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1.
Medicine (Baltimore) ; 99(34): e21889, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846850

RESUMO

Electromyographic biofeedback (EMG-BF) therapy provides information on the state of contraction of the targeted muscles and relaxation of their antagonists, which can facilitate early active range of motion (RoM) after elbow surgery. Our aim in this study was to calculate the minimum detectable change (MDC) during EMG-BF therapy, initiated in the early postoperative period after elbow surgery.This study is an observational case series. EMG-BF of muscle contraction and relaxation was provided during active elbow flexion and extension exercises. Patients completed 3 sets of 10 trials each of flexion and extension over 4 weeks. The total range of flexion-extension motion and scores on the Japanese Society for Surgery of the Hand version of the disability of the arm, shoulder, and hand questionnaire and the Japanese version of the Patient-Rated Elbow Evaluation were obtained at baseline and weekly during the 4-week intervention period. A prediction formula was developed from the time-series data obtained during the intervention period, using the least-squares method. The estimated value was calculated by removing the slope from the prediction formula and adding the initial scores to residuals between the measured scores and predicted scores individually. Systematic error, MDC at the 95th percentile cutoff (MDC95), repeatability of the measures, and the change from the baseline to each time-point of intervention were assessed.The MDC95 was obtained for all 3 outcome measures and the range of values was as follows: RoM, 8.3° to 22.5°; Japanese version of the Patient-Rated Elbow Evaluation score, 17.6 to 30.6 points; and disability of the arm, shoulder, and hand questionnaire subscale: disability and symptoms score, 14.2 to 22.9 points.The efficacy of EMG-BF after elbow surgery was reflected in earlier initiation of elbow RoM after surgery and improvement in patient-reported upper limb function scores. The calculated MDC95 cut-offs could be used as reference values to assess the therapeutic effects of EMG-BF in individuals.


Assuntos
Biorretroalimentação Psicológica/métodos , Cotovelo/cirurgia , Amplitude de Movimento Articular/fisiologia , Reabilitação/métodos , Adulto , Idoso , Avaliação da Deficiência , Cotovelo/patologia , Eletromiografia , Terapia por Exercício/métodos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Relaxamento Muscular/fisiologia , Medidas de Resultados Relatados pelo Paciente , Período Pós-Operatório , Reabilitação/tendências , Reprodutibilidade dos Testes , Inquéritos e Questionários , Resultado do Tratamento
2.
Sports Health ; 12(5): 478-487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32758080

RESUMO

CONTEXT: Shoulder injuries are highly prevalent in sports involving the upper extremity. Some risk factors have been identified in the literature, but consensus is still lacking. OBJECTIVES: To identify risk factors of overuse shoulder injury in overhead athletes, as described in the literature. DATA SOURCES: A systematic review of the literature from the years 1970 to 2018 was performed using 2 electronic databases: PubMed and Scopus. STUDY SELECTION: Prospective studies, written in English, that described at least 1 risk factor associated with overuse shoulder injuries in overhead sports (volleyball, handball, basketball, swimming, water polo, badminton, baseball, and tennis) were considered for analysis. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Data were extracted from 25 studies. Study methodology quality was evaluated using the Modified Coleman Methodology Score. RESULTS: Intrinsic factors, previous injury, range of motion (lack or excess), and rotator cuff weakness (isometric and isokinetic) highly increase the risk of future injuries. Additionally, years of athletic practice, body mass index, sex, age, and level of play seem to have modest influence. As for the effect of scapular dysfunction on shoulder injuries, it is still controversial, though these are typically linked. Extrinsic factors, field position, condition of practice (match/training), time of season, and training load also have influence on the occurrence of shoulder injuries. CONCLUSION: Range of motion, rotator cuff muscle weakness, and training load are important modifiable factors associated with shoulder injuries. Scapular dysfunction may also have influence. The preventive approach for shoulder injury should focus on these factors.


Assuntos
Traumatismos em Atletas/fisiopatologia , Transtornos Traumáticos Cumulativos/fisiopatologia , Lesões do Ombro/fisiopatologia , Traumatismos em Atletas/prevenção & controle , Transtornos Traumáticos Cumulativos/prevenção & controle , Humanos , Amplitude de Movimento Articular/fisiologia , Fatores de Risco , Manguito Rotador/fisiopatologia , Escápula/fisiopatologia , Lesões do Ombro/prevenção & controle
3.
PLoS One ; 15(8): e0238197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841286

RESUMO

The aim of this study was to compare artistic swimmers (ASs) and water polo players (WPs) in their polyrhythmic production ability and entrainment between arm and leg motion frequency. Nine ASs and nine WPs participated in the study. First, we assessed the natural eggbeater kick frequency of each participant without any additional motion for 20 s. We then required the participants to perform a circular arm movement in synchronization with two sequences of metronome rhythms (either 100%, 80% and 120% or100%, 120% and 80% of their natural eggbeater kick frequency) while maintaining their natural eggbeater kick frequency. All tasks were repeated three times. The participants' performances were recorded by a motion capture system synchronized with the metronome. A two-way mixed-design ANOVA was performed on the coefficient of variation of natural eggbeater kick frequency obtained from the first task to confirm the consistency of participants' kicking motion. In the second task, a three-way mixed-design ANOVA was performed on the average frequency of the arm and leg motions to assess the entrainment between the two. In the first task, there were no significant main effects and interaction between group and trial in the coefficient of variation of eggbeater kick frequency, suggesting that both WPs and ASs maintained their natural eggbeater kick frequency equally consistently. In the second task, however, WPs were not able to maintain their natural eggbeater kick frequency when they were required to do circular arm movements at 120% tempo (p < .01). On the other hand, ASs successfully maintained their natural eggbeater kick frequency with all metronome rhythms, suggesting that they have a better polyrhythmic production ability than WPs.


Assuntos
Música , Natação/fisiologia , Esportes Aquáticos/fisiologia , Adolescente , Adulto , Braço/fisiologia , Desempenho Atlético/fisiologia , Fenômenos Biomecânicos , Feminino , Humanos , Perna (Membro)/fisiologia , Masculino , Destreza Motora/fisiologia , Movimento/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
4.
Bone Joint J ; 102-B(8): 1010-1015, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32731826

RESUMO

AIMS: Responsiveness and ceiling effects are key properties of an outcome score. No such data have been reported for the original English version of the International Hip Outcome Tool 12 (iHOT-12) at a follow-up of more than four months. The aim of this study was to identify the responsiveness and ceiling effects of the English version iHOT-12 in a series of patients undergoing hip arthroscopy for intra-articular hip pathology at a minimum of one year postoperatively. METHODS: A total of 171 consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement (FAI) under the care of a single surgeon between January 2013 and March 2017 were included. iHOT-12 and EuroQol 5D-5L (EQ-5D-5L) scores were available pre- and postoperatively. Effect size and ceiling effects for the iHOT-12 were calculated with subgroup analysis. RESULTS: A total of 122 patients (71.3%) completed postoperative PROMs scores with median follow-up of 24.3 months (interquartile range (IQR) 17.2 to 33.5). The median total cohort iHOT-12 score improved significantly from 31.0 (IQR 20 to 58) preoperatively to 72.5 (IQR 47 to 90) postoperatively (p < 0.001). The effect size (Cohen's d) was 1.59. In all, 33 patients (27%) scored within ten points (10%) of the maximum score and 38 patients (31.1%) scored within the previously reported minimal clinically important difference (MCID) of the maximum score. Furthermore, nine (47%) male patients aged < 30 years scored within 10% of the maximum score and ten (53%) scored within the previously reported MCID of the maximum score. CONCLUSION: There is a previously unreported ceiling effect of the iHOT-12 at a minimum one-year follow-up which is particularly marked in young, male patients following hip arthroscopy for FAI. This tool may not have the maximum measurement required to capture the true outcome following this procedure. Cite this article: Bone Joint J 2020;102-B(8):1010-1015.


Assuntos
Artroscopia/métodos , Impacto Femoroacetabular/diagnóstico , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Amplitude de Movimento Articular/fisiologia , Adulto , Estudos de Coortes , Feminino , Impacto Femoroacetabular/cirurgia , Seguimentos , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Diferença Mínima Clinicamente Importante , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Pesos e Medidas
5.
Bone Joint J ; 102-B(8): 981-996, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32731832

RESUMO

AIMS: Whether to perform hybrid surgery (HS) in contrast to anterior cervical discectomy and fusion (ACDF) when treating patients with multilevel cervical disc degeneration remains a controversial subject. To resolve this we have undertaken a meta-analysis comparing the outcomes from HS with ACDF in this condition. METHODS: Seven databases were searched for studies of HS and ACDF from inception of the study to 1 September 2019. Both random-effects and fixed-effects models were used to evaluate the overall effect of the C2-C7 range of motion (ROM), ROM of superior/inferior adjacent levels, adjacent segment degeneration (ASD), heterotopic ossification (HO), complications, neck disability index (NDI) score, visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Odom's criteria, blood loss, and operating and hospitalization time. To obtain more credible results contour-enhanced funnel plots, Egger's and Begg's tests, meta-regression, and sensitivity analyses were performed. RESULTS: In total, 17 studies involving 861 patients were included in the analysis. HS was found to be superior to ACDF in maintaining C2-C7 ROM and ROM of superior/inferior adjacent levels, but HS did not reduce the incidence of associated level ASD. Also, HS did not cause a higher rate of HO than ACDF. The frequency of complications was similar between the two techniques. HS failed to achieve more favourable outcomes than ACDF using the NDI, VAS, JOA, and Odom's scores. HS did not show any more advantages in operating or hospitalization time but did show reduction in blood loss. CONCLUSION: Although HS maintained cervical kinetics, it failed to reduce the incidence of ASD. This finding differs from previous reports. Moreover, patients did not show more benefits from HS with respect to symptom improvement, prevention of complications, and clinical outcomes. Cite this article: Bone Joint J 2020;102-B(8):981-996.


Assuntos
Vértebras Cervicais/cirurgia , Discotomia/métodos , Degeneração do Disco Intervertebral/cirurgia , Amplitude de Movimento Articular/fisiologia , Fusão Vertebral/métodos , Substituição Total de Disco/métodos , Adulto , Idoso , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Japão , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Cervicalgia/fisiopatologia , Cervicalgia/cirurgia , Medição da Dor , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Espondilose/diagnóstico por imagem , Espondilose/cirurgia , Resultado do Tratamento
6.
Bone Joint J ; 102-B(8): 967-980, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32731835

RESUMO

AIMS: The aims of this study were to validate the outcome of total elbow arthroplasty (TEA) in patients with rheumatoid arthritis (RA), and to identify factors that affect the outcome. METHODS: We searched PubMed, MEDLINE, Cochrane Reviews, and Embase from between January 2003 and March 2019. The primary aim was to determine the implant failure rate, the mode of failure, and risk factors predisposing to failure. A secondary aim was to identify the overall complication rate, associated risk factors, and clinical performance. A meta-regression analysis was completed to identify the association between each parameter with the outcome. RESULTS: A total of 38 studies including 2,118 TEAs were included in the study. The mean follow-up was 80.9 months (8.2 to 156). The implant failure and complication rates were 16.1% (95% confidence interval (CI) 0.128 to 0.200) and 24.5% (95% CI 0.203 to 0.293), respectively. Aseptic loosening was the most common mode of failure (9.5%; 95% CI 0.071 to 0.124). The mean postoperative ranges of motion (ROMs) were: flexion 131.5° (124.2° to 138.8°), extension 29.3° (26.8° to 31.9°), pronation 74.0° (67.8° to 80.2°), and supination 72.5° (69.5° to 75.5°), and the mean postoperative Mayo Elbow Performance Score (MEPS) was 89.3 (95% CI 86.9 to 91.6). The meta-regression analysis identified that younger patients and implants with an unlinked design correlated with higher failure rates. Younger patients were associated with increased complications, while female patients and an unlinked prosthesis were associated with aseptic loosening. CONCLUSION: TEA continues to provide satisfactory results for patients with RA. However, it is associated with a substantially higher implant failure and complication rates compared with hip and knee arthroplasties. The patient's age, sex, and whether cemented fixation and unlinked prosthesis were used can influence the outcome. Level of Evidence: Therapeutic Level IV. Cite this article: Bone Joint J 2020;102-B(8):967-980.


Assuntos
Artrite Reumatoide/cirurgia , Artroplastia de Substituição do Cotovelo/métodos , Medição da Dor , Falha de Prótese , Amplitude de Movimento Articular/fisiologia , Adulto , Fatores Etários , Idoso , Artrite Reumatoide/diagnóstico , Artroplastia de Substituição do Cotovelo/efeitos adversos , Estudos de Coortes , Bases de Dados Factuais , Articulação do Cotovelo/fisiopatologia , Articulação do Cotovelo/cirurgia , Prótese de Cotovelo , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Reoperação/métodos , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Resultado do Tratamento
7.
Medicine (Baltimore) ; 99(27): e21139, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629749

RESUMO

INTRODUCTION: Most symptomatic large-to-massive rotator cuff tears (RCTs) should be operated, but the surgical reparability depended on the degree of rotator cuff muscle atrophy or fatty infiltration. The orthopedic surgeons will decide whether the teared stump is reparable during the surgery, but preoperative evaluation can be done by some assessment tools. Magnetic resonance imaging (MRI) was used in recent studies to predict the reparability of large-to-massive RCTs, but the clinical availability was not as good as ultrasound. We hypothesize that the ultrasound elastography can predict the reparability of large-to-massive RCTs. METHODS: This is a prospective observational study and participants with large-to-massive RCTs who are going to have surgeries will be included. Out investigators will evaluate the shoulder passive range of motion (ROM) and strength of all participants. Participants' degree of shoulder pain and activities of daily living (ADLs) will be assessed by American Shoulder and Elbow Surgeons (ASES) score. The ultrasound elastography will be used to evaluate the tissue quality of supraspinatus muscle and infraspinatus muscle. To test the reliability of the ultrasound elastography, two physicians will perform the ultrasound elastography independently and twenty participants will be selected for the reliability test. Besides, MRI will be used to evaluate the size of tear, the degree of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, the orthopedic surgeons will perform surgeries and decide whether the teared stump can be completely repaired intraoperatively. The primary analysis is the predictive validity of ultrasound elastography for the reparability of large-to-massive RCTs. Before the predictive validity of ultrasound elastography is measured, our investigators will assess the reliability of ultrasound elastography when administered to cases with large-to-massive RCTs, and we will check the correlations between the findings of ultrasound elastography and MRI. DISCUSSION: The outcome will provide the evidence of ultrasound elastography for preoperative evaluation of large-to-massive RCTs. The relationships between the findings of ultrasound elastography and MRI will also be examined for further analysis. TRIAL REGISTRATION: Clinicaltrials.gov NCT03682679. Date of Registration: 25 September 2018, https://clinicaltrials.gov/ct2/show/NCT03682679?cond=rotator+cuff&cntry=TW&draw=2&rank=1.


Assuntos
Lesões do Manguito Rotador/diagnóstico por imagem , Ruptura/cirurgia , Ombro/fisiopatologia , Atividades Cotidianas , Tecido Adiposo/patologia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Atrofia Muscular/patologia , Valor Preditivo dos Testes , Período Pré-Operatório , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Reprodutibilidade dos Testes , Manguito Rotador/patologia , Lesões do Manguito Rotador/patologia
8.
Orv Hetil ; 161(29): 1208-1214, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32628620

RESUMO

INTRODUCTION: Total knee arthroplasty has become one of the most successful and safest surgical procedures in orthopedic surgery. Of the many different types of surgical exposure, the most common, so-called medial parapatellar (MP) incision is the cut of the quadriceps tendon, which impairs extensor function. In contrast, subvastus (S) exposure, which spares the extensor apparatus, may promise better healing. AIM: The purpose of our prospective observational study at the Orthopedic Clinic of Semmelweis University is to compare the effects of the MP and the S excision on the early postoperative period. METHOD: The 60 patients enrolled were randomly assigned to two different groups according to the type of intervention. In the study, we measured the effects of the two different methods of surgical exposure on homogeneous patient groups in the early postoperative period based on international literature and the parameters we defined. RESULTS: Visual analog scale (VAS) measured resting and active pain levels for the first 10 days, suggesting a more pronounced difference in active VAS values for the S group. In the case of active VAS, patients in the S group also had significantly less pain on days 2, 3, and 10 than in the MP group. Taking into account the results of the other days, it is in favour of preserving the integrity of the extensor apparatus for improved postoperative functionality. Patients' knee joint range of motion was also measured. On day 1, those in the S group were significantly larger. As the days progress, MP group members catch up with S group during their rehabilitation. Group S patients had an average of 1.944 days to extended leg elevation, which is nearly two days shorter compared to the MP group (p<0.0001). CONCLUSIONS: After statistical analysis of data, subvastus exposure appears to be more beneficial in the rehabilitation of the early postoperative period. However, large-scale, multicentre observational studies are required to establish evidence. Orv Hetil. 2020; 161(29): 1208-1214.


Assuntos
Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular/fisiologia , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/reabilitação , Humanos , Articulação do Joelho , Osteoartrite do Joelho/diagnóstico , Patela/cirurgia , Cuidados Pós-Operatórios , Período Pós-Operatório , Estudos Prospectivos , Recuperação de Função Fisiológica , Resultado do Tratamento , Escala Visual Analógica
9.
PLoS One ; 15(7): e0236266, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726351

RESUMO

The aim of this study was an evaluation of the musculoskeletal system in women and men with Generalized Joint Hypermobility (GJH). The study included 87 participants- 40 with Generalized Joint Hypermobility (aged 21.2 ±1.8 years) and 47 (aged 21.0 ±1.3 years) in the control group (CG). The study included the Beighton score, the measurements of body composition, muscle flexibility (Straight Leg Raise test, Popliteal Angle test, Modified Thomas Test), and the measurements of muscle strength and muscle power. T-test and Mann-Whitney U Test were applied to assess the differences between independent groups. The study showed that there were no significant differences (p>.05) in the assessed body composition and the muscle flexibility between both women and men with GJH and the participants in the CG. Under isokinetic conditions for the non-dominant lower extremity, men from the CG received significantly higher (p = .02) flexion peak torque at 180°/s angular velocity. Women from the CG received a statistically significantly lower (p = .04) F/E ratio at 180°/s velocity. Under isometric conditions for both women and men with GJH, there were no statistically significant differences (p>.05) in the maximum torques in knee extension and flexion compared to the CG. For women and men with GJH, the maximum power in the lower extremities and jumping ability were not significantly different (p>.05) compared to the CG participants. The body composition, muscle flexibility, muscle strength, and muscle power of adults with Generalized Joint Hypermobility did not differ compared to healthy participants. The fact that there are no differences does not exclude the efficacy of strength training in increasing levels of muscle strength and its impact on body posture and proprioception or coordination.


Assuntos
Instabilidade Articular/fisiopatologia , Articulação do Joelho/fisiopatologia , Força Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Adulto , Composição Corporal/fisiologia , Feminino , Humanos , Instabilidade Articular/epidemiologia , Extremidade Inferior/fisiopatologia , Masculino , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
10.
PLoS One ; 15(7): e0235679, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645095

RESUMO

INTRODUCTION: Static stretching (SS) program are widely used in clinical and athletic settings. Many previous studies investigate the effect of SS program on muscle strength and muscle architecture (muscle thickness, and pennation angleh). However, no consensus has been reached about the effect of SS programs on muscle strength and muscle architecture. The aim of this study was to investigate the effects of 6-week SS programs performed at different weekly frequencies on muscle strength, muscle thickness and pennation angle at different ankle joint positions. METHODS: A total of 24 healthy male volunteers were performed 6-week SS programs (2,160 s of SS: 360 s/week*6 weeks) and were randomized to a group that performed SS once a week, or a group that performed SS three times per week. Total time under stretching was equated between groups. The muscle strength (maximum voluntary isometric contraction) at three different ankle joints were assessed before and after the 6-week SS program. In addition, muscle thickness and pennation angle were assessed by ultrasonography before and after 6-week SS program. RESULTS: There were no significant changes in all variables before and after the 6-week SS program, regardless of weekly frequency (p > 0.05). CONCLUSIONS: Our results suggest that 6-week SS programs do not increase muscle strength or muscle architecture at different ankle joint positions, regardless of stretching frequency; however, no negative effect on these outcomes was observed, contrary to evidence on the immediate, detrimental effects of SS.


Assuntos
Força Muscular/fisiologia , Exercícios de Alongamento Muscular , Músculo Esquelético , Articulação do Tornozelo , Humanos , Masculino , Exercícios de Alongamento Muscular/efeitos adversos , Exercícios de Alongamento Muscular/métodos , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Amplitude de Movimento Articular/fisiologia , Ultrassonografia , Adulto Jovem
11.
PLoS One ; 15(7): e0236341, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702027

RESUMO

The study aimed to quantify the measurement error / reliability of a musculoskeletal profiling test battery administered in young, elite academy soccer players, and to examine if the order in which the test battery was administered, and who it was administered by, influenced reliability. Players (n = 75; age 12-20 years; stature 1.47-1.95 m; body mass 36-89 kg) from U-12 to U-23 age groups were assigned to either: 1) intra-rater-fixed order; 2) intra-rater-non-fixed order; 3) inter-rater-fixed order; or, 4) inter-rater-non-fixed order groups. On two separate occasions separated by 3 to 7 days, 12 raters conducted a musculoskeletal profiling test battery comprising 10 tests (Supine Medial Hip Rotation, Supine Lateral Hip Rotation, Hamstring 90/90, Prone Medial Hip Rotation [degrees]; Combined Elevation, Thoracic Rotation, Weight-Bearing Dorsiflexion, Y-Balance [centimetres]; Beighton, Lumbar Quadrant [categorical]). The measurement error / reliability for tests measured in degrees and centimetres was evaluated using the intraclass correlation (relative reliability), coefficient of variation and ratio limits of agreement (absolute reliability). Intraclass correlations varied from 0.04 ("poor") to 0.95 ("excellent"), coefficient of variation from 2.9 to 43.4%, and the ratio limits of agreement from 1.058 (*/÷ 1.020) to 2.026 (*/÷ 1.319) for the tests measured in degrees and centimetres. The intraclass correlation, coefficient of variation and ratio limits of agreement were smallest for five out of eight tests measured in degrees and centimetres when the tests were administered in an intra-rater-fixed test order. These findings emphasise that different testing methods, and the administration of a musculoskeletal profiling test battery using a less than optimal design, will influence measurement error and hence test reliability. These observations need to be considered when investigating musculoskeletal function and age, injury, training or asymmetry in young, elite academy soccer players.


Assuntos
Atletas , Região Lombossacral/fisiologia , Músculo Esquelético/fisiologia , Futebol/fisiologia , Adolescente , Criança , Teste de Esforço , Humanos , Masculino , Movimento/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
13.
Medicine (Baltimore) ; 99(21): e20248, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481302

RESUMO

RATIONALE: Lipomas are common benign tumors, constituting 16% of soft tissue mesenchymal tumors. They usually occur under the skin or in the large muscles of the thigh, shoulder, or upper arm. There are few reported cases of lipomas located in the forearm and hand muscles, accounting for less than 1% of all lipomas. PATIENT CONCERNS: A 47-year old man presented with a history of swelling and accompanying pain in the left wrist for 2 years. DIAGNOSES: The patient was diagnosed with intramuscular lipoma in the pronator quadratus. INTERVENTIONS: The mass was resected completely with wide-awake technique. OUTCOMES: The patient was followed up for 2 years with no recurrence. The symptoms of swelling and pain resolved within 3 weeks post-surgery, and there was no clear abnormality in wrist and finger movement and sensation. A satisfactory outcome was achieved. LESSONS: Intramuscular lipoma in the pronator quadratus is a rare benign tumor which should be distinguished from malignant tumors. Especially for patients with carpal tunnel syndrome presenting with wrist swelling, ultrasound, computed tomography, or magnetic resonance imaging can be used to assess deep tissue masses.


Assuntos
Lipoma/cirurgia , Músculo Esquelético/patologia , Neoplasias de Tecidos Moles/patologia , Antebraço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento , Punho/patologia
14.
Medicine (Baltimore) ; 99(21): e20015, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481269

RESUMO

The purpose of this study is to define the rate of implant failure and risk factors for failure in patients treated operatively for displaced medial epicondyle fractures.Patients <18 years of age with medial epicondyle humerus fractures that were treated with screw or k-wire fixation between 2005 and 2015 were eligible. Inclusion criteria included follow-up until radiographic union and no known medical conditions that could impair healing.Thirty four patients with 35 fractures were identified with an average age of 12 years old. 11.4% (n = 4/35) of fractures were treated using K-wires, 25.7% (n = 9/35) were treated using a screw and washer construction, and 62.9% (n = 22/35) were treated using screw alone. There were 16 reported complications (46%) including implant prominence requiring reoperation (6), implant failure (1), and fracture displacement (1). Other complications included non-union/delayed union (4), new ulnar nerve palsy (2), and decreased range of motion (2). Rates of complications were not different between the types of fixation (P = 1.0). Those who developed complications were younger than those who did not (P = 0.05). 91.4% of patients returned to full activity including weight bearing and throwing sports.Although 25% of patients experienced implant complications and the overall complication rate approached 50%, nearly all reported return to full activity.


Assuntos
Fixação Interna de Fraturas/efeitos adversos , Fraturas do Úmero/cirurgia , Complicações Pós-Operatórias/etiologia , Adolescente , Parafusos Ósseos/efeitos adversos , Fios Ortopédicos/efeitos adversos , Criança , Falha de Equipamento , Feminino , Fixação Interna de Fraturas/métodos , Humanos , Masculino , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos
15.
Can J Surg ; 63(3): E196-E201, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32356946

RESUMO

Background: Literature on the survival rates and function of hinged total knee replacement (HTKR) prostheses is scarce, and to our knowledge there is not yet any published literature on the Legion HK Hinge Knee Replacement prosthesis (Smith & Nephew) with guided-motion articulation. The objective of this study was to establish the early survival rate of this modern HTKR at a single institution and to investigate postoperative patient function and satisfaction. Methods: This retrospective study included patients who received the Legion HTKR prosthesis with guided-motion inserts as a primary or revision implant between October 11 and March 2016 at a tertiary care centre in Manitoba, Canada. Preoperative and postoperative functional scores on the 12-item Oxford Knee Score and postoperative patient satisfaction were assessed. Results: Thirty-nine HTKR implantations (38 patients) were included in this study: 12 primary cases and 27 revision cases. Three revision surgeries and 4 perioperative complications were noted at a mean follow-up of 29.1 months. The 2-year survivorship of the HTKR system was 90.7%. Postoperative functional scores improved significantly and the majority of patients were satisfied or very satisfied at all follow-up time points. Conclusion: The early survival rate of a modern guided-motion HTKR prosthesis is similar to the survival rates of other hinged knee prostheses published in the literature. The prosthesis demonstrated substantial postoperative functional improvement when used in the setting of complex primary or revision total knee replacement.


Assuntos
Artroplastia do Joelho/métodos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Satisfação do Paciente , Amplitude de Movimento Articular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Manitoba/epidemiologia , Pessoa de Meia-Idade , Osteoartrite do Joelho/mortalidade , Desenho de Prótese , Falha de Prótese , Reoperação , Estudos Retrospectivos , Taxa de Sobrevida/tendências
16.
Rev Assoc Med Bras (1992) ; 66(2): 216-221, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32428158

RESUMO

OBJECTIVE: In diabetics, foot deformities are risk factors that increase the risk of amputation as a result of developing ulcers. However, knowledge of the influence of plantar stiffness is still limited. The main objective was to describe connections between the degree of stiffness of the ankle, atypical amputation, and the Foot Posture Index (FPI). METHODS: 62 diabetic patients, 58 with type 2 and 4 with type 1 (average age 63.35 years) were included. Records of foot deformities were included; A range of motion test of the ankle joint was used to determine the degree of stiffness. An exploratory analysis of the association of foot position and the degree of rigidity was performed. RESULTS: The dorsal flexion range of the ankle was 9.6 ± 5.1 0, 13.8 ± 5.9 0 and 17.2 ± 6.5 0 and 20.5 ± 6.8 0 to 45, 67, 89 and 111 N respectively in the amputated feet., And 14 patients (22.58%) had a high level of pronation of IPF with an average value of 3.7 ± 2.629, CI (3.032.-4.367) in amputated feet compared to non-amputees. We use the device "Iowa ankle range of motion" (IAROM) to determine the differences in ankle stiffness. Proper IPF was associated with the presence of amputation and an increase in stiffness. CONCLUSIONS: There was an increase in the degree of limitation of movement of the ankle, as a greater force was applied. Comparing FPI between the groups, there was a higher frequency of prone feet in the group of amputees.


Assuntos
Amputação , Articulação do Tornozelo/fisiopatologia , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Idoso , Antropometria , Estudos Transversais , Feminino , Pé/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura/fisiologia , Valores de Referência , Estatísticas não Paramétricas
17.
Nat Commun ; 11(1): 2183, 2020 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366821

RESUMO

Coupling myoelectric and mechanical signals during voluntary muscle contraction is paramount in human-machine interactions. Spatiotemporal differences in the two signals intrinsically arise from the muscular excitation-contraction process; however, current methods fail to deliver local electromechanical coupling of the process. Here we present the locally coupled electromechanical interface based on a quadra-layered ionotronic hybrid (named as CoupOn) that mimics the transmembrane cytoadhesion architecture. CoupOn simultaneously monitors mechanical strains with a gauge factor of ~34 and surface electromyogram with a signal-to-noise ratio of 32.2 dB. The resolved excitation-contraction signatures of forearm flexor muscles can recognize flexions of different fingers, hand grips of varying strength, and nervous and metabolic muscle fatigue. The orthogonal correlation of hand grip strength with speed is further exploited to manipulate robotic hands for recapitulating corresponding gesture dynamics. It can be envisioned that such locally coupled electromechanical interfaces would endow cyber-human interactions with unprecedented robustness and dexterity.


Assuntos
Eletromiografia/métodos , Força da Mão/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Amplitude de Movimento Articular/fisiologia , Membros Artificiais , Bioengenharia/instrumentação , Bioengenharia/métodos , Fenômenos Biomecânicos , Eletrônica Médica/instrumentação , Eletrônica Médica/métodos , Dedos/fisiologia , Antebraço/fisiologia , Mãos/fisiologia , Humanos , Desenho de Prótese/instrumentação , Desenho de Prótese/métodos
18.
PLoS One ; 15(5): e0232513, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407415

RESUMO

BACKGROUND: The unipodal stance task is a clinical task that quantifies postural stability and alignment of the lower limb joints, while weight bearing on one leg. As persons with knee osteoarthritis (KOA) have poor postural and knee joint stability, objective assessment of this task might be useful. OBJECTIVE: To investigate the discriminant validity of three-dimensional joint kinematics and centre of mass displacement (COM) between healthy controls and persons with knee KOA, during unipodal stance using inertial sensors. Additionally, the reliability, agreement and construct validity are assessed to determine the reproducibility and accuracy of the discriminating parameters. METHODS: Twenty healthy controls and 19 persons with unilateral severe KOA were included. Five repetitions of the unipodal stance task were simultaneously recorded by an inertial sensor system and a camera-based system (gold standard). Statistical significant differences in kinematic waveforms between healthy controls and persons with severe knee KOA were determined using one-dimensional statistical parametric mapping (SPM1D). RESULTS: Persons with severe knee KOA had more lateral trunk lean towards the contralateral leg, more hip flexion throughout the performance of the unipodal stance task, more pelvic obliquity and COM displacement towards the contralateral side. However, for the latter two parameters the minimum detectable change was greater than the difference between healthy controls and persons with severe knee KOA. The construct validity was good (coefficient of multiple correlation 0.75, 0.83 respectively) and the root mean squared error (RMSE) was low (RMSE <1.5°) for the discriminant parameters. CONCLUSION: Inertial sensor based movement analysis can discriminate between healthy controls and persons with severe knee KOA for lateral trunk lean and hip flexion, but unfortunately not for the knee angles. Further research is required to improve the reproducibility and accuracy of the inertial sensor measurements before they can be used to assess differences in tasks with a small range of motion.


Assuntos
Articulação do Joelho/fisiologia , Osteoartrite do Joelho/fisiopatologia , Idoso , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Humanos , Imageamento Tridimensional , Articulação do Joelho/fisiopatologia , Extremidade Inferior/fisiologia , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Amplitude de Movimento Articular/fisiologia , Tecnologia de Sensoriamento Remoto , Reprodutibilidade dos Testes
19.
PLoS One ; 15(5): e0233701, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32453805

RESUMO

Young female soccer players are at high risk of anterior cruciate ligament injury due to the fast-paced nature of the sport and surplus of unplanned movements during play. Neuromuscular training programs that aim to reduce this injury by targeting the associated biomechanical movements are a potential solution. While previous studies have examined the lack of dynamic knee control during landing, there are few that outline the role that maturation can play during unanticipated cutting. Therefore, the purpose of this study was to determine if young female soccer players across multiple phases of maturation exhibited the before seen differences in knee control during a drop landing as well as an unanticipated cutting task. 139 female soccer players volunteered to participate in this study and were classified in three maturational groups based on percent adult stature: prepubertal (PRE), pubertal (PUB), and post-pubertal (POST). Each group performed a drop vertical jump (DVJ) and an unanticipated cutting task (CUT). Standard 3D motion capture techniques were used to determine peak knee flexion/abduction angles and moments during each task. Within tasks, POST exhibited significantly greater peak abduction angles and moments compared to PUB/PRE. While each maturational group exhibited greater peak knee abduction angles during the DVJ compared to the CUT, peak knee abduction moments during the CUT were greater compared to the DVJ. Participants within each maturational group exhibited greater knee flexion during the DVJ compared to the CUT, however there were no differences identified between groups. During both tasks, POST/PUB exhibited greater peak knee flexion moments compared to PRE, as well as POST compared to PUB. Overall, each group exhibited significantly greater peak knee flexion moments during the CUT compared to the DVJ. These observed differences indicate the need for neuromuscular training programs that target both jumping and cutting techniques to reduce ACL injuries.


Assuntos
Atletas , Joelho/fisiologia , Movimento/fisiologia , Futebol , Adolescente , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Amplitude de Movimento Articular/fisiologia
20.
Arch Orthop Trauma Surg ; 140(7): 987-992, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32367376

RESUMO

INTRODUCTION: The reverse homodigital dorsoradial flap remains a useful alternative for covering thumb defects. However, the description of pedicle width of dorsoradial flap is not clear. The aim of this study was to compare the results of narrow pedicle with wide pedicle in dorsoradial flaps and describe our experience with the thumb reconstruction. MATERIALS AND METHODS: From July 2014 to February 2019, 42 patients were treated with the reverse dorsoradial flap for thumb reconstruction. The patients were divided as Group A (pedicle width ≤ 0.8 cm) and Group B (pedicle width > 0.8 cm). Flap survival, time to return to work, flap sensibility, the range of motion (ROM) of the joints, and final aesthetic outcomes were evaluated. RESULTS: Respectively in the Group A (17 cases) and Group B (25 cases), 14-19 flaps survived uneventfully, whereas 3-6 flaps experienced venous congestion with no or partial flap loss. No significant difference was identified between the two groups for the incidence of venous congestion, static 2-point discrimination and ROM of the injured thumbs. Time to return to work was significantly shorter in Group A. The aesthetic satisfaction of the patients in Group A was significantly better comparing with that in Group B. CONCLUSIONS: The reverse homodigital dorsoradial flap with narrow pedicle width is associated with more favorable outcomes in terms of time lost from work and aesthetic satisfaction of the patients.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos/cirurgia , Polegar , Humanos , Satisfação do Paciente , Amplitude de Movimento Articular/fisiologia , Polegar/lesões , Polegar/cirurgia
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