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1.
J Bodyw Mov Ther ; 30: 210-220, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35500973

RESUMO

BACKGROUND: Although Movement System Impairment (MSI) model classifies patients with knee impairments, it has some limitations. This study compares MSI model with a new Partitioning Around Medoids (PAM) model in knee pain patients. METHODS: In this cross-sectional study, knee movement impairments (signs) and symptoms. (pain) of 200 patients were studied in eight different functional positions. After modification of impairments, the examinations were repeated to record the changes in symptoms. The patients were then classified based on the signs and symptoms firstly by MSI model and secondly using PAM clustering by R software. RESULTS: PAM model has a similar acceptable grouping compared to MSI because most patients are in 4 similar categories in both methods: valgus, varus, hyperextension and hypomobility. However, due to low discriminative power of the tests used for finding hypermobility and patellar dysfunctions, these sub-clusters are absent in PAM model. Instead, two new sub-clusters of self-management and valgus with hypomobility were found. Most importantly, the PAM model sorted the signs and symptoms based on their discriminative power and eliminated trivial tests so that the therapist can classify patients more quickly by performing clinically relevant tests. CONCLUSION: The new PAM method can be advantageous for therapists since it defines the importance of signs over symptoms in examination, prioritizes examination tests, and outlines tests with lower discriminative power. In PAM model, patients in the hypermobility and patellar subgroups of MSI model merged into other sub-clusters due to low discriminating power of their characteristics.


Assuntos
Articulação do Joelho , Joelho , Análise por Conglomerados , Estudos Transversais , Humanos , Dor
2.
J Orthop Surg Res ; 17(1): 258, 2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35526039

RESUMO

BACKGROUND: Studies have given some pieces of evidence for the effect of total knee arthroplasty (TKA) on knee proprioception of patients with knee osteoarthritis (KOA), but their results were conflicting. This review was performed to provide an updated evidence-based meta-analysis investigating the influence of TKA on knee proprioception. METHODS: The electronic databases including PubMed, Google Scholar, and the Cochrane Library were accessed from their inception to March 2020. Two reviewers identified the studies that met the selection criteria for this review. Information on study type, participants, follow-up time, and outcome measures was extracted. Methodological quality was independently assessed by two reviewers using the Cochrane Handbook 5.1.0. Eleven studies with 475 participants were included in the meta-analysis. RESULTS: The I2 index assessed the heterogeneity between studies. The results showed that the pooled standard mean difference of mean angle of error was - 0.58° (95% CI - 1 to - 0.16; P = 0.007; I2 = 69%), and the joint position sense of KOA patients was better after TKA surgery than that before surgery. Pooled standard mean difference of displacement of center of pressure (COP) was - 0.39 (95% CI - 0.72 to - 0.06; P = 0.02; I2 = 51%), and KOA patients had better static balance after TKA surgery than before surgery. CONCLUSIONS: To conclude, no standardized comprehensive evaluation protocol presently exists though different assessment tools are available to measure proprioception. Contrasting results were found in the literature since some studies found that TKA improves proprioception in KOA patients, while others found no difference in proprioception. These differences are seen whether the proprioception was assessed by joint position sense (JPS), or it was indirectly assessed by static balance. However, the lack of sufficient data on the threshold to detect passive movement (TTDPM) and dynamic balance made it difficult to draw a conclusion about whether or not the sense of motion improved after surgery. The method for measuring and evaluating knee joint force sense is worth paying attention, which will make progress with knee proprioception on TKA patients.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Humanos , Joelho/cirurgia , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Propriocepção
3.
Sports Med Arthrosc Rev ; 30(2): 102-110, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35533062

RESUMO

Osteoarthritis of the knee generally affects individuals from the fifth decade, the typical age of middle-age athletes. In the early stages, management is conservative and multidisciplinary. It is advisable to avoid sports with high risk of trauma, but it is important that patients continue to be physically active. Conservative management offers several options; however, it is unclear which ones are really useful. This narrative review briefly reports the conservative options for which there is no evidence of effectiveness, or there is only evidence of short-term effectiveness.


Assuntos
Osteoartrite do Joelho , Esportes , Atletas , Humanos , Joelho , Articulação do Joelho , Pessoa de Meia-Idade , Osteoartrite do Joelho/terapia
4.
Magn Reson Imaging Clin N Am ; 30(2): 215-226, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35512886

RESUMO

The posteromedial and posterolateral corners of the knee are important areas to consider when assessing the patient with a possible knee injury. An understanding of the anatomy, associated biomechanics, and typical injury patterns in these regions will improve the value that the radiologist interpreting the MRIs brings to this patient population.


Assuntos
Traumatismos do Joelho , Imageamento por Ressonância Magnética , Fenômenos Biomecânicos , Humanos , Joelho/diagnóstico por imagem , Traumatismos do Joelho/diagnóstico por imagem , Articulação do Joelho/anatomia & histologia , Articulação do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos
5.
Magn Reson Imaging Clin N Am ; 30(2): 325-338, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35512893

RESUMO

Accurate diagnosis and management of pediatric patients undergoing magnetic resonance (MR) imaging necessitates familiarity with the normal changes of skeletal maturation and the spectrum of normal variation seen in children. This article reviews key patterns of normal bone and cartilage development. The most common and important variants of bone, cartilage, and soft tissue structures encountered on pediatric MR studies are discussed. Emphasis is placed on those variants that can be mistaken for pathology and those that may predispose to the development of symptoms.


Assuntos
Articulação do Joelho , Imageamento por Ressonância Magnética , Osso e Ossos , Criança , Humanos , Joelho , Articulação do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Meniscos Tibiais
6.
Magn Reson Imaging Clin N Am ; 30(2): 339-350, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35512894

RESUMO

Intra-articular masses affecting the knee joint are uncommon lesions that encompass a range of neoplastic and nonneoplastic disorders. A joint mass limited to a single articulation is most commonly related to neoplastic or focal proliferative disease, whereas masses affecting multiple articulations are typically caused by underlying inflammatory arthritides, metabolic abnormalities, or systemic deposition disorders. This article focuses on those masses that present in a monoarticular fashion, emphasizing the lesions that most commonly affect the knee joint. MR imaging is the modality of choice for evaluation of knee masses, allowing specific diagnosis in most cases.


Assuntos
Neoplasias , Sinovite Pigmentada Vilonodular , Humanos , Joelho , Articulação do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Sinovite Pigmentada Vilonodular/diagnóstico , Sinovite Pigmentada Vilonodular/patologia
9.
PLoS One ; 17(4): e0266881, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35427407

RESUMO

The purpose of this study was to evaluate the strength of the knee flexors and extensors and hip abductor and adductor muscles in young soccer players. Twenty-three male under-19 soccer players participated in this study (age: 17.7 ± 0.2 years; height: 173.0 ± 1.1 cm; body mass: 66.1 ± 1.3 kg). Body composition was measured using a bioelectrical impedance (InBody770), and the dynamometry was performed by an isokinetic dynamometer (Biodex System 3) for knee flexion and extension, and by an isometric dynamometer (Smart Groin Trainer), for hip adduction and abduction. Comparisons were made between dominant members (D) vs. non-dominant members (ND) and adductors vs. abductors (ADD:ABD) using the Wilcoxon test. There were statistically significant differences in the peak torques between the dominant and non-dominant members in the flexion function (Z = -4.198, p < 0.01) and in the extension function (Z = -4.197, p < 0.01) of the knee in concentric muscular action, and the flexion (Z = -4.198, p < 0.01) and in the extension (Z = -4.198, p < 0.01) of the knee in eccentric muscular action. No statistically significant differences were obtained in the conventional ratio (Z = -0.456, p = 0.648) nor the functional ratio (Z = -0.335, p = 0.738) between D and ND members. There were no statistically significant differences between adductors and abductors at the moment of strength for absolute values (N). The reference absolute and normalized to the weight values and the ADD:ABD can be used as a guideline for classifying players in screening and comparison in return tests to sports practice after an injury.


Assuntos
Futebol , Adolescente , Humanos , Joelho/fisiologia , Articulação do Joelho , Masculino , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Futebol/fisiologia , Torque
10.
Appl Ergon ; 102: 103756, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35413576

RESUMO

OBJECTIVE: Investigate the influence of sex, strength capacity, and relative load mass on low-back exposure and lower extremity joint power generation in backboard lifting. BACKGROUND: Sex and strength have been shown to influence lifting strategy, but without load mass being scaled to strength it is unknown which factor influences low-back exposures, and whether there are interactions with load mass. METHODS: Motion capture and force plate data from 28 participants were collected during backboard lifting at load masses scaled to strength capacity. Differences in normalized peak low-back moment, peak knee-to-hip power magnitude ratio and timing were tested as a function of sex, strength, and load mass. RESULTS: Stronger participants had lower normalized peak low-back moments (average 32% change from low-capacity across all load masses), with no significant sex effect (p = 0.582). As load mass increased, normalized peak low-back moment, peak knee-to-hip power magnitude and synchronicity decreased. CONCLUSION: Training to both increase strength capacity and hip-joint power generation may be a strategy to reduce low-back exposure in backboard lifting.


Assuntos
Dorso , Remoção , Fenômenos Biomecânicos , Humanos , Joelho , Articulação do Joelho
12.
Artigo em Inglês | MEDLINE | ID: mdl-35409635

RESUMO

BACKGROUND: Although a knee valgus position is related to the increase in injury risk in volleyball players, there is a lack of studies on the relationship between knee valgus and vertical jump (VJ) performance. Hence, the aim of this study was to investigate the effects of a postural exercise program on VJ height in young female volleyball players with knee valgus. METHODS: This pilot study included 19 young female volleyball players divided into the following groups: the Valgus Experimental Group (VEG); the Valgus Control Group (VCG); and the Neutral Control Group (NCG). All three groups carried out the same volleyball training program. In addition, only the VEG underwent a 3-month postural exercise program of 30-45 min/session, twice/week. VJ performance was measured through the Sargent test before (T0), at 6 weeks (T1), and at 12 weeks (T2). RESULTS: A significant effect from T0 to T1 (p = 0.0017) and from T0 to T2 (p = 0.0001) was found in the VEG. No significant differences were found over time in the VCG and in the NCG. CONCLUSION: An integrated postural exercise program might lead to a more balanced muscle efficiency inducing athletes to obtain a higher VJ performance.


Assuntos
Voleibol , Exercício Físico/fisiologia , Terapia por Exercício , Feminino , Humanos , Joelho/fisiologia , Força Muscular/fisiologia , Projetos Piloto , Voleibol/fisiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-35409759

RESUMO

(1) Background: The aim of the present study was to evaluate and to detect neuromuscular deficiencies in static and dynamic tests among federated youth basketball players. (2) Methods: Cross-sectional study with 778 basketball players. Specific tests and trials were conducted to evaluate members of teams from several clubs in male and female from under 12 (U12) to under 17 (U17) categories. The evaluations consisted of static physical measurements and dynamic measurements. (3) Results: 575 players were included in this study. A total of 95% of participants are unable to keep their ankle stable in monopodial loading; 86% present dynamic lower extremity valgus with statistically significant differences between categories (p = 0.004); 94% are unable to keep the pelvis stable when performing a single-leg squat; 93% are unable to keep their trunk stable when performing the same movement. During landing, 96% present dynamic lower extremity valgus. The thighs of 92% do not reach parallel (peak of jump). (4) Conclusions: The most frequent neuromuscular deficits in federated youth basketball players are related to instability, the most frequent being ankle instability, followed by lumbo-pelvic instability, dynamic postural instability and dynamic knee valgus. Deficits in jumping/landing technique are also very frequent in all the items analyzed (jumping, landing and plyometrics). The performed tests, which mostly showed a poor performance by the sample, can be indicative of injury probability.


Assuntos
Basquetebol , Adolescente , Fenômenos Biomecânicos , Estudos Transversais , Feminino , Humanos , Joelho , Articulação do Joelho , Masculino
14.
J Healthc Eng ; 2022: 2550120, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35444781

RESUMO

In recent times, knee joint pains have become severe enough to make daily tasks difficult. Knee osteoarthritis is a type of arthritis and a leading cause of disability worldwide. The middle of the knee contains a vital portion, the anterior cruciate ligament (ACL). It is necessary to diagnose the ACL ruptured tears early to avoid surgery. The study aimed to perform a comparative analysis of machine learning models to identify the condition of three ACL tears. In contrast to previous studies, this study also considers imbalanced data distributions as machine learning techniques struggle to deal with this problem. The paper applied and analyzed four machine learning classification models, namely, random forest (RF), categorical boosting (Cat Boost), light gradient boosting machines (LGBM), and highly randomized classifier (ETC) on the balanced, structured dataset of ACL. After oversampling a hyperparameter adjustment, the above four models have achieved an average accuracy of 95.72%, 94.98%, 94.98%, and 98.26%. There are 2070 observations and eight features in the collection of three diagnosis ACL classes after oversampling. The area under curve value was approximately 0.998, respectively. Experiments were performed using twelve machine learning algorithms with imbalanced and balanced datasets. However, the accuracy of the imbalanced dataset has remained under 76% for all twelve models. After oversampling, the proposed model may contribute to the investigation of ACL tears on magnetic resonance imaging and other knee ligaments efficiently and automatically without involving radiologists.


Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Humanos , Joelho/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Aprendizado de Máquina , Imageamento por Ressonância Magnética/métodos
15.
BMC Musculoskelet Disord ; 23(1): 331, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35395841

RESUMO

BACKGROUND: Risk for non-contact anterior cruciate ligament (ACL) injury can be assessed based on drop vertical jump (DVJ). However, biomechanics of DVJ may differ with various sporting activities. The purpose of the present study was to clarify whether biomechanical features of DVJ are different among various sporting activities in female athletes. METHODS: A total of 42 female athletes, including 25 basketball, 8 soccer and 9 volleyball players, participated in the current investigation. DVJ was done for each female athlete using a three-dimensional motion analysis system which consisted of six cameras, two force plates and 46 retro-reflective markers. Kinematic and kinetic data were recorded for both limbs in each athlete. Simultaneously, frontal and sagittal plane views of the DVJ were recorded using two different high-resolution video cameras to evaluate Landing Error Scoring System (LESS) score. Three-dimensional biomechanical parameters at the knee joint and LESS were compared among three different sporting activities using ANOVA or Kruskal-Wallis test after confirming normality assumption. Thereafter post hoc Tukey or Steel-Dwass was utilized for multiple comparison. RESULTS: Soccer players had better LESS score, and peak knee flexion angle was significantly larger in soccer players compared to the other sports. In addition, knee abduction angle at initial contact (IC), peak knee abduction angle, knee internal rotation angle, and knee abduction moment within 40 ms from IC were significantly smaller in soccer players, compared to basketball players. In terms of volleyball players, knee abduction angle at IC and knee internal rotation angle at IC were significantly larger than soccer players, whereas no significant biomechanical differences were found between basketball and volleyball players. CONCLUSIONS: From the present study, female basketball and volleyball players have worse LESS score, smaller peak knee flexion angle, greater knee abduction angle at IC and greater knee internal rotation angle at IC, compared to female soccer players. Thus, female basketball and volleyball players may have an increased risk of non-contact ACL injury during the jump-landing task, compared to soccer players. Biomechanics of DVJ depends on characteristics of the athlete's primary sport.


Assuntos
Lesões do Ligamento Cruzado Anterior , Basquetebol , Futebol , Atletas , Basquetebol/lesões , Fenômenos Biomecânicos , Feminino , Humanos , Joelho , Articulação do Joelho , Futebol/lesões
17.
J Biomech ; 136: 111074, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35413514

RESUMO

This short communication provides details on customized Tekscan Analysis Programs (TAP) which extract comprehensive contact mechanics metrics from piezoelectric sensors in articulating joints across repeated loading cycles. The code provides functionality to identify regions of interest (ROI), compute contact mechanic metrics, and compare contact mechanics across multiple test conditions or knees. Further, the variability of identifying ROIs was quantified between seven different users and compared to an expert. Overall, the contribution of four variables were studied: two knee specimens; two points in the gait cycle; two averaging methods; and seven observers, to determine if variations in these values played a role in accurately quantifying the ROI. The relative error between the force ratio from each observer's ROI and the expert ROI was calculated as the output of interest. A multivariate linear mixed effects model was fit to the four variables for the relative error with an observer- and knee-specific random intercept. Results from the fitted model showed a statistically significant difference at the 0.05 level in the mean relative errors at the two gait points. Additionally, variability in the relative errors attributed to the observer, knee, and random errors was quantified. To reduce variability amongst users, by ensuring low inter-observer variability and increasing segmentation accuracy of knee contact mechanics, a training module and manual have been included as supplemental material. By sharing this code and training manual, we envisage that it can be used and modified to analyze outputs from a range of sensors, joints, and test conditions.


Assuntos
Marcha , Articulação do Joelho , Fenômenos Biomecânicos , Cadáver , Humanos , Joelho
18.
Artigo em Inglês | MEDLINE | ID: mdl-35457540

RESUMO

This study aimed to: (1) determine the magnitude and direction of lateral asymmetry in well-trained soccer players using hip and knee ROM tests; (2) inquire if asymmetry relies on the ROM test performed and/or gender; and (3) establish asymmetry thresholds for each ROM test to individualize lower-limbs asymmetry. One hundred amateur soccer players were assessed using hip-knee ROM tests: Straight Leg Raise, modified Thomas Test, hip internal rotation and external rotation, hip abduction (ABD) and adduction (ADD), Nachlas Test and Rigde Test. There are significant differences between tests when determining the magnitude of lateral asymmetry (F = 3.451; p = 0.001; ηp2 = 0.031) without significant differences between gender (F = 0.204; p = 0.651; ηp2 = 0.001). Asymmetry threshold results differ significantly between using a fixed or a specific threshold (F = 65.966; p = 0.001; ηp2 = 0.985). All tests indicate that the direction of asymmetry is towards the dominant limb. In conclusion, the ROM test used determines the magnitude and direction of the lateral asymmetry of the amateur soccer players. The ABD and ADD are the ROM tests that showed higher percentages of asymmetry, without differences between female and male soccer players. Using a specific asymmetry threshold formula can classify more players as asymmetrical than with a fixed threshold.


Assuntos
Futebol , Feminino , Humanos , Joelho , Articulação do Joelho , Extremidade Inferior , Masculino , Amplitude de Movimento Articular
19.
Gait Posture ; 94: 153-159, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35334335

RESUMO

BACKGROUND: The sit-to-stand test (STS) is commonly used to evaluate functional capabilities within a variety of clinical populations. Traditionally STS is a timed test, limiting the depth of information which can be gained from its evaluation. The Azure Kinect has the potential to add in-depth analysis to STS. Despite these potential benefits, the recently released (2019) Azure Kinect has yet to be evaluated for its ability to accurately assess STS. RESEARCH QUESTIONS: Purposes of this work were to compare data captured during STS using both a 12 camera Vicon motion capture system and the Azure Kinect; and to calculate kinematic and spatiotemporal variables related to the four phases of the STS cycle. METHODS: Spatiotemporal and kinematic measures for STS were simultaneously collected by both devices for 15 participants. Cycle waveforms were compared for right and left hip and knee flexion/extension angular displacement, right and left hip and knee flexion/extension angular velocity, and knee-to-ankle separation ratio. Evaluated discrete outcome variables included: phase time points, maximum knee extension velocity from phases 3 to 4, medial-lateral pelvic sway range, and total time to completion. Waveform summary data were compared using R, R2, and RMSE. Discrete variables were analyzed using Spearman's Rank correlation coefficient. RESULTS: R and R2 values between the two systems indicated high levels of correlation (all R values > 0.711, all R2 values > 0.660). Although there was an overall high level of agreement between waveform shapes, high RMSE values indicated some minor tracking errors for Kinect within the STS cycle. Spearman's Rank correlation coefficient indicated high levels of correlation between the systems for discrete variables (all R values > 0.89), with the exception of medial-lateral pelvic sway range. SIGNIFICANCE: The Azure Kinect provides valuable insight into STS movement strategies allowing for improved precision in clinical decision making across multiple clinical populations.


Assuntos
Articulação do Joelho , Movimento , Fenômenos Biomecânicos , Humanos , Joelho , Movimento (Física)
20.
Eur J Radiol ; 150: 110249, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35338955

RESUMO

PURPOSE: To externally validate an artificial intelligence (AI) tool for radiographic knee osteoarthritis severity classification on a clinical dataset. METHOD: This retrospective, consecutive patient sample, external validation study used weight-bearing, non-fixed-flexion posterior-anterior knee radiographs from a clinical production PACS. The index test was ordinal Kellgren-Lawrence grading by an AI tool, two musculoskeletal radiology consultants, two reporting technologists, and two resident radiologists. Grading was repeated by all readers after at least four weeks. Reference test was the consensus of the two consultants. The primary outcome was quadratic weighted kappa. Secondary outcomes were ordinal weighted accuracy, multiclass accuracy and F1-score. RESULTS: 50 consecutive patients between September 24, 2019 and October 22, 2019 were retrospectively included (3 excluded) totaling 99 knees (1 excluded). Quadratic weighted kappa for the AI tool and the consultant consensus was 0.88 CI95% (0.82-0.92). Agreement between the consultants was 0.89 CI95% (0.85-0.93). Intra-rater agreements for the consultants were 0.96 CI95% (0.94-0.98) and 0.94 CI95% (0.91-0.96) respectively. For the AI tool it was 1 CI95% (1-1). For the AI tool, ordinal weighted accuracy was 97.8% CI95% (96.9-98.6 %). Average multiclass accuracy and F1-score were 84% (83/99) CI95% (77-91%) and 0.67 CI95% (0.51-0.81). CONCLUSIONS: The AI tool achieved the same good-to-excellent agreement with the radiology consultant consensus for radiographic knee osteoarthritis severity classification as the consultants did with each other.


Assuntos
Osteoartrite do Joelho , Inteligência Artificial , Humanos , Joelho , Osteoartrite do Joelho/diagnóstico por imagem , Radiografia , Estudos Retrospectivos
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