores de Referencia , Respiración , Ultrasonografía
13.
Int J Psychiatr Nurs Res ; 12(1): 1393-401, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17016901

RESUMEN

This article reviews dementia care in the context of an adapted version of an Alzheimer's Cafe focusing on eight couples newly diagnosed with dementia. It is primarily a reflective account. The adapted version of an Alzheimer Café focused on providing an informal café with more emphasis on communication, education and support for couples. It also seeks to provide a critical platform to evaluate the impact of developing such approaches like, (Alzheimer Café) in contrast to other approaches like, couple therapy, relationship and person centred approaches.


Asunto(s)
Enfermedad de Alzheimer/prevención & control , Educación del Paciente como Asunto/organización & administración , Grupos de Autoayuda/organización & administración , Esposos/psicología , Adaptación Psicológica , Enfermedad de Alzheimer/psicología , Actitud Frente a la Salud , Centros de Día , Progresión de la Enfermedad , Investigación sobre Servicios de Salud , Humanos , Evaluación de Resultado en la Atención de Salud , Evaluación de Programas y Proyectos de Salud , Aislamiento Social , Apoyo Social , Esposos/educación , Pensamiento , Reino Unido
14.
Nurs Times ; 102(15): 29-31, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16640210

RESUMEN

Discussing emotional trauma is a central part of care in dementia and can help individuals value and make sense of their lives. The Alzheimer's cafe, started in 1997 in the Netherlands, can help facilitate this. This article reviews an adapted version of an Alzheimer's cafe focusing on eight couples where one partner was newly diagnosed with dementia. It is primarily a reflective account.


Asunto(s)
Actitud Frente a la Salud , Cuidadores/psicología , Demencia/prevención & control , Grupos de Autoayuda/organización & administración , Esposos/psicología , Actividades Cotidianas , Adaptación Psicológica , Anciano , Actitud del Personal de Salud , Cuidadores/educación , Comunicación , Recolección de Datos , Demencia/psicología , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Modelos Psicológicos , Investigación Metodológica en Enfermería , Educación del Paciente como Asunto/organización & administración , Evaluación de Programas y Proyectos de Salud , Proyectos de Investigación , Apoyo Social , Esposos/educación , Pensamiento
15.
Man Ther ; 22: 1-8, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26995776

RESUMEN

BACKGROUND: The commonly used open kinetic chain knee extensor (OKCKE) exercise loads the sagittal restraints to knee anterior tibial translation. OBJECTIVE: To investigate the effect of different loads of OKCKE resistance training on anterior knee laxity (AKL) in the uninjured knee. STUDY DESIGN: non-clinical trial. METHODS: Randomization into one of three supervised training groups occurred with training 3 times per week for 12 weeks. Subjects in the LOW and HIGH groups performed OKCKE resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Subjects in the isokinetic training group (ISOK) performed isokinetic OKCKE resistance training using 2 sets of 20 maximal efforts. AKL was measured using the KT2000 arthrometer with concurrent measurement of lateral hamstrings muscle activity at baseline, 6 weeks and 12 weeks. RESULTS: Twenty six subjects participated (LOW n = 9, HIGH n = 10, ISOK n = 7). The main finding from this study is that a 12-week OKCKE resistance training programme at loads of 20 sets of 2RM, leads to an increase in manual maximal AKL. CONCLUSIONS: OKCKE resistance training at high loads (20 sets of 2RM) increases AKL while low load OKCKE resistance training (2 sets of 20RM) and isokinetic OKCKE resistance training at 2 sets of 20RM does not.


Asunto(s)
Inestabilidad de la Articulación/rehabilitación , Articulación de la Rodilla/fisiopatología , Rango del Movimiento Articular/fisiología , Entrenamiento de Fuerza/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiología , Adulto Joven
16.
BMJ Open Sport Exerc Med ; 2(1): e000170, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27900198

RESUMEN

BACKGROUND: People with chronic low back pain (CLBP) demonstrate greater postural instability compared with asymptomatic individuals. Rocker-sole shoes are inherently unstable and may serve as an effective balance training device. This study hypothesised that wearing rocker-sole shoes would result in long-term improvement in barefoot postural stability in people with CLBP. METHODS: 20 participants with CLBP were randomised to wear rocker-sole or flat-sole shoes for a minimum of 2 hours each day. Participants were assessed barefoot and shod, over three 40 s trials, under 4 posture challenging standing conditions. The primary outcome was postural stability assessed by root mean squared error of centre of pressure (CoP) displacement (CoPRMSE AP) and mean CoP velocity (CoPVELAP), both in the anteroposterior direction, using force plates. Participants' were assessed without knowledge of group allocation at baseline, 6 weeks and 6 months (main outcome point). Analyses were by intention-to-treat. RESULTS: At 6 months, data from 11 of 13 (84.6%) of the rocker-sole and 5 of 7 (71.4%) of the flat-sole group were available for analysis. At baseline, there was a mean increase in CoPRMSE AP (6.41 (2.97) mm, p<0.01) and CoPVELAP (4.10 (2.97) mm, p<0.01) in the rocker-sole group when shod compared with barefoot; there was no difference in the flat-sole group. There were no within-group or between-group differences in change in CoP parameters at any time point compared with baseline (1) for any barefoot standing condition (2) when assessed shod eyes-open on firm ground. CONCLUSIONS: Although wearing rocker-sole shoes results in greater postural instability than flat-sole shoes, long-term use of rocker-sole shoes did not appear to influence postural stability in people with CLBP.

17.
Med Sci Sports Exerc ; 37(3): 360-3, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15741831

RESUMEN

PURPOSE: Decreasing swelling after ankle sprain is a main focus of treatment, as it is believed that swelling is related to function. The purpose of this study was to evaluate the relationship between ankle-foot swelling and self-assessed ankle function in the early period after ankle sprain. METHODS: Thirty-six individuals were tested for ankle-foot volume and self-assessed ankle function within days of spraining their ankle. Volumetric measurements of the injured and uninjured ankle-foot segment were taken with a foot and ankle volumeter. Stepwise linear regression analysis was performed, with function being the dependent variable, and the following variables included as independent variables: gender, age, body mass index, previous history of sprain in the injured ankle, and the volume difference between the injured and uninjured ankle-foot segment. RESULTS: None of the independent variables were significantly related to self-assessed function. Pearson's correlation coefficient for the injured minus uninjured ankle-foot volume and self-assessed ankle function was -0.003. CONCLUSION: The results indicate that there is no relationship between ankle-foot swelling and self-assessed ankle function in the early period after ankle sprain injury.


Asunto(s)
Traumatismos del Tobillo/fisiopatología , Esguinces y Distensiones/fisiopatología , Adolescente , Adulto , Traumatismos del Tobillo/complicaciones , Pesos y Medidas Corporales , Edema/etiología , Edema/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuperación de la Función/fisiología , Esguinces y Distensiones/complicaciones
18.
Man Ther ; 20(5): 709-14, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25825328

RESUMEN

BACKGROUND: Increased knee anterior laxity results when the anterior cruciate ligament is injured. This increased laxity can cause knee dysfunction. Until recently this laxity was believed to be only diminished through surgery. But recent findings indicate that knee anterior laxity may be decreased with repeated loading of the knee. OBJECTIVE: The purpose of this study was to test the hypothesis that regular passive anterior loading of the uninjured human knee would enhance its stiffness. STUDY DESIGN: Randomized controlled trial. METHODS: Knee anterior laxity was tested using an arthrometer in 22 young, uninjured females before, during and after a 3 month period during which passive anterior loading was applied by a trained physiotherapist over 5 sessions per week to a randomly assigned knee. RESULTS: Knee anterior laxity was not affected by the passive anterior loading of the knee. CONCLUSIONS: Given that in this study repeated passive loading of the knee did not change knee anterior laxity, it would be easy to conclude that this training is ineffective and no further research is required. We caution against this given the relatively short duration and possibly insufficient intensity of the training and the population studied; individuals with normal joint laxity. We recommend that future research be performed that consists of individuals with lax joints who receive training for prolonged periods.


Asunto(s)
Inestabilidad de la Articulación , Articulación de la Rodilla/fisiología , Rango del Movimiento Articular/fisiología , Soporte de Peso/fisiología , Adulto , Femenino , Voluntarios Sanos , Humanos , Adulto Joven
19.
Med Sci Sports Exerc ; 35(4): 630-4, 2003 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-12673147

RESUMEN

PURPOSE: The purpose of this study was to assess whether the increase in foot and ankle volume after 30 min of motionless standing in healthy subjects could be minimized by neuromuscular electrical stimulation (NMES). METHODS: A crossover, counterbalanced design was used where foot and ankle volume in 20 healthy subjects was measured using water volumetry before and after 30 min of motionless standing and standing with NMES applied to the lower leg muscles. The NMES produced repeated tetanic contractions of the gastrocnemius and tibialis anterior muscles causing slight ankle dorsi- and plantar-flexion. RESULTS: Posttest foot and ankle volume was significantly greater than pretest volume after 30 min of motionless standing (t = -7.093, P < 0.001), but no significant differences were found after 30 min of standing with NMES (t = -1.374, P = 0.185). The mean volume changes from pretest to posttest in the conditions without NMES and with NMES were significantly different (51 +/- 32 mL and 12 +/- 39 mL, respectively; t = 3.905, P = 0.001). CONCLUSION: This study demonstrates the potential uses of NMES as a means to reduce swelling in the lower limbs for individuals who do not fully activate the musculo-venous pump. The activation of the musculo-venous pump by NMES-induced muscle contraction may have minimized the increase in foot and ankle volume by increasing venous return, reducing venous stasis, increasing lymph flow, and increasing interstitial hydrostatic pressure, which would reduce capillary filtration and assist fluid reabsorption.


Asunto(s)
Tobillo/anatomía & histología , Edema/prevención & control , Estimulación Eléctrica , Pie/anatomía & histología , Equilibrio Hidroelectrolítico , Adulto , Tobillo/fisiología , Estudios Cruzados , Mareo , Femenino , Pie/fisiología , Humanos , Pierna/irrigación sanguínea , Masculino , Persona de Mediana Edad , Postura , Flujo Sanguíneo Regional
20.
Phys Ther ; 83(6): 520-35, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12775198

RESUMEN

BACKGROUND AND PURPOSE: Controversy exists about the effectiveness of physical therapy after arthroscopic partial meniscectomy. This randomized controlled trial evaluated the effectiveness of supervised physical therapy with a home program versus a home program alone. SUBJECTS: Eighty-four patients (86% males; overall mean age=39 years, SD=9, range=21-58; female mean age=39 years, SD=9, range=24-58; male mean age=40, SD=9, range=21-58) who underwent an uncomplicated arthroscopic partial meniscectomy participated. METHODS: Subjects were randomly assigned to either a group who received 6 weeks of supervised physical therapy with a home program or a group who received only a home program. Blinded test sessions were conducted 5 and 50 days after surgery. Outcome measures were: (1) Hughston Clinic questionnaire, (2) Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and EuroQol EQ-5D (EQ-5D) questionnaires, (3) number of days to return to work after surgery divided by the Factor Occupational Rating System score, (4) kinematic analysis of knee function during level walking and stair use, and (5) horizontal and vertical hops. RESULTS: No differences between groups were found for any of the outcomes measured. DISCUSSION AND CONCLUSION: The results indicate that the supervised physical therapy used in this study is not beneficial for patients in the early period after uncomplicated arthroscopic partial meniscectomy.


Asunto(s)
Traumatismos de la Rodilla/rehabilitación , Traumatismos de la Rodilla/cirugía , Meniscos Tibiales/cirugía , Modalidades de Fisioterapia , Adulto , Artroscopía , Terapia por Ejercicio , Femenino , Humanos , Modelos Lineales , Masculino , Dimensión del Dolor , Rango del Movimiento Articular , Encuestas y Cuestionarios , Lesiones de Menisco Tibial , Resultado del Tratamiento
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