Does leg predomination affect measuring vasti muscle onsets during single leg squatting? A reliability study.

INTRODUCTION: Although measuring vasti muscle onset may reveal whether pain relief is associated with altering this parameter during activities in subjects with patellofemoral pain syndrome (PFPS), it may be necessary to determine whether the inherent properties of the dominant leg influences the reliability of measuring VMO-VL muscle onset. The aim of the present study was to examine the effect of leg predomination on reliability testing of the VMO-VL muscle onset measurement during single leg squatting in healthy subjects. METHODS: The onset of VMO and VL muscles of ten healthy subjects with a right dominant leg was assessed during single leg squatting. Data was collected from the muscle bellies of the VMO and VL. This procedure was performed on the both legs, during three separate single leg squats from a neutral position to a depth of approximately 30° of knee flexion. Subjects were then asked to repeat the test procedure after a minimum of a week's interval. The full wave rectified onsets of VMO and VL were then calculated. RESULTS: There was no significant difference between the VMO-VL onset mean values of paired test of right and left knees. The ICC (intra class correlation coefficient) values during within and between sessions tests showed the poor reliability of these measurements on both knees. CONCLUSION: The low intratester reliability of within and between sessions measurement of VMO-VL onset on the both dominant and non-dominant legs revealed that repeatability of these measurements have little accepted reliability, however similar values of these measurements indicated that leg predomination does not affect the measurements during single leg squatting.

Investigating the Short-Term Effects of Manual Lymphatic Drainage and Compression Garment Therapies on Lymphatic Function Using Near-Infrared Imaging.

BACKGROUND: Lymphedema is a chronic peripheral swelling caused by a dysfunction of the lymphatic system, leading to discomfort and loss of upper limb movement. Therapies to treat or manage this swelling have limited evidence, partly because of a paucity in objective lymphatic measures. This study explored the role of near-infrared (NIR) imaging in evaluating interventions. METHODS: Nine healthy volunteers underwent NIR fluoroscopy using a microdose (50 µL, 0.05% w/v) of indocyanine green to quantify lymphatic behavior before and after a 15-minute period of manual lymph drainage followed by compression garment (CG) therapy for a 10-minute period. Images were taken at the forearm and elbow after each intervention. Lymphatic function was defined by the number, size, displacement, and speed of lymph packets. The lymph parameters were analyzed to assess the effects of the interventions compared with basal values. RESULTS: Baseline (BL) parameters of lymph function revealed high variability in the number, size, and speed of packets between individuals. Despite this variance, both interventions showed statistically significant improvement (p < 0.05) in displacement and speed at the forearm compared with BL. The velocity of transient lymph packets increased from a median of 6.7 mm/s at BL to 13.3 mm/s after manual lymphatic drainage (MLD) and 10.5 mm/s after CG. CONCLUSION: Lymphatic activity increased significantly after MLD, with relative increases being maintained after a short time period of CG application. NIR fluoroscopy has the potential to both monitor lymph pathology and provide robust parameters in the assessment of interventions.

Identifying barriers and facilitators to participation in pressure ulcer prevention in allied healthcare professionals: a mixed methods evaluation.

OBJECTIVES: To evaluate the barriers and facilitators for allied health professional's participation in pressure ulcer prevention. DESIGN: Mixed method cohort study. SETTING: Single centre study in an acute university hospital trust. PARTICIPANTS: Five physiotherapists and four occupational therapists were recruited from the hospital trust. Therapists had been working in the National Health Service (NHS) for a minimum of one year. MAIN OUTCOME MEASURES: Therapist views and experiences were collated using an audio recorded focus group. This recording was analysed using constant comparison analysis. Secondary outcomes included assessment of attitudes and knowledge of pressure ulcer prevention using questionnaires. RESULTS: Key themes surrounding barriers to participation in pressure ulcer prevention included resources (staffing and equipment), education and professional boundaries. Fewer facilitators were described, with new training opportunities and communication being highlighted. Results from the questionnaires showed the therapists had a positive attitude towards pressure ulcer prevention with a median score of 81% (range 50 to 83%). However, there were gaps in knowledge with a median score of 69% (range 50 to 77%). CONCLUSIONS: The therapist reported several barriers to pressure ulcer prevention and few facilitators. The primary barriers were resources, equipment and education. Attitudes and knowledge in AHPs were comparable to data previously reported from experienced nursing staff.

Does leg predomination affect the measurement of vasti muscle activity during single leg squatting? A reliability study.

INTRODUCTION: Although measuring vasti muscle activity may reveal whether pain relief is associated with altering this parameter during functional activities in subjects with patellofemoral pain syndrome (PFPS), it may be necessary to determine whether the inherent properties of the dominant leg influences the reliability of measuring VMO/VL amplitude. The aim of the present study was to examine the effect of leg predomination on reliability testing of the VMO/VL amplitude measurement during single leg squatting in healthy subjects. METHODS: Using an electromyography (EMG) unit, the ratio amplitudes of VMO and VL muscles of ten healthy subjects with a right dominant leg was assessed during single leg squatting. Data was collected from two silver-silver surface electrodes placed over the muscle bellies of the VMO and VL. This procedure was performed on the both right and left legs, during three separate single leg squats from a neutral position to a depth of approximately 30° of knee flexion. Subjects were then asked to repeat the test procedure after a minimum of a week's interval. The amplitude of VMO and VL were then calculated using root mean square (RMS). RESULTS: There was no significant difference between the VMO/VL amplitude mean values of paired test of right (mean, SD of 0.85, 0.10) and left knees (mean, SD of 0.82, 0.10) (p > 0.05). The CV (coefficient of variation) values during within and between session tests, revealed the high repeatability and reproducibility of VMO/VL amplitude measurements on both knees. The ICC (intra class correlation coefficient) values during within and between sessions tests showed the high reliability of these measurements on both knees. CONCLUSION: The high reliability of VMO/VL amplitude measurements on both dominant and non-dominant legs of healthy subjects suggests that the VMO/VL amplitude measurement would not be influenced by the leg predomination during single leg squatting.

Reliability testing of vasti activity measurements in taped and untaped patellofemoral conditions during single leg squatting in healthy subjects: a pilot study.

INTRODUCTION: Measuring vasti muscles activity may provide reliable evidence for patellar taping to correct probable malalignment in subjects with patellofemoral pain syndrome (PFPS). The aim of present study was to examine the reliability of vasti activity measurements in different patellofemoral conditions during squatting in healthy subjects. METHODS: Using an electromyography (EMG) unit, the ratio amplitudes and onsets of VMO and VL muscles of twelve healthy subjects were assessed during single leg squatting. Data was collected from surface electrodes placed over the muscle bellies of the VMO and VL. This procedure was performed on the right knees, before (BT), during (WT) and shortly after patellar taping (SAT). RESULTS: While the CV (coefficient of variation), ICC (intra class correlation coefficient), LSD (least significant difference) and SEM (standard error of measurement) values revealed the high reliability of the VMO/VL amplitude measurements during single leg squatting (p < 0.05), the related values demonstrated poor to moderate reliability of VMO-VL onset measurements during the similar activity (p > 0.05). CONCLUSION: Reliability tests conducted during the current study showed that, while the relative amplitude of vasti could be used as highly reliable parameter, the muscle onsets of vasti had poor to moderate reliability.

Does leg predomination affect the measurement of patellofemoral joint reaction force (PFJRF) during single leg squatting?: a reliability study.

INTRODUCTION: Although measuring patellofemoral joint reaction forces (PFJRF) may provide reliable evidence for conservative treatments to correct probable malalignment in subjects with patellofemoral pain syndrome (PFPS), it may be necessary to determine whether the inherent properties of the dominant leg influences the reliability of measuring PFJRF. The aim of the present study was to examine the effect of leg predomination on reliability testing of the PFJRF measurement during single leg squatting in healthy subjects. METHODS: Using a motion analysis system and one force plate, PFJRF of 10 healthy subjects with a right dominant leg was assessed during single leg squatting. Data was collected from superficial markers taped to selected landmarks. This procedure was performed on the both right and left legs, during three separate single leg squats from a neutral position to a depth of approximately 30° of knee flexion. Subjects were then asked to repeat the test procedure after a minimum of a week's interval. The PFJRF was calculated using a biomechanical model of the patellofemoral joint. RESULTS: There was significant difference between the PFJRF mean values of paired test of right (mean, SD of 1887.7, 325.1 N) and left knees (mean, SD of 2022.6, 270.5 N) (p < 0.05). The CV (coefficient of variation) values during within and between session tests, revealed the high repeatability and reproducibility of PFJRF measurements on both knees. The ICC (intra class correlation coefficient) values during within and between sessions tests showed the high reliability of these measurements on both knees. CONCLUSION: The high reliability of PFJRF measurements on both dominant and non-dominant legs of healthy subjects suggests that the PFJRF measurement would not be influenced by the leg predomination during single leg squatting.

Reliability testing of the patellofemoral joint reaction force (PFJRF) measurement during double-legged squatting in healthy subjects: a pilot study.

INTRODUCTION: Anterior knee pain or patellofemoral pain syndrome (PFPS) is supposed to be related to patellofemoral joint reaction forces (PFJRF). Measuring these forces may therefore provide reliable evidence for conservative treatments to correct probable malalignment in subjects with PFPS. The aim of the present study was to examine the reliability of PFJRF measurements during double-legged squatting in healthy subjects. METHODS: Using a motion analysis system and one forceplate, PFJRF of 10 healthy subjects were assessed during double-legged squatting. Data were collected from superficial markers taped to selected landmarks. This procedure was performed on the right knees, at three different knee flexion angles of 30, 45 and 60° during three separate double-legged squats. Subjects were then requested to repeat this test procedure on two separate test sessions at different occasions. The PFJRF was calculated using a biomechanical model of the patellofemoral joint. RESULTS: The data reveal an increase in PFJRF values (from mean, SD of 425.2, 35.5N to 1075.4, 70.1N)with an increase in the tibiofemoral joint angle during double-legged squatting. The CV (coefficient of variation) values during within and between session tests, revealed the high repeatability and reproducibility of PFJRF measurements, while the ICC (intra class correlation coefficient) values showed the low reliability of these measurements. CONCLUSION: The low reliability of PFJRF measurements suggests that the PFJRF measurement during double-legged squatting should be performed with caution with improving the method of kinetic measurement of the patellofemoral joint in healthy subjects.

Reliability testing of the patellofemoral joint reaction force (PFJRF) measurement in taped and untaped patellofemoral conditions during single leg squatting: a pilot study.

INTRODUCTION: Measuring patellofemoral joint reaction forces (PFJRF) may provide reliable evidence for patellar taping to correct probable malalignment in subjects with anterior knee pain, or patellofemoral pain syndrome (PFPS). The aim of the present study was to examine the reliability of PFJRF measurements in different patellofemoral conditions during squatting in healthy subjects. METHODS: Using a motion analysis system and one forceplate, PFJRF of eight healthy subjects was assessed during single leg squatting. Data was collected from superficial markers taped to selected landmarks. This procedure was performed on the right knees, before (BT), during (WT) and shortly after patellar taping (SAT). The PFJRF was calculated using a biomechanical model of the patellofemoral joint. RESULTS: The results revealed that, there were no significant differences between the PFJRF mean values for three conditions of BT (2100.55 ± 455.25), WT (2026.20 ± 516.45) and SAT (2055.35 ± 669.30) (p > 0.05). The CV (coefficient of variation), ICC (intra class correlation coefficient), LSD (least significant difference) and SEM (standard error of measurement) values revealed the high reliability of PFJRF measurements during single leg squatting (p < 0.05). CONCLUSION: The high reliability of PFJRF measurements reveals that the future studies could rely on these measurements during single leg squatting.

The effect of patellar taping on joint reaction forces during squatting in subjects with Patellofemoral Pain Syndrome (PFPS).

SUMMARY INTRODUCTION: The mechanisms of pain reduction have not completely been established following patellar taping in subjects with patellofemoral pain syndrome (PFPS); although it might be related to alteration in the kinetics of the patellofemoral joint. METHODS: Patellofemoral Joint Reaction Force (PFJRF) of eighteen subjects with PFPS and eighteen healthy subjects as controls were assessed by a motion-analysis system and one force plate. This procedure was performed on the affected knee of subjects with PFPS, before, during and finally after patellar taping during unilateral squatting. A similar procedure was also performed on the unaffected knees of both groups. RESULTS: The mean values of PFJRF prior to taping (2025N, SD 347N) were decreased significantly following a period of taping (1720N, SD 303N) (P<0.05). There were no significant differences between the mean values of PFJRF among controls (1922N, SD 398N) and subjects with PFPS prior to taping (P>0.05) which might be due to small sample size in both groups and large variability observed in the study. INTERPRETATION: Decreased values of PFJRF may explain the mechanism of pain reduction following patellar taping in subjects with PFPS.

Glucose concentration and medium volume influence cell viability and glycosaminoglycan synthesis in chondrocyte-seeded alginate constructs.

Increasing the thickness of tissue-engineered cartilage is associated with loss of chondrocyte viability and biosynthetic activity at the tissue center. Exceptionally high volumes of culture medium, however, can maintain cellularity and glycosaminoglycan synthesis throughout 4-mm-thick constructs. We hypothesized that glucose supplementation could replicate the augmentation of tissue formation achieved by medium volume. Chondrocyte-alginate constructs (40x10(6) cells/mL) were cultured for 14 days in 0.4-6.4 mL/10(-6) cells of either low- (5.1 mM) or high- (20.4 mM) glucose medium. Glucose was critical to chondrocyte viability, and glucose uptake increased significantly (P < .001) with both medium volume and glucose supplementation. After 14 days, constructs cultured in 0.4 mL/10(-6) cells of low-glucose medium had a mass of 172 +/- 6.1 mg and glycosaminoglycan (GAG) content of 0.32 +/- 0.03 mg (mean +/- standard deviation). A 4-fold increase in medium volume increased the final construct mass by 44% and GAG content by 207%. An equivalent increase in glucose supply in the absence of volume change increased these parameters by just 10% and 73%, respectively. A similar trend was observed from 0.8 to 3.2 mL/10(-6) cells, when maximal values of construct GAG content and mass were obtained. Therefore, medium volume remains an important consideration for the optimal culture of tissue-engineered cartilage.