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1.
J Biomech Eng ; 145(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35838323

RESUMO

Injuries in the anterior cruciate ligament (ACL), including partial tear and lengthening of the ACL, change the dynamic function of the knee. However, there is a lack of information on the effect of ACL partial tear on knee kinematics during walking. This study aimed to investigate the effects of different levels of ACL injuries on knee stability and ACL tensional force to identify the critical injury level. Motion data of five normal subjects were acquired along with the ground reaction force. A knee model with 14 ligaments was developed using cadaveric specimen data. The initial length and stiffness of the ACL were changed to develop ACL-injured knee models. Musculoskeletal simulations of the knee models were performed using the measured gait data. The average tibial anterior translation increased significantly by 2.6 ± 0.7 mm when the ACL stiffness decreased to 25% of its original stiffness. The average tibial anterior translation increased significantly by 2.6 ± 0.3 mm at an increase in initial length of 10%. The knee with partial ACL tear had a nonlinear decrease in ACL forces owing to the increase in the level of ACL injury, while the knee with ACL lengthening had linear decreased ACL forces. The partial tear of the ACL caused translational instability, while the complete tear caused both rotational and translational instabilities during the musculoskeletal walking simulation. This study presents the effects of partial ACL injuries on joint kinematics and ACL tensional force during the dynamic motion of walking.


Assuntos
Lesões do Ligamento Cruzado Anterior , Instabilidade Articular , Ligamento Cruzado Anterior , Fenômenos Biomecânicos , Cadáver , Humanos , Articulação do Joelho , Amplitude de Movimento Articular , Rotação , Caminhada
2.
J Biomech Eng ; 145(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35864785

RESUMO

Contemporary finite element (FE) neck models are developed in a neutral posture; however, evaluation of injury risk for out-of-position impacts requires neck model repositioning to non-neutral postures, with much of the motion occurring in the upper cervical spine (UCS). Current neck models demonstrate a limitation in predicting the intervertebral motions within the UCS within the range of motion, while recent studies have highlighted the importance of including the tissue strains resulting from repositioning FE neck models to predict injury risk. In the current study, the ligamentous cervical spine from a contemporary neck model (GHBMC M50 v4.5) was evaluated in flexion, extension, and axial rotation by applying moments from 0 to 1.5 N·m in 0.5 N·m increments, as reported in experimental studies and corresponding to the physiologic loading of the UCS. Enhancements to the UCS model were identified, including the C0-C1 joint-space and alar ligament orientation. Following geometric enhancements, an analysis was undertaken to determine the UCS ligament laxities, using a sensitivity study followed by an optimization study. The ligament laxities were optimized to UCS-level experimental data from the literature. The mean percent difference between UCS model response and experimental data improved from 55% to 23% with enhancements. The enhanced UCS model was integrated with a ligamentous cervical spine (LS) model and assessed with independent experimental data. The mean percent difference between the LS model and the experimental data improved from 46% to 35% with the integration of the enhanced UCS model.


Assuntos
Vértebras Cervicais , Instabilidade Articular , Fenômenos Biomecânicos , Vértebras Cervicais/lesões , Análise de Elementos Finitos , Humanos , Ligamentos Articulares , Amplitude de Movimento Articular/fisiologia
3.
J Orthop Surg Res ; 17(1): 407, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064425

RESUMO

BACKGROUND: Mobile-bearing unicompartmental knee arthroplasty (MB-UKA) is an effective treatment for anteromedial knee osteoarthritis. Meticulous intraoperative soft tissue balancing remains challenging yet consequential for a successful operation. Currently, surgeons rely mostly on their experience during soft tissue balancing, yielding unreproducible results. The purpose of this study was to quantified measure the soft tissue tension of medial compartment and determine if an optimal "target" tension values with the natural state exists. METHODS: This was an observational study of 24 consecutive patients. All 30 UKAs were performed by a single surgeon. The piezoresistive sensor was custom designed to fit in the medial compartment gap. Contact pressures were measured at 5 angular positions of the knee intraoperatively: 0°, 20°, 45°, 90°, and 110° of flexion. The change in pressure from extension (20° position) and flexion (110° position) was also calculated (E-FPD). Data on age, sex, body mass index, operative side, and bearing size were collected. Outcome measures were measured at baseline and at the 6-month postoperative follow-up; Oxford Knee Score, visual analog scale score, and range of motion were compared to evaluate clinical outcomes. RESULTS: There was a significant improvement in patients in all measured outcomes at 6 months from baseline (P < 0.05). The E-FPD of 14.9 N (8.9, 24.6) was indicative of appropriate soft tissue balancing throughout the functional range of knee motion. Of 30 knees, 22 were 3-mm bearing and 8 were 4- or 5-mm bearing. The pressure data of the 3-mm bearing group was larger than that of the non-3-mm bearing group for each knee flexion degree, but the difference was not statistically significant (P > 0.05). CONCLUSIONS: Objective data from sensor output may assist surgeons in decreasing loading variability during MB-UKA. The data suggested that MB-UKA could not accurately restore soft tissue tension to the natural state, which was related to the inability of MB-UKA surgical instruments to fine adjust the bone cut and soft tissue release. STUDY REGISTRATION: Chinese Clinical Trial Registry ( http://www.chictr.org.cn ): ChiCTR1900024146.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/métodos , Humanos , Articulação do Joelho/cirurgia , Prótese do Joelho/efeitos adversos , Amplitude de Movimento Articular
4.
J Hand Surg Am ; 47(9): 874-880, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36058565

RESUMO

PURPOSE: Four-corner fusion (4CF) is a surgical option for refractory scapholunate advanced collapse and scaphoid nonunion advanced collapse wrist arthritis. Preoperative range of motion (ROM) predicts outcomes in many orthopedic procedures. This study investigates ROM in a cohort of 4CF patients to examine the relationship between preoperative and postoperative motion and identifies different clinical patterns. METHODS: We performed a retrospective review of 4CF patients. Patients with a history of inflammatory arthritis and radiographic characteristics of inflammation were excluded. Demographics, prior wrist surgery history, and ROM data were collected at preoperative and postoperative intervals after cast removal at 8 weeks, 3 months, and 8 months. Regression analysis compared the motion before and after 4CF. Subsequent cluster analysis to reduce confounding compared postoperative motion differences in the top 20% to the bottom 20% of patients by preoperative motion. RESULTS: We included 148 patients; 27 had prior surgery on the ipsilateral wrist. Preoperative arc averaged 86° ± 28° (flexion 46° ± 17°, extension 40° ± 15°); 8-week arc 43° ± 19° (flexion 19° ± 12°, extension 24° ± 12°); 3-month arc 62° ± 17° (flexion 30° ± 12°, extension 32° ± 11°); and 8-month arc 74° ± 17° (flexion 36° ± 11°, extension 37° ± 12°). Preoperative and final arcs were (r = 0.39). Clustering by the preoperative arc, the top 20% (mean 124° ± 15°) achieved a mean final arc of 81° ± 16°, while the bottom 20% (mean 47° ± 16°) achieved a mean final arc of 65° ± 19°. Intercluster differences were statistically significant. The bottom 20% gained motion postoperatively. Most patients in the middle 60% did not differ significantly in postoperative motion. CONCLUSIONS: Although wrist motion following 4CF correlates positively with preoperative motion, most patients do not differ significantly in postoperative motion. Patients with substantial preoperative motion deficits gain motion after 4CF. This information is important when counseling patients, determining the timing of surgical intervention, and managing expectations related to motion outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.


Assuntos
Osteoartrite , Osso Escafoide , Artrodese/métodos , Análise por Conglomerados , Humanos , Osteoartrite/diagnóstico por imagem , Osteoartrite/cirurgia , Amplitude de Movimento Articular , Análise de Regressão , Estudos Retrospectivos , Osso Escafoide/diagnóstico por imagem , Osso Escafoide/cirurgia , Punho , Articulação do Punho/cirurgia
5.
J Am Acad Orthop Surg ; 30(16): e1066-e1075, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-36067462

RESUMO

Shoulder arthrodesis is an end-stage, salvage procedure for the glenohumeral joint and can provide a pain-free, stable shoulder with varying levels of function. Common indications include brachial plexus injury, chronic instability with rotator cuff and deltoid dysfunction, and failed shoulder arthroplasty. Multiple techniques are described, including intra-articular and extra-articular arthrodeses. Fusion can be accomplished with screw fixation, plate fixation, external fixation, and arthroscopic-assisted techniques. The optimal position of the arm is heavily debated in the literature, but the ideal position is thought to be 30° of flexion, 30° of abduction, and 30° of internal rotation. After successful fusion, the patient should be able to bring their hand to their mouth, reach their back pocket, and cross the midline for hygiene. Complications are not uncommon and include nonunion, malunion, fracture, and infection. With the increasing incidence of shoulder arthroplasty, failed arthroplasties are more commonly encountered. In a salvage situation, shoulder arthrodesis may be considered.


Assuntos
Plexo Braquial , Articulação do Ombro , Artrodese/métodos , Placas Ósseas , Plexo Braquial/lesões , Humanos , Amplitude de Movimento Articular , Ombro , Articulação do Ombro/cirurgia , Resultado do Tratamento
6.
Med Eng Phys ; 107: 103850, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36068031

RESUMO

The interspinous spacer (ISP) is a minimally invasive surgical device implanted into the interspinal space to treat lumbar degenerative diseases. Unfortunately, ISPs sometimes cause device breakage and spinal process fracture. Our aim was to elaborate the design of lumbar customized posterior fixation system (CISP system), encompassing a customized ISP body and transfacetopedicular screws, and examine its biomechanical effect on the lumbar spine using finite element (FE) analysis. We constructed the CISP system, based on the interspinal anatomical data at the surgical level. We generated the L3-S1 FE models, implanted with the polyetheretherketone (PEEK) CISP system, titanium alloy (TI) CISP system, and Coflex device at the L4/L5 segment, and determined the lumbar segmental range of motions (ROMs), intervertebral discs (IVD) peak stress, and implant stresses. The CISP system enhanced mobility restriction at the surgical level, compared to the Coflex device. Furthermore, the IVD peak stress reduction was more obvious in the CISP system than the Coflex device, particularly during extension. Under the same motion mode, the maximum stress on the TI CISP system was smaller than on the Coflex device, but larger than the PEEK CISP system. Given these evidences, PEEK appeared to be a better material for the CISP body.


Assuntos
Fusão Vertebral , Fenômenos Biomecânicos , Parafusos Ósseos , Análise de Elementos Finitos , Cetonas , Vértebras Lombares/cirurgia , Amplitude de Movimento Articular
7.
Med Eng Phys ; 107: 103854, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36068039

RESUMO

We present a systematic and automated stepwise method to calibrate computational models of the spine. For that purpose, a sequential resection study on one lumbar specimen (L2-L5) was performed to obtain the individual contribution of the IVD, the facet joints and the ligaments to the kinematics of the spine. The experimental data was prepared for the calibration procedure in such manner that the FE model could reproduce the average motion of the 10 native spines from former cadaveric studies as well as replicate the proportional change in ROM after removal of a spinal structure obtained in this resection study. A Genetic Algorithm was developed to calibrate the properties of the intervertebral discs and facet joints. The calibration of each ligament was performed by a simple and novel technique that requires only one simulation to obtain its mechanical property. After calibration, the model was capable of reproducing the experimental results in all loading directions and resections.


Assuntos
Disco Intervertebral , Vértebras Lombares , Fenômenos Biomecânicos , Calibragem , Análise de Elementos Finitos , Humanos , Vértebras Lombares/cirurgia , Amplitude de Movimento Articular
8.
Biomed Res Int ; 2022: 9151831, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36082154

RESUMO

Background: Impingement syndrome was shown to be associated with shoulder pain in 44-70% of patients worldwide. It usually occurs due to imbalance and insufficient activation of the rotator cuff (RC) muscles. Aim: This study explores the relative effects of handgrip-strengthening exercises on shoulder function, pain, strength, and active range of motion as part of the treatment program for the patients with primary subacromial impingement syndrome. Materials and Methods: A total of 58 patients aged 18-50 years with primary subacromial impingement syndrome were randomly enrolled to participate in this single-blind randomized clinical trial. Out of them, only forty patients have eligibly matched the inclusion criteria and randomly assigned to one of two groups to undergo a standardized therapeutic program consisting of two sessions a week for 8 weeks. The control group prescribed ultrasound therapy, ice, and stretching exercises, while the experimental group followed the same program with the addition of handgrip-strengthening exercises (HGSE). Both patients of conventional therapy (control) and handgrip-strengthening exercises (experimental group) were advised to adhere also to stretching and HGSE exercises once a day at home for eight weeks. The outcomes were the shoulder function, pain intensity, muscle strength, and active range of motion of the shoulder joint. Results: Patients treated with conventional interventions plus handgrip-strengthening exercises showed the significant improvement over time in shoulder pain and function, strength of rotator cuff muscles, and pain-free range of motion forward flexion, abduction, and external and internal rotation through eight weeks in the experimental group compared to control patient group treated with conventional interventions. In addition, patients of both control and experimental groups showed no significant difference in the adherence to respective home-based stretching and HGSE exercises once a day at home for eight weeks. Conclusions: Adding handgrip-strengthening exercises to conventional intervention increases the efficacy of treatment for patients with primary subacromial impingement syndrome in terms of shoulder function, pain, muscle strength, and active range of motion.


Assuntos
Síndrome de Colisão do Ombro , Terapia por Exercício , Força da Mão , Humanos , Amplitude de Movimento Articular , Manguito Rotador , Síndrome de Colisão do Ombro/terapia , Dor de Ombro , Método Simples-Cego
9.
Eur J Med Res ; 27(1): 171, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071511

RESUMO

PURPOSE: To investigate the effect of modified Laprade technique on the reconstruction of posterolateral structure of knee and anterolateral ligament of knee in the treatment of posterolateral injury of knee. METHODS: From December 2013 to June 2020, multiple ligament injury patients who received surgery in our hospital were collected in this research. These patients underwent a modified Laprade technique for posterolateral structural reconstruction of the knee. Lysholm scores of patients pre- and post-operation were recorded. RESULT: The operations of the observation group or the control group patients were completed. There were no significant differences in gender, age, preoperative knee range of motion and preoperative Lysholm score. At the time of follow-up 1 month after operation, there was no significant difference in knee range of motion, dial-up test angle and Lysholm score between the observation and the control group. When followed up 1 year after operation, the Lysholm score of the observation group was higher than that of the control group. The difference was statistically significant. The same situation occurred in the range of motion of the knee in both groups. However, there was still no significant difference between the two groups in the dial-up test 1 year after operation, whether the knee flexion was 30° or 90°. CONCLUSION: For patients with posterolateral structure injury of knee, the modified Laprade technique is a feasible surgical technique.


Assuntos
Instabilidade Articular , Traumatismos do Joelho , Humanos , Instabilidade Articular/cirurgia , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Ligamentos , Amplitude de Movimento Articular
10.
BMC Musculoskelet Disord ; 23(1): 851, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076212

RESUMO

OBJECTIVE: To investigate and evaluate the biomechanical behaviour of tension-band-reconstruction (TBR) and ordinary titanium plates in open-door laminoplasty by finite element (FE) analysis. METHODS: TBR titanium plate and ordinary titanium plate were implanted into a validated finite element model of healthy adult cervical vertebrae. Among them, 5 ordinary titanium plate were used in model A, 2 TBR titanium plates and 3 ordinary titanium plates were used in model B, and 5 TBR titanium plates were used in model C. The same loading conditions was applied identically to all models. Range of motion (ROM) of the vertebral body, stress distribution of the titanium plate and intradiscal pressure (IDP) were compared in flexion, extension, lateral bending and rotation. RESULTS: The ROM of model B and C was similar in flexion and extension, and both were smaller than that of model A. The highest von Mises stress in the titanium plate appears is in model C. The IDP in C2/3 was significantly higher than that in other segments in flexion. There was no significant difference in IDP among three models in left lateral bending and left axial rotation. CONCLUSION: Application of TBR titanium plate in open-door laminoplasty can reduced ROM in flexion, extension and axial rotation of the cervical vertebrae. But the increase of stress in TBR titanium plate could lead to higher risk of adverse events such as titanium plate deformation. Moreover, compared with complete TBR titanium plate, the combination of TBR titanium plate for C3 and C7 with ordinary titanium plate for the other vertebrae largely reduce the stress of the titanium plates by ensuring stability. The proposed FE model (C2-T1) exhibits a great potential in evaluating biomechanical behaviour of TBR titanium plate for open-door laminoplasty.


Assuntos
Inosina Difosfato , Laminoplastia , Adulto , Fenômenos Biomecânicos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Análise de Elementos Finitos , Humanos , Laminoplastia/efeitos adversos , Amplitude de Movimento Articular , Titânio
11.
BMC Musculoskelet Disord ; 23(1): 850, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076229

RESUMO

BACKGROUND: Curved intertrochanteric varus osteotomy (CVO) is a useful treatment option for osteonecrosis of the femoral head (ONFH). However, the effect of proximal femoral deformity in cases of CVO converted to total hip arthroplasty (THA) remains unclear. The aim of this study was to evaluate the effect of trochanter displacement on impingement and the contact state of the implant and femur in THA. METHODS: Thirty-eight hips that had undergone CVO for ONFH were reviewed and compared with a control group of 30 contralateral hips that had not undergone surgery. The range of motion (ROM) and impingement patterns and the percentage of cortical bone in the stem placement within the femur were measured by simulation using CT-based three-dimensional template software. We also measured the ROM and the number of joints that achieved the ROM required for activities of daily living when the upward displaced apex of the greater trochanter with osteotomy was resected and compared the findings with those obtained when the apex was not resected. RESULTS: The CVO group showed a significantly greater bony impingement in external rotation (68.4% vs. 43.3%, p = 0.033) and abduction (78.9% vs. 33.3%, p < 0.001) than in the control group. The CVO group showed a significantly smaller range of external rotation (19.0° [interquartile range; 4.0-28.8] vs. 38.0° [interquartile range; 36.0-41.8], p < 0.001) and abduction (23.0° [interquartile range; 8.5-38.8] vs. 56.0° [interquartile range; 50.3-60.0], p < 0.001) than in the control group. Significantly more joints achieved the ROM necessary for activities of daily living when the apex was resected than when it was not (10.5% vs. 63.2%, p < 0.001). The percentage of cortical bone in the stem placement position was significantly higher in the CVO group than in the control group in the proximal portion of the stem (25.5% vs. 0.0%, p < 0.001). CONCLUSION: In cases requiring conversion to THA, we recommend resecting the upward displaced apex to achieve a sufficient ROM and carefully resecting the bone to avoid malignment of the stem.


Assuntos
Artroplastia de Quadril , Necrose da Cabeça do Fêmur , Atividades Cotidianas , Artroplastia de Quadril/efeitos adversos , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Cabeça do Fêmur/cirurgia , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/etiologia , Necrose da Cabeça do Fêmur/cirurgia , Articulação do Quadril/cirurgia , Humanos , Osteotomia/métodos , Amplitude de Movimento Articular
12.
Sensors (Basel) ; 22(17)2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36080913

RESUMO

Inertial motion capture (IMC) has gained popularity in conducting ergonomic studies in the workplace. Because of the need to measure contact forces, most of these in situ studies are limited to a kinematic analysis, such as posture or working technique analysis. This paper aims to develop and evaluate an IMC-based approach to estimate back loading during manual material handling (MMH) tasks. During various representative workplace MMH tasks performed by nine participants, this approach was evaluated by comparing the results with the ones computed from optical motion capture and a large force platform. Root mean square errors of 21 Nm and 15 Nm were obtained for flexion and asymmetric L5/S1 moments, respectively. Excellent correlations were found between both computations on indicators based on L5/S1 peak and cumulative flexion moments, while lower correlations were found on indicators based on asymmetric moments. Since no force measurement or load kinematics measurement is needed, this study shows the potential of using only the handler's kinematics measured by IMC to estimate kinetics variables. The assessment of workplace physical exposure, including L5/S1 moments, will allow more complete ergonomics evaluation and will improve the ecological validity compared to laboratory studies, where the situations are often simplified and standardized.


Assuntos
Ergonomia , Postura , Fenômenos Biomecânicos , Humanos , Fenômenos Mecânicos , Amplitude de Movimento Articular
13.
Sensors (Basel) ; 22(17)2022 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-36080957

RESUMO

Motion capture systems using skin markers are widely used to evaluate scapular kinematics. However, soft-tissue artifact (STA) is a major limitation, and there is insufficient knowledge of the marker movements from the original locations. This study explores a scapular STA, including marker movements with shoulder elevation using upright computed tomography (CT). Ten healthy males (twenty shoulders in total) had markers attached to scapular bony landmarks and underwent upright CT in the reference and elevated positions. Marker movements were calculated and compared between markers. The bone-based and marker-based scapulothoracic rotation angles were also compared in both positions. The median marker movement distances were 30.4 mm for the acromial angle, 53.1 mm for the root of the scapular spine, and 70.0 mm for the inferior angle. Marker movements were significantly smaller on the superolateral aspect of the scapula, and superior movement was largest in the directional movement. Scapulothoracic rotation angles were significantly smaller in the marker-based rotation angles than in the bone-based rotation angles of the elevated position. We noted that the markers especially did not track the inferior movement of the scapular motion with shoulder elevation, resulting in an underestimation of the marker-based rotation angles.


Assuntos
Movimento , Escápula , Fenômenos Biomecânicos , Humanos , Masculino , Amplitude de Movimento Articular , Rotação , Escápula/diagnóstico por imagem , Ombro/diagnóstico por imagem , Posição Ortostática
14.
J Musculoskelet Neuronal Interact ; 22(3): 364-368, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36046992

RESUMO

OBJECTIVES: Stretch reflex responses were considered to be affected by the velocity of muscle fiber lengthening and angular velocity. However, the results of previous studies in vivo and in vitro are inconsistent in this regard. The purpose of the present study was to investigate the effects of the velocity of fascicle lengthening on the amplitude of the stretch reflex for each trial with a high angular velocity and wide range of motion. METHODS: Thirteen healthy men volunteered for this study. While the ankle was passively moved from 100 to 80 deg at five different angular velocities (100, 200, 300, 500, and 600 deg⋅s-1), the velocity of fascicle lengthening in the soleus muscle was measured using ultrasonography. In addition, the amplitude of the short latency stretch reflex in the soleus muscle was also measured. RESULTS: As angular velocity increased, the amplitude of the stretch reflex and velocity of fascicle lengthening significantly increased (both p<0.001). For each trial in all subjects, the amplitude of the stretch reflex was not correlated with the velocity of fascicle lengthening at any of the angular velocities. CONCLUSION: In conclusion, the stretch reflex size is not related to the fascicle behavior in each trial.


Assuntos
Músculo Esquelético , Reflexo de Estiramento , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/fisiologia , Eletromiografia , Humanos , Masculino , Contração Muscular , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Amplitude de Movimento Articular , Reflexo de Estiramento/fisiologia
15.
J Musculoskelet Neuronal Interact ; 22(3): 369-374, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36046993

RESUMO

OBJECTIVES: Previous studies showed that vibration foam rolling (VFR) on damaged muscles improves muscle soreness and range of motion (ROM). VFR intervention can also increase the ROM and pain pressure threshold (PPT) in the non-rolling side, known as a cross-education effect. However, this is not clear for the non-rolling side. Therefore, this study aimed to investigate the cross-education effects of VFR intervention on ROM, muscle soreness, and PPT in eccentrically damaged muscles. METHODS: Participants were sedentary healthy male volunteers (n=14, 21.4±0.7 y) who performed eccentric exercise of the knee extensors with the dominant leg and received 90-s VFR intervention of the quadriceps at the nondamaged side 48 h after the eccentric exercise. The dependent variables were measured before the exercise (baseline), before (preintervention), and after VFR intervention (postintervention) 48 h after the eccentric exercise. The Bonferroni post hoc test was used to determine the differences between baseline, preintervention, and postintervention. RESULTS: Results showed that the VFR intervention on the nondamaged side 48 h after the eccentric exercise improved significantly (p<0.05) the knee flexion ROM, muscle soreness at palpation, and PPT compared to baseline. CONCLUSION: VFR intervention on the nondamaged side can recover ROM and muscle soreness in eccentrically damaged muscles.


Assuntos
Mialgia , Vibração , Humanos , Joelho/fisiologia , Masculino , Músculo Esquelético/fisiologia , Mialgia/terapia , Músculo Quadríceps/fisiologia , Amplitude de Movimento Articular/fisiologia , Vibração/uso terapêutico
16.
Arthroscopy ; 38(9): 2600-2601, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36064274

RESUMO

The anterolateral complex (ALC) of the knee has received renewed research interest because of the potential role of this anatomic region in anterior cruciate ligament (ACL) tear biomechanics and surgical treatment outcomes. The primary structures of the ALC include the iliotibial band deep (Kaplan) fibers, the anterolateral ligament (ALL), and the capsulo-osseous layer (COL) of the iliotibial band, although there remains disagreement on the precise anatomic locations and biomechanical relevance of these structures. Sectioning studies in the ACL-deficient knee have revealed a contribution of the ALC in restraining tibial internal rotation and anterior translation. Biomechanical studies have revealed a potential role for lateral extra-articular reconstruction as an augmentation to ACL reconstruction in knees with combined ACL and ALC sectioning. Clinical studies have reported a reduced ACL reconstruction failure rate with both ALL reconstruction and lateral extra-articular tenodesis procedures.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Instabilidade Articular , Tenodese , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Fenômenos Biomecânicos , Cadáver , Humanos , Instabilidade Articular/cirurgia , Articulação do Joelho/cirurgia , Amplitude de Movimento Articular , Tenodese/métodos
17.
Arthroscopy ; 38(9): 2636-2637, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36064276

RESUMO

Severe anterior shoulder instability with glenoid bone loss can be very difficult to treat. A recent cadaveric, biomechanical, time-zero study compared the stability of Bankart repair with long head of the biceps brachi transfer versus conjoined tendon transfer in the scenario of 20% anteroinferior glenoid bone loss. The result is long head of the biceps tendon transfer in combination with the Bankart repair provided the best overall condition compared to Bankart repair alone, or with a conjoined tendon transfer. However, a limitation is that this does not confirm that this surgical approach would provide sufficient long-term noncontractile shoulder stability to withstand repetitive soft-tissue loading in a dynamic, clinical situation.


Assuntos
Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Fenômenos Biomecânicos , Humanos , Instabilidade Articular/cirurgia , Amplitude de Movimento Articular , Ombro , Luxação do Ombro/cirurgia , Articulação do Ombro/cirurgia
18.
Arthroscopy ; 38(9): 2697-2701, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36064280

RESUMO

Isolated anterior cruciate ligament reconstruction is associated with a risk of graft rupture that is more than 5-fold higher than that of combined anterior cruciate ligament-anterolateral ligament (ALL) reconstruction at a mean follow-up of greater than 100 months. However, biomechanical and clinical studies report that overconstraint is a concern with nonanatomic lateral-sided reconstruction. In fact, the normal biomechanics of the native ALL are anisometric. The ligament is tight in extension (providing rotational control) and slack in flexion (allowing physiological internal rotation). The ALL femoral attachment is proximal and posterior to the lateral epicondyle. The tibial tunnel or tunnels are located anterior to the fibular head and posterior to the Gerdy tubercle. An ALL graft must lie deep to the iliotibial band and superficial to the lateral collateral ligament. Fixation is performed in extension and neutral rotation. A single- or double-strand technique may be used. Surgeons performing lateral extra-articular procedures must understand the technical pitfalls that can lead to overconstraint and must seek to avoid them. Overconstraint can occur for a number of reasons, including the use of nonanatomic reconstruction and technical errors in tensioning, fixation angle, and tunnel positioning.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Instabilidade Articular , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Fenômenos Biomecânicos/fisiologia , Cadáver , Humanos , Instabilidade Articular/cirurgia , Articulação do Joelho/fisiologia , Articulação do Joelho/cirurgia , Ligamentos , Amplitude de Movimento Articular
19.
Med Probl Perform Art ; 37(3): 176-191, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36053495

RESUMO

BACKGROUND: Recently, Wolf et al. proposed a novel, marker-based method to analyze the three-dimensional upper-body kinematics of high string players for clinical application. The method provides an objective evaluation of high string players' motor strategies, especially in the shoulder complex, by distinguishing between the scapulothoracic (ST) and glenohumeral (GH) joints, while minimizing skin movement artifacts, marker occlusions, and limitations due to instrument placement. Nevertheless, reproducibility of kinematic measurements is crucial for clinical applications. The aim of this study was to assess the method's reproducibility in terms of reliability and repeatability. METHODS: One healthy professional violinist underwent a total of nine bowing trials in three different laboratory sessions. Each trial was conducted by one of two different examiners. A biomechanical model was applied to motion capture data of the pelvis, thorax, spine, and head, as well as both upper limbs (consisting of the scapula, upper arm, forearm and hand). Reproducibility was assessed by calculating inter- and intra-tester, inter-session, and intra-subject measurement errors for each rotational degree of freedom in the upper-body segments and joints. FINDINGS: Small measurement errors were accepted to be good indicators for reproducibility. Intra- and inter-tester errors were found to be small (< 3° for the most part). Both inter-session and intra-subject repeatability were found to be larger (< 5° for the most part). INTERPRETATION: This study generally showed the novel, marker-based method to have good reproducibility for a healthy violinist. This indicates that the proposed method is a reliable tool for quantifying upper-body movements during violin playing across subjects, examiners, laboratories, and motion capture systems.


Assuntos
Braço , Escápula , Fenômenos Biomecânicos , Humanos , Movimento , Amplitude de Movimento Articular , Reprodutibilidade dos Testes
20.
BMC Pediatr ; 22(1): 523, 2022 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057568

RESUMO

BACKGROUND: This study aimed to assess the clinical and radiologic outcomes of a functional brace in combination with physical therapy (FBPT) for early correction of cubitus varus in young children. METHODS: Eighteen consecutive patients with cubitus varus secondary to supracondylar fractures were enrolled between July 2017 and March 2019. We used the FBPT technique to correct varus and sagittal plane deformity for early cubitus varus in young children. The clinical evaluation included measurement of varus angulation, sagittal plane, and range of motion at three, six, and twelve months post-intervention. The clinical and radiographic results were assessed according to the Bellemore criteria. RESULTS: Pre-treatment humerus-elbow-wrist (HEW) angle measured on the affected side (varus deformity) ranged between -38° and -12° (average, -23.2°) while the post-treatment HEW angle ranged between -10° and + 15° (average, 8.8°). Compared with the unaffected side, no statistically significant difference was found in the affected side post-intervention (P > 0.05). According to the Bellemore criteria, we got excellent results in fourteen patients (77.8%), good results in three patients (16.7%), and poor result in one patient (5.5%). All patients and their parents (except one patient with residual varus deformities) were satisfied with the functional and cosmetic outcomes. CONCLUSIONS: The FBPT is effective for the treatment of cubitus varus in children, especially for young children within 6 months of the injury.


Assuntos
Articulação do Cotovelo , Fraturas do Úmero , Deformidades Articulares Adquiridas , Criança , Pré-Escolar , Articulação do Cotovelo/lesões , Humanos , Fraturas do Úmero/complicações , Fraturas do Úmero/terapia , Deformidades Articulares Adquiridas/complicações , Osteotomia/métodos , Modalidades de Fisioterapia , Amplitude de Movimento Articular
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