Return to play decision after shoulder dislocation in upper limb athletes: Critical analysis between the habits of medical professionals and the literature.

BACKGROUND: The return to field is a critical moment for an athlete who has dislocated his shoulder as there is a significant risk of recurrence. The decision to return to field made by the doctor will therefore be crucial for the smooth continuation of the athlete's career. HYPOTHESIS: This objective is to compare the criteria most used by specialists in clearing an overhead athlete to return to competition after a first episode of antero-internal dislocation of the glenohumeral joint with or without surgery and those mentioned in the literature. PATIENTS AND METHODS: The target population consisted of French-speaking physicians in orthopedic surgery, physical medicine and rehabilitation or sports medicine. This study was conducted by the means of a questionnaire. The questionnaire was validated by three experts in sports medicine and published on an online survey website. RESULTS: Sixty-three medical specialists responded to the questionnaire. On average, they use more than nine criteria to decide if an athlete is fit to return to competition. Over the 12 criteria proposed, four are used by more than 90% of respondents: laxity/instability, pain, range of motion and patient's subjective feeling. The methods used to evaluate certain criteria such as pain, joint range or muscular strength are often subjective and very often not validated by the literature. CONCLUSION: Doctors use a set of criteria to allow an overhead athlete to return to competition. This study highlights that the techniques employed to evaluate these criteria are not always thoroughly validated by literature reviews. LEVEL OF EVIDENCE: III; observational study.

Foot and Ankle Muscle Isometric Strength in Nonrearfoot Compared With Rearfoot Endurance Runners.

Background: Transitioning to a forefoot strike pattern can be used to manage running-related knee injuries. However, adopting a nonrearfoot strike induces a higher load on foot and ankle structures than rearfoot strike. Sufficient foot muscle strength is also necessary to prevent excessive longitudinal arch (LA) deformation when running with nonrearfoot strike. The aim of this study was to investigate the potential differences in foot-ankle muscle strength between RF and NRF runners. Methods: A cross-sectional study including 40 RF and 40 NRF runners was conducted. The foot posture and the maximal voluntary isometric strength (MVIS) of 6 foot-ankle muscles were measured. The footstrike pattern was determined using a 2-D camera during a self-paced run on a treadmill. Results: NRF had higher MVIS for ankle plantar flexor (+12.5%, P = .015), ankle dorsiflexor (+17.7%, P = .01), hallux flexor (+11%, P = .04), and lesser toe flexor (+20.8%, P = .0031). We found a small positive correlation between MVIS of ankle plantar flexor with MVIS of hallux flexor (r = 0.26; P = .01) and lesser toe flexor (r = 0.28; P = .01). Conclusion: In this cross-sectional study, we found that NRF runners on average have a higher MVIS of hallux and lesser toe flexor compared with RF runners. NRF runners also have a higher MVIS of ankle plantar flexor and dorsiflexor than RF runners. We found only a small correlation between ankle plantar flexor and foot muscle strength. Level of Evidence: Level III, case-control study.

Survey of physicians' and physiotherapists' ankle muscle strength assessment practices for safe return to sports after lateral ankle sprain: A short report.

BACKGROUND AND PURPOSE: Ankle muscle strength is an important criterion to consider and assess for return to play (RTP) after lateral ankle sprain (LAS). This study therefore focuses on the reported ankle muscle strength consideration for RTP by physicians and physiotherapists, both clinicians involved in RTP decisions, and how they assess it in daily practice. The primary aim is to compare reported clinical practice on ankle muscle strength evaluation between physicians and physiotherapists. Our secondary aims are: to assess the prevalence of use of qualitative versus quantitative assessment and; to determine if there are any differences in how clinicians with or without a Sports Medicine or Physiotherapy Education approach this assessment. METHODS: A survey on RTP criteria after LAS was completed by 109 physicians in a previous study. A number of 103 physiotherapists completed the same survey. A comparison between clinicians' answers was realized and additional questions on ankle muscle strength were analysed. RESULTS: Physiotherapists consider ankle strength for RTP more than physicians (p < 0.001). A large majority of physicians (93%) and physiotherapists (92%) reported assessing ankle strength manually and less than 10% use a dynamometer. Physicians and physiotherapists with Sports Medicine or Physiotherapy Education selected more quantitative assessment than those without (p < 0.001). DISCUSSION: Despite being recognized as an important criterion, ankle muscle strength is not always part of the RTP criteria after LAS in daily practice. The dynamometers are scarcely used by physicians and physiotherapists, whereas it could accurately quantify ankle strength deficits. Sports Medicine or Physiotherapy Education increases the use of quantitative ankle strength assessments by clinicians.

[Hamstring muscle injury in football players. Part 2 : preventive strategies]. / La lésion musculaire des ischio-jambiers chez le footballeur. Partie 2 : stratégies de prévention lésionnelle.

Prevention of hamstring injuries represents an important issue for football players and clubs. Preventive strategies can be effective if they include multiple dimensions and are well-structured. Five points appear essential in order to obtain a high-quality preventive strategy: progressive muscle strengthening, optimal workload management, lumbopelvic stability exercises, development of physical condition and optimization of sprint technique. While recognizing the limitations of preventive screening and the difficulty of predicting future injury, screening tests appear relevant for the identification of an individual risk profile for each footballer and in defining each player's work priorities. Finally, secondary prevention starts with the implementation of rigorous and high-level rehabilitation, as well as a special attention to players with a history of hamstring injury.

La prévention des lésions musculaires des ischio-jambiers représente une thématique de première importance pour les joueurs et clubs de football. Les stratégies préventives peuvent se révéler efficaces, à condition d'inclure de multiples dimensions à celles-ci et de structurer ces démarches. Cinq points apparaissent incontournables dans l'optique d'obtenir une stratégie préventive de qualité : le renforcement musculaire progressif et raisonné, la gestion équilibrée de la charge de travail, le travail de la stabilité lombo-pelvienne, le développement de la condition physique et l'optimalisation de la gestuelle de course. Tout en reconnaissant les limites du screening préventif et la difficulté de prédire une future blessure, un état des lieux précis peut s'avérer pertinent pour identifier le profil de risque individuel de chaque footballeur et pour définir les priorités de travail de chacun. Enfin, la prévention secondaire démarre par la mise en place d'une rééducation rigoureuse et structurée, ainsi que par une attention particulière aux joueurs avec antécédents de lésions aux ischio-jambiers.

The awareness of injury prevention programmes is insufficient among French- and German-speaking sports medicine communities in Europe.

PURPOSE: Evaluate the current state of sports injury prevention perception, knowledge and practice among sports medicine professionals located in Western Europe and involved in injury prevention. METHODS: Members of two different sports medicine organizations (GOTS and ReFORM) were invited to complete a web-based questionnaire (in German and in French, respectively) addressing perception, knowledge and implementation of sports injury prevention through 22 questions. RESULTS: 766 participants from a dozen of countries completed the survey. Among them, 43% were surgeons, 23% sport physicians and 18% physiotherapists working mainly in France (38%), Germany (23%) and Belgium (10%). The sample rated the importance of injury prevention as "high" or "very high" in a majority of cases (91%), but only 54% reported to be aware of specific injury prevention programmes. The French-speaking world was characterized by lower levels of reported knowledge, unfamiliarity with existing prevention programmes and less weekly time spent on prevention as compared to their German-speaking counterparts. Injury prevention barriers reported by the respondents included mainly insufficient expertise, absence of staff support from sports organizations and lack of time. CONCLUSION: There is a lack of awareness regarding injury prevention concepts among sports medicine professionals of the European French- and German-speaking world. This gap varied according to the professional occupation and working country. Relevant future paths for improvement include specific efforts to build awareness around sports injury prevention. LEVEL OF EVIDENCE: Level IV.

Impact of COVID-19 Vaccination on Short-Term Perceived Change in Physical Performance among Elite Athletes: An International Survey.

COVID-19 vaccination raised concerns about its potential effects on physical performance. To assess the impact of COVID-19 vaccination on the perceived change in physical performance, we conducted an online survey among elite athletes from Belgium, Canada, France and Luxembourg, with questions about socio-demographics, COVID-19 vaccination, perceived impact on physical performance and perceived pressure to get vaccinated. Full vaccination was defined as two doses of mRNA or vector vaccine or a heterologous vaccine scheme. Among 1106 eligible athletes contacted, 306 athletes answered the survey and were included in this study. Of these, 72% perceived no change in their physical performance, 4% an improvement and 24% a negative impact following full COVID-19 vaccination. For 82% of the included athletes, the duration of the negative vaccine reactions was ≤3 days. After adjustment for potential confounding variables, practicing an individual sport, a duration of vaccine reactions longer than 3 days, a high level of vaccine reaction and the perceived pressure to get vaccinated were independently associated with a perceived negative impact on physical performance of more than 3 days after the vaccination. The perceived pressure to get vaccinated appears to be a parameter associated with the negative perceived change in the physical performance and deserves further consideration.

[Hamstring muscle injury in football players - Part I : epidemiology, risk factors, injury mechanisms and treatment]. / La lésion musculaire des ischio-jambiers chez le footballeur. Partie 1 : épidémiologie, facteurs de risque, mécanismes lésionnels et traitement.

Due to its high frequency and recurrence rate, hamstring injury represents an important issue in football currently. The mechanisms of injury and the main modifiable and non-modifiable risk factors are now well documented and should allow the implementation of effective preventive strategies. In the treatment of the injured player, the physician will have to rely on a close collaboration with a quality sports physiotherapist and implement a series of key elements allowing an optimal return to the soccer field, which means at the same level of performance compared to the pre-injury period and with a minimal risk of recurrence. This article discusses these different elements in the form of a narrative review of the literature.

La lésion musculaire des ischio-jambiers, de par sa fréquence et son taux de récidive élevés, représente une problématique actuelle importante dans le football. Les mécanismes lésionnels et les principaux facteurs de risque modifiables et non modifiables sont désormais bien documentés et devraient permettre la mise en place de stratégies préventives efficaces. Dans le suivi du joueur blessé, le médecin devra compter sur une collaboration étroite avec un kinésithérapeute du sport de qualité et mettre en place toute une série d'éléments clés permettant un retour optimal sur les terrains de football, c'est-à-dire au même niveau de performance comparativement à la période d'avant blessure et avec un risque minimal de récidive. Cet article aborde ces différents éléments sous l'aspect d'une revue narrative de la littérature.

Preseason assessment of anaerobic performance in elite soccer players: comparison of isokinetic and functional tests.

Isokinetic and functional jump tests are frequently performed for assessing the physical qualities of soccer players during preseason. The purpose of this investigation was to explore, in an elite soccer players population, the relationships between isokinetic strength and functional jump performances. Thirty-eight professional soccer players were evaluated as follows: isokinetic knee assessment in concentric (CON) mode (60, 240°/s) for quadriceps and hamstrings, and in eccentric (ECC) mode for the hamstrings only (30°/s); one-leg hop tests for distance (single hop (SH), triple hop (TH) and triple crossover hop (TCH)); one-leg vertical jump tests (countermovement jump, drop jump). Players with a low bodyweight normalised (BWN) quadriceps (Q) strength (<2.71 Nm/kg) performed, for a majority of the measured variables, significantly reduced jump performances compared to the players with high BWN Q strength (>3.14 Nm/kg; p < 0.05). Greater bilateral differences between uninjured and past injured lower limbs were found with isokinetics (Q CON 60°/s (mean bilateral difference (MBD): 10.3%; p < 0.01), Q CON 240°/s (MBD: 9.9%; p < 0.05), H ECC 30°/s (MBD: 16.1%; p < 0.001) than with functional tests (MBD: 2 to 9%; p > 0.05. In conclusion, due to their complementary role and implications for performance, functional and isokinetic tests should be associated in a preseason soccer players assessment.

Pilot study to investigate the feasibility of conducting a randomised controlled trial that compares Immediate versus Optional Delayed surgical repair for treatment of acute Anterior cruciate ligament injury: IODA pilot trial.

INTRODUCTION: Standard care for anterior cruciate ligament (ACL) injuries includes surgical reconstruction of the ACL. However, two randomised controlled trials (RCTs) concluded that conservative treatment does not result in inferior clinical outcomes compared with immediate ACL reconstruction. More research is needed to in the first place verify these results, and second to assess whether patient-specific parameters determine whether a patient would benefit from one treatment option over the other. However, before running a full RCT, it seems necessary to perform a pilot study that assesses the feasibility of recruiting patients with ACL for such a RCT. This is because recruitment may be challenging as many patients have strong treatment beliefs. Therefore, this pilot study will assess whether a large RCT is feasible with regard to participant recruitment, adherence to the allocated treatment arm and protocol feasibility. These pilot findings will help deciding about progressing to a future full RCT. METHODS AND ANALYSIS: This is a pragmatic, multicentre, randomised controlled pilot trial with two parallel groups. Patients with an acute ACL injury will be recruited from two Belgian hospitals. Patients will be randomised to either conservative treatment or surgical treatment. Patients will be followed-up at 3, 6 and 12 months postrandomisation. Recruitment feasibility will be evaluated by calculating the recruitment rate 4 months after the two sites have been initiated. Clear criteria for progression to a full trial are defined. Adherence to the protocol will be assessed by calculating the proportion of patients who complete the assessments. Furthermore the proportion of patients who cross-over between treatment arms during the follow-up period will be assessed. ETHICS AND DISSEMINATION: The study was approved by the ethical committees: Ethische Commissie Onderzoek UZ/KU Leuven (S62004) and Comité d'Ethique Hospitalo-Facultaire Universitaire de Liège (2020212). Results will be made available to caregivers, researchers and funder. TRIAL REGISTRATION NUMBER: This trial is registered on ClinicalTrials.gov (NCT04408690) on 29 May 2020.

Exercise-Based Injury Prevention in High-Level and Professional Athletes: Narrative Review and Proposed Standard Operating Procedure for Future Lockdown-Like Contexts After COVID-19.

In regular times, implementing exercise-based injury prevention programs into the training routine of high-level and professional athletes represents a key and challenging aspect to decrease injury risk. Barriers to implementing such prevention programs have previously been identified such as lack of resources, logistic issues or motivation. The COVID-19 pandemic associated with restrictions on daily life dramatically impacted sports participation from training to competition. It is therefore reasonable to assume that such lockdown-like context has exacerbated the challenge to implement exercise-based injury prevention programs, potentially leading to a greater musculoskeletal injury risk. In this narrative review, recommendations are proposed for building an expertise- and evidence-based Standard Operating Procedure for injury prevention in lockdown-like contexts for high-level and professional athletes. The following recommendations can be provided: (1) assess the global and sport-specific risks in the light of the ongoing cause of isolation; (2) adapt remote training materials and programs; (3) ensure regular quality communication within the staff, between athletes and the staff as well as between athletes; (4) follow the athlete's mental well-being; and (5) plan for a safe return-to-sports as well as for an ongoing monitoring of the load-recovery balance. These key domains should further be addressed to comply with local policies, which are subject to change over time in each individual country. The use of these recommendations may improve the readiness of athletes, coaches, physicians and all sports stakeholders for future lockdown-like contexts.

Influence of a Field Hamstring Eccentric Training on Muscle Strength and Flexibility.

Muscle strength imbalances and poor flexibility are frequently described as risk factors for hamstring injury. Preventive strategies include eccentric exercises, but the influence of field eccentric exercises on these risk factors remains unclear. We investigated the influence of a field hamstring eccentric program on hamstring strength and flexibility. Twenty-seven amateur athletes were randomly assigned to an intervention (n=13) or control group (n=14). In the intervention group, participants were involved in 15 sessions of four eccentric exercises. Peak torque, hamstring-to-quadriceps ratios, passive and active flexibility were analyzed. No significant modifications of strength, passive or active flexibility were observed in the control group (p>0.05). Hamstring eccentric peak torque (+7.1%) and functional hamstring-to-quadriceps ratios (9.3%) were significantly increased (p<0.05) in the intervention group, but not concentric strength (p<0.05). Passive straight leg raise was significantly increased by 11.4° (+12.7%, p<0.001), but not active flexibility (+3.1%, p>0.05). In conclusion, a 6-week eccentric program, including four field exercises for hamstring muscles, is an effective method of improving eccentric strength, functional ratios and, especially, passive flexibility. As this program may be easily implemented in a real-world context, this association of multiple eccentric exercises might be useful in an injury prevention strategy.

Preseason Strength Assessment of the Rotator Muscles and Shoulder Injury in Handball Players.

CONTEXT: Few researchers have identified intrinsic risk factors for shoulder injury in team handball players by analyzing measurements of maximal isokinetic rotator muscle strength. OBJECTIVE: To identify possible intrinsic risk factors for shoulder injury by analyzing measurements of maximal isokinetic rotator muscle strength. DESIGN: Cross-sectional study. SETTING: Male team handball senior divisions (the highest level) in France and Belgium. PATIENTS OR OTHER PARTICIPANTS: A total of 108 male high-level handball players (age = 24 ± 4 years, height = 189 ± 6 cm, mass = 87 ± 11 kg) were enrolled. MAIN OUTCOME MEASURE(S): All players completed a preseason questionnaire and performed a bilateral isokinetic assessment of the shoulder rotator muscles. On a monthly questionnaire, players reported any shoulder injury that they sustained during the season. RESULTS: On the preseason questionnaire, 51 of 108 (47%) participants reported a history of dominant-shoulder injury. A total of 106 participants completed the in-season questionnaire, with 22% (n = 23) reporting a shoulder injury on their dominant side during the subsequent season. Fourteen percent (n = 15) sustained microtraumatic injuries, and 8% (n = 8) described a traumatic injury. Backcourt players had a 3.5-times increased risk of injury during the new season compared with players in other positions. Among the isokinetic results, no risk factor for further injury was identified in handball players with microtraumatic injuries. For traumatic injuries, the concentric maximal strength developed by the internal rotators at high speed (240°/s) in the dominant shoulder was a protective factor against the risk of further injury. CONCLUSIONS: These results can potentially identify intrinsic risk factors for shoulder injury and may be used to determine potential interventions for reducing this risk in handball players.

Cross-cultural adaptation and validation of the Patient-Rated Tennis Elbow Evaluation Questionnaire on lateral elbow tendinopathy for French-speaking patients.

STUDY DESIGN: Translation and validation of algo-functional questionnaire. INTRODUCTION: The lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to measure pain and functional limitations in patients with lateral epicondylitis (tennis elbow). First developed in English, this questionnaire has since been translated into several languages. PURPOSE OF THE STUDY: The aims of the study were to translate and cross-culturally adapt the PRTEE questionnaire into French and to evaluate the reliability and validity of this translated version of the questionnaire (PRTEE-F). METHODS: The PRTEE was translated and cross-culturally adapted into French according to international guidelines. To assess the reliability and validity of the PRTEE-F, 115 participants were asked twice to fill in the PRTEE-F, and once the Disabilities of Arm, Shoulder and Hand Questionnaire (DASH) and the Short Form Health Survey (SF-36). Internal consistency (using Cronbach's alpha), test-retest reliability (using intraclass correlation coefficient (ICC), standard error of measurement and minimal detectable change), and convergent and divergent validity (using the Spearman's correlation coefficients respectively with the DASH and with some subscales of the SF-36) were assessed. RESULTS: The PRTEE was translated into French without any problems. PRTEE-F showed a good test-retest reliability for the overall score (ICC 0.86) and for each item (ICC 0.8-0.96) and a high internal consistency (Cronbach's alpha = 0.98). The correlation analyses revealed high correlation coefficients between PRTEE-F and DASH (convergent validity) and, as expected, a low or moderate correlation with the divergent subscales of the SF-36 (discriminant validity). There was no floor or ceiling effect. DISCUSSION AND CONCLUSIONS: The PRTEE questionnaire was successfully cross-culturally adapted into French. The PRTEE-F is reliable and valid for evaluating French-speaking patients with lateral elbow tendinopathy.

Cross-cultural Adaptation and Validation of the Victorian Institute of Sport Assessment-Patella Questionnaire for French-Speaking Patients With Patellar Tendinopathy.

Study Design Clinical measurement study. Background The Victorian Institute of Sport Assessment-Patella (VISA-P), originally developed in English, assesses the severity of patellar tendinopathy symptoms. To date, no French version of the questionnaire exists. Objectives The aim of our study was to translate the VISA-P into French and verify its psychometric properties. Methods The translation and cultural adaptation were performed according to international recommendations in 6 steps: initial translation, translation merging, back translation to the original language, use of an expert committee to reach a prefinal version, test of the prefinal version, and expert committee appraisal of a final version. Afterward, the psychometric properties of the final French version (VISA-PF) were assessed in 92 subjects, divided into 3 groups: pathological subjects (n = 28), asymptomatic subjects (n = 22), and sports-risk subjects (n = 42). Results All members of the expert committee agreed with the final version. On a scale ranging from 0 to 100, with 100 representing an asymptomatic subject, the average ± SD scores on the VISA-PF were 53 ± 17 for the pathological group, 99 ± 2 for the healthy group, and 86 ± 14 for the sports-risk group. The test-retest reliability of the VISA-PF was excellent, with good internal consistency. Correlations between the VISA-PF and divergent validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were low, and the correlation coefficient values measured between the VISA-PF scores and converged items of the SF-36 were higher. Conclusion The VISA-PF is understandable, valid, and suitable for French-speaking patients with patellar tendinopathy. J Orthop Sports Phys Ther 2016;46(5):384-390. Epub 21 Mar 2016. doi:10.2519/jospt.2016.5937.

Validity and reliability of the French translation of the VISA-A questionnaire for Achilles tendinopathy.

PURPOSE: The Victorian Institute of Sport Assessment - Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate the VISA-A into French and to study the reliability and validity of this French version, the VISA-AF. METHOD: The VISA-A was translated into French to produce the VISA-AF using a validated methodology in six steps. Thereafter, several psychometric properties of this French version such as test-retest reliability, internal consistency, construct validity and floor and ceiling effects were evaluated. Therefore, we recruited 116 subjects, distributed into 3 groups: pathological patients (n = 31), at-risk athletes (n = 63) and healthy people (n = 22). RESULTS: The final version of the VISA-AF was approved by an expert committee. On a scale ranging from 0 to 100, the average scores of the VISA-AF obtained were 59 (± 18) for the pathological group, 99 (± 1) for the healthy group and 94 (± 7) for the at-risk group. The VISA-AF shows excellent reliability, low correlations with the discriminant subscales of the SF-36 and moderate correlations with the convergent subscales of the SF-36. CONCLUSIONS: The French version of the VISA-A is equivalent to its original version and is a reliable and valid questionnaire for French-speaking patients with Achilles tendinopathy. Implication for Rehabilitation The VISA-AF questionnaire is a reliable translation of the original VISA-A, from English into French, which is one of the most widespread languages in the world. The VISA-AF questionnaire is now a valid instrument that can be used by clinicians and researchers to assess the severity of pain and disability of French-speaking subjects with Achilles tendinopathy. The VISA-AF is a questionnaire to assess the severity of Achilles tendinopathy symptoms but is not a diagnostic tool.

Description of a standardized rehabilitation program based on sub-maximal eccentric following a platelet-rich plasma infiltration for jumper's knee.

INTRODUCTION: Different series emphasized the necessity of rehabilitation program after infiltration of platelet-rich plasma (PRP) in case of tendinopathy. However, most of them describe only briefly the reeducation protocol and these programs vary. Our aim was to extensively describe a specific standardized rehabilitation program. METHODS: After a review of literature of post-PRP infiltration protocols, we had developed a standardized rehabilitation protocol. This protocol was evaluated by 30 subjects with chronic jumper's knee who. A standardised progressive sub-maximal eccentric program supervised by a physical therapist for 6 weeks was started 1 week post-infiltration. The patient benefited also from electromyostimulation, isometric strengthening and stretching of the quadriceps, cycloergometer and cryotherapy. After the supervised program, the patient had to make an auto-reeducation added to the reathletisation protocol for 6 more weeks which was followed by maintenance exercises up to 1 year. The assessments were made using a VAS, IKDC and VISA-P scores. RESULTS: The VAS, IKDC and VISA-P scores decreased very significantly with time. The compliance to auto-reeducation was good. CONCLUSIONS: We proposed a simple and efficient protocol based on sub-maximal eccentric reeducation to add to PRP infiltrations in case of patellar tendinopathy.

Evaluation of the influence of age on pulmonary arterial pressure by use of right ventricular catheterization, pulsed-wave Doppler echocardiography, and pulsed-wave tissue Doppler imaging in healthy Beagles.

OBJECTIVE: To assess the influence of age on pulmonary hemodynamics and hemorheological properties in healthy dogs. ANIMALS: 14 healthy Beagles. PROCEDURES: Dogs were placed in 2 age groups as follows: young dogs (or= 8 years old; 6). Hematologic characteristics, plasma total protein and fibrinogen concentrations, and blood viscosity were measured. Systolic time intervals of pulmonary blood flow were recorded by pulsed-wave Doppler echocardiography. Early (E') and late (A') diastolic myocardial velocities, isovolumic contraction velocity, and systolic myocardial velocity of the free tricuspid annulus were recorded by pulsed-wave tissue Doppler imaging (TDI). Dogs were anesthetized and pulmonary arterial pressures (PAP) and cardiac output were recorded with a pediatric thermodilution Swan-Ganz catheter. RESULTS: Hemorheological measurements were not different between the 2 groups. Systolic, mean, and diastolic PAP were higher in old dogs, compared with values in young dogs; this difference was attributed to a high pulmonary vascular resistance and low arterial compliance in old dogs. Systolic time intervals of pulmonary blood flow stayed unchanged. The A' wave of the free tricuspid annulus was increased in old, compared with that young dogs, and the E':A' ratio was decreased. Pulmonary vascular resistance was inversely correlated with compliance. CONCLUSIONS AND CLINICAL RELEVANCE: The age of dogs should be taken into account when interpreting pulmonary hemodynamic results and TDI variables of right ventricular diastolic function.

Functional, inflammatory and morphological characterisation of a cat model of allergic airway inflammation.

The aims of this study were to characterise a model of feline allergic airway inflammation and to test through a longitudinal investigation whether five repeated allergen exposures would lead to signs of airway remodelling that would be detectable in vivo. Eight healthy control cats and eight cats sensitised with Ascaris suum allergens were investigated. Barometric whole body plethysmography (BWBP) was used for the assessment of respiratory variables and airway responsiveness (AR). Bronchoalveolar lavage fluid (BALF) was sampled for cytology and determination of F(2)-isoprostane concentration and matrix metalloproteinase type 9 (MMP-9) activity. Thoracic radiography and bronchoscopy scores were also established. Cats were investigated prior to sensitisation and after inhalation of placebo or allergen challenge 1. BWBP measurements revealed a significant increase of enhanced pause (Penh), an index of bronchoconstriction, and AR in sensitised cats in response to allergen challenge 1. A significant increase in BALF neutrophil and eosinophil %, F(2)-isoprostane concentration and MMP-9 activity, and increased radiography and bronchoscopy scores were recorded. After a recovery period of 6 weeks, all variables except BALF MMP-9 returned to baseline values. Four further allergen challenges induced similar changes to those seen in challenge 1 and no signs of persistent changes suggestive of bronchial remodelling were detectable. The model provides an in vivo approach to functional, inflammatory and morphological changes occurring in response to single and repeated allergen exposure.