Conservative care of sports hernias within soccer players: a case series.

OBJECTIVE: To detail the progress of 2 high-level soccer players and 1 recreational soccer player with chronic groin pain that was exacerbated by participation in sports and relieved by rest. The patients under went a conservative treatment plan featuring manual therapy, therapeutic modalities, and plyometric training. CLINICAL FEATURES: The most important examination findings were palpable tenderness over the internal oblique fascia and anterior pubic tubercle, pain with resisted hip adduction, and pain with a resisted abdominal curl-up. Conventional treatment aimed at decreasing healing time of the injury through manual therapy, including soft tissue and modality techniques; rehabilitative exercises, focusing on the pelvic muscles; and plyometric training, aiming at sport specific functional improvement. INTERVENTION: The conservative treatment approach utilized in this case series involved manual therapy, 1-2 times a week for 6-8 weeks, consisting of soft tissue, laser, microcurrent, and acupuncture; rehabilitative exercise and plyometric training, 3 times a week for 8 weeks, to help improve strength, coordination, and correct pelvic muscle imbalances. Outcome measures included visual analog scale scores and resisted muscle testing. SUMMARY: Three soccer players, of varying levels of ability, presenting with a suspected sports hernia (chronic groin pain exacerbated by sports and relieved by rest) were relieved of their pain after 8 weeks of conservative care featuring manual therapy, rehabilitative exercises, and plyometric training.

Evaluation of patients with spinal operation according to functional mobility.

OBJECTIVE: The aim of our study is to determine the effect of age, BMI (Body Mass Index: kg/m(2)), gender, level of lumbar disc operation and standardized physiotherapy of the patients during hospitalization on the Physiotherapy Functional Mobility Profile (PFMP). DESIGN: A retrospective study. PATIENTS: Eighty three patients who had undergone surgery with lumbar disc hernia were included in the study. Data were separately interpreted considering such parameters as age, BMI, gender, and level of operation which we believe might have affected the associated consequences. METHODS: PFMP was used in the assessment of the patients. Evaluations were made on the days when they were referred and discharged. RESULTS AND CONCLUSION: Increases were observed in totals and subheadings of PFMP scores during the early period of the inpatients exposed to lumbar disc operations to whom we applied standardized physiotherapy programs, with increases in subheadings involving ambulation being found significant. It follows from the conclusions of grouping our patients that functionality was positively influenced by 4th decade muscularity and by one-level operation in the early period.

Estudio de la relación entre el tipo de Unidad de Cirugía Mayor Ambulatoria y los indicadores de calidad / No disponible

Objetivos: El objetivo de este trabajo es estudiar la repercusión que la estructura y la organización interna de la Unidad de Cirugía Mayor Ambulatoria del Complejo Hospitalario de Jaén han tenido en los indicadores clínicos de calidad en la cirugía de la herniainguinocrural. Material y métodos: Hemos estudiado 708 hernias inguinocrurales intervenidas desde el día 1 de enero de 2005 hasta el 1de marzo de 2007: 334 pacientes fueron intervenidos cuando la unidad era de tipo integrado y 374 en la unidad de tipo separado. Se han monitorizado cuatro indicadores: intervenciones suspendidas, ingresos, reintervenciones y reingresos. Se realizó un análisis estadístico para estudiar la posible asociación entre el tipo de unidad y los indicadores mediante el test de Chi-cuadrado. Resultados: Intervenciones suspendidas: la tasa de suspensiones fue del 3,2% en la unidad integrada y del 2,1% en la unidad de tipo separado. Ingresos: la tasa de ingresos en la unidad integrada fue 5,6 y del 4,8% en la de tipo separado. Reintervenciones: en la unidad integrada se reintervinieron 4 pacientes(1,2%), y dos en la unidad separada (0,5%). Reingresos: dos ingresos ocurrieron en la unidad integrada (0,6%) y uno en el tipo separado (0,27%).No se observó una asociación estadísticamente significativa entre el tipo de unidad y los indicadores clínicos de calidad estudiados. Conclusiones: 1. Los indicadores han mejorado en la unidad independiente respecto a la integrada. 2. No observamos asociación significativa entre el tipo de unidad y los indicadores de calidad (AU)

Objectives: The aim of this work is to study the effects on clinical quality indicators of changes in the structure and functional organisation of the Ambulatory Surgical Unit at the Complejo Hospitalario de Jaén, regarding the treatment of inguinal and femoralhernias. Material and methods: A series of 708 inguinal and femoralhernias undergoing surgery during 2005 –integrated unit (IntU),334 patients– and from January 2006 to March 2007 –independent unit (IndU), 374 patients– were studied. In these two sets of patients, four quality indicators were monitored (suspension of surgery, admission to Hospital, post-surgical re-operation, and readmissions).A statistical analysis was carried out to study the possible association between the type of Unit and quality indicators, using the Chi-square test. Results: Suspended surgery: suspension rate was 3.2% in the IntU and 2.1% in the IndU. Admission to hospital: admission rate was 5.6% in IntU and 4.8% in IndU. Re-operations: in IntU, four patients needed re-operation (1.2%) and only two (0.5%) in IndU. Readmission: two patients (0.6%) were readmitted in IntU and only one (0.27%) in IndU. There were no statistically significant associations between unit type and the studied clinical qualityindicators. Conclusions: 1. Quality indicators have shown an improvement from the integrated to the independent unit. 2. However, there is no statistically significant association between unit type and quality indicators (AU)

Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair.

BACKGROUND: Polymer mesh has been used to repair incisional hernias with lower recurrence rates than suture repair. A new generation of mesh has been developed with reduced polypropylene mass and increased pore size. The aim of this study was to compare standard mesh with new lightweight mesh in patients undergoing incisional hernia repair. METHODS: Patients were randomized to receive lightweight composite mesh, or standard polyester or polypropylene mesh. Outcomes were evaluated at 21 days, 4, 12 and 24 months from patient responses to the Short Form 36 (SF-36) and daily activity questionnaires. Complications and recurrence rates were recorded. RESULTS: A total of 165 patients were included in an intention-to-treat analysis (83 lightweight mesh, 82 standard mesh). Postoperative complication rates were similar. The overall hernia recurrence rate was 17 per cent with the lightweight mesh versus 7 per cent with the standard mesh (P = 0.052). There were no differences in SF-36 physical function scores or daily activities between 21 days and 24 months after surgery. CONCLUSION: The use of the lightweight composite mesh for incisional hernia repair had similar outcomes to polypropylene or polyester mesh with the exception of a non-significant trend towards increased hernia recurrence. The latter may be related to technical factors with regard to the specific placement and fixation requirements of lightweight composite mesh.

Rehabilitation exercises for preventing recurrence of lumbar vertebral disc hernia

A monitoring of 150 cases of stabilized lumbar disc herniation showed that in the group of subjects who dit not practise physical exercises, the recurrent rate was rather high, 34% within 6 months, 44% in 12 months, while in subjects practized the exercises, these indices were 4% and 6% respectively. Moreover in these practized subjects, the severity of recurrent condition was mild with the syndrome of lumbar spinal column and rarely lumbar radicle. Heavy works such as military works, agriculture and industrial works were still the cause of recurrence of lumbar disc herniation.