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1.
Appl Ergon ; 98: 103581, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34592635

RESUMO

The number of older adults unable to transfer or ambulate independently is increasing. High support chairs enable people experiencing loss of mobility to be mobile, but current chair designs are associated with global functional loss and pressure ulcers. This pilot study compared the functionality of a traditional design high support chair to a new design of motorised high support chair: 1) a motion laboratory study compared joint angles and pressure at the hip, knee, ankle, elbow and spine when pushing each chair, and 2) a pressure mapping study compared the interface pressure when older people with limited mobility used the chairs. Significant reduction in joint angles for the person pushing the chair (degree difference range -3.6 to 14.2) and decreased seated pressure (w/kg difference range -0.2 to 2.1) for the seated user were identified for the motorised chair. Longitudinal investigations are required to determine if the significant differences identified in this pilot study result in less manual handling injuries and pressure areas.


Assuntos
Postura , Coluna Vertebral , Idoso , Humanos , Joelho , Articulação do Joelho , Projetos Piloto
2.
Appl Ergon ; 98: 103553, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34428619

RESUMO

This study assessed the influence of different types of flooring on infants' crawling motion patterns and performance. Each participating infant (range: 8.7-12.4 months) was encouraged to crawl on a tatami mat made of woven straw as well as other flooring types such as hardwood, carpet, and joint mat. Material tests were conducted to quantify the friction and shock absorption of the flooring. A three-dimensional motion capture system was used to measure spatiotemporal and kinematic variables during hands-and-knees crawling. An increased crawling rate was associated with a faster cadence of cyclic arm movements, but not with crawling stride length. Hardwood flooring had a significantly lower crawling rate and longer duration of hand-floor contact than tatami, while the crawling stride length and range of motion of joint movements were hardly affected by flooring type. The results of this study suggest a drawback of hardwood flooring in terms of infants' effective quadrupedal locomotion.


Assuntos
Pisos e Cobertura de Pisos , Mãos , Fenômenos Biomecânicos , Humanos , Lactente , Joelho , Locomoção , Movimento
3.
Phys Ther Sport ; 52: 297-304, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34742028

RESUMO

OBJECTIVE: To compare lower limb strength and countermovement jump (CMJ) kinetics between elite female footballers with and without a history of anterior cruciate ligament reconstruction (ACLR), hamstring strain, or hip/groin injury. DESIGN: Cross-sectional. SETTING: Field-based. PARTICIPANTS: 369 elite female Australian football, soccer and rugby league players aged 15-35. MAIN OUTCOME MEASURES: Isometric hip adductor and abductor strength, eccentric knee flexor strength, and CMJ vertical ground reaction forces, including between-leg asymmetry. Players reported their lifetime history of ACLR, and whether they had sustained a hamstring strain, or hip/groin injury in the previous 12-months. RESULTS: Players with a unilateral history of ACLR (n = 24) had significant between-leg asymmetry in eccentric knee flexor strength (mean = -6.3%, 95%CI = -8.7 to -3.9%, P < .001), isometric hip abductor strength (mean = -2.5%, 95%CI = -4.3 to -0.7%, P = .008), and CMJ peak landing force (mean = -5.5%, 95%CI = -10.9 to -0.1%, P = .046). Together, between-leg asymmetry in eccentric knee flexor strength, isometric hip abductor strength, and CMJ peak landing force distinguished between players with and without prior ACLR with 93% accuracy. CONCLUSION: Elite female footballers with a history of ACLR, but not hamstring or hip/groin injury, exhibit persistent between-leg asymmetries in lower limb strength and jump kinetics following a return to sport.


Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior , Austrália , Estudos Transversais , Feminino , Virilha , Humanos , Cinética , Joelho , Força Muscular
4.
Artigo em Inglês | MEDLINE | ID: mdl-34770202

RESUMO

BACKGROUND: The present study analyzes the associations between the muscle contractile properties (MCP) measured at different neuromuscular electrical stimulation amplitudes (NMESa) and the performance or transient fatigue after a bout of repeated sprints. METHODS: Seventeen physically active male subjects performed six repeated sprints of 30 m with 30 s of passive recovery. Capillary blood creatine kinase (CK) concentration, knee extension or flexion isometric peak torque, tensiomyography, and repeated sprint performance were assessed. RESULTS: Muscle displacement and contraction time were different in relation to the NMESa used in the rectus femoris and biceps femoris muscles. At rest, significant (p < 0.05) associations were found between muscle displacement and the loss of time in the repeated sprints (sprint performance) at 20 or 40 mA in the rectus femoris. At post +24 h or +48 h, the highest significant associations were found between the muscle displacement or the contraction time and CK or peak torques also at submaximal amplitudes (20 mA). The NMESa which elicits the peak muscle displacement showed lack of practical significance. CONCLUSION: Although MCP are typically assessed in tensiomyography using the NMESa that elicit peak muscle displacement, a submaximal NMESa may have a higher potential practical application to assess neuromuscular fatigue in response to repeated sprints.


Assuntos
Fadiga Muscular , Músculo Esquelético , Eletromiografia , Humanos , Joelho , Masculino , Contração Muscular , Torque
5.
BMJ Case Rep ; 14(11)2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789531

RESUMO

Charcot's joint is a type of neuro-arthropathy, where asymmetrical damage of the involved joint happens haphazardly, without following any described pattern. We present a rare case of Charcot's joint involving the knee joint in an adult male following spina bifida. His knee joint was successfully fused after two surgeries. Later, he sustained a fracture through the arthrodesis after a fall, which we managed surgically. The fracture through the knee arthrodesis was managed surgically by an open reduction and internal fixation, using a 14-hole broad low contact dynamic compression locking plate with bone grafting. Union was achieved at the knee arthrodesis site in 6 months. Fracture through a fused knee requires surgical management. Re-arthrodesis was done using a stable fixation. Postoperative rehabilitation should include protected weight bearing with braces and splints until a sound bony union is achieved.


Assuntos
Artropatia Neurogênica , Fraturas Ósseas , Adulto , Artrodese , Artropatia Neurogênica/diagnóstico por imagem , Artropatia Neurogênica/etiologia , Artropatia Neurogênica/cirurgia , Humanos , Joelho , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino
6.
BMC Musculoskelet Disord ; 22(1): 966, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34798859

RESUMO

BACKGROUND: Although knee extensors are essential in daily activities (e.g. walking, climbing stairs), knee extensor strength is often not measured in clinical settings. Existing devices to test muscle strength are not always suitable to accurately measure the high forces of this muscle group. Therefore, a device to test muscle strength that is convenient, feasible, reliable, and valid in clinical settings is required. This study evaluated the reliability, responsiveness, and level of discomfort of the newly developed Q-Force ӀӀ (i.e. a portable device to measure isometric knee extensor strength) in healthy middle-aged and elderly adults. METHODS: Participants (n = 22) conducted two standardized test sessions on the Q-Force ӀӀ (five to ten days apart). Each session consisted of one familiarisation trial followed by three trials of peak isometric knee extension per each leg. Per trial, peak and mean knee extension force (N) and torque (Nm) were measured at 90° flexion. The level of discomfort was determined using a visual analog scale (VAS: 0-100). Intra Class Correlation (ICC, model: two-way mixed with absolute agreement), Standard Error of Measurement (SEM), and minimal detectable change (MDC) were determined. A repeated measures ANOVA was used to determine between-test variation. RESULTS: Excellent test-retest (ICC > 0.95) and inter-trial (ICC > 0.91) reliability for both legs were shown. No significant differences were found in peak and mean knee forces and torques between test and retest of both legs, indicating good test-retest reliability (P-value range: 0.360-0.538; F(1,21) range: 0.4-0.9). The SEM of the peak and mean forces and torques ranged from 28.0 to 30.4 N (6.0-6.8%) and from 9.2 to 10.4 Nm (6.4-7.7%), respectively. The MDC for these outcomes ranged respectively from 77.6 to 84.1 N (16.5-18.8%) and from 25.5 to 28.9 Nm (17.6-21.4%). The level of discomfort was low (median range: 7-10, IQR: 4-18). CONCLUSION: The portable Q-Force ӀӀ is a comfortable, responsive, and relatively cheap device with excellent test-retest reliability. This device would be potentially suitable to measure isometric knee extensor strength in clinical settings.


Assuntos
Contração Isométrica , Força Muscular , Adulto , Idoso , Humanos , Joelho , Pessoa de Meia-Idade , Dinamômetro de Força Muscular , Reprodutibilidade dos Testes
7.
Sensors (Basel) ; 21(19)2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34640935

RESUMO

The relationship between motor unit (MU) firing behavior and the severity of neurodegeneration in Parkinson's disease (PD) is not clear. This study aimed to elucidate the association between degeneration with dopaminergic pathways and MU firing behavior in people with PD. Fourteen females with PD (age, 72.6 ± 7.2 years, disease duration, 3.5 ± 2.1 years) were enrolled in this study. All participants performed a submaximal, isometric knee extension ramp-up contraction from 0% to 80% of their maximal voluntary contraction strength. We used high-density surface electromyography with 64 electrodes to record the muscle activity of the vastus lateralis muscle and decomposed the signals with the convolution kernel compensation technique to extract the signals of individual MUs. We calculated the degree of degeneration of the central lesion-specific binding ratio by dopamine transporter single-photon emission computed tomography. The primary, novel results were as follows: (1) moderate-to-strong correlations were observed between the degree of degeneration of the central lesion and MU firing behavior; (2) a moderate correlation was observed between clinical measures of disease severity and MU firing behavior; and (3) the methods of predicting central nervous system degeneration from MU firing behavior abnormalities had a high detection accuracy with an area under the curve >0.83. These findings suggest that abnormalities in MU activity can be used to predict central nervous system degeneration following PD.


Assuntos
Doença de Parkinson , Idoso , Eletromiografia , Feminino , Humanos , Contração Isométrica , Joelho , Músculo Quadríceps
8.
Biomed Res Int ; 2021: 2624860, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34692828

RESUMO

Background: People with multiple sclerosis (MS) suffer from symptoms related to neural control, such as reduced central activation, lower muscle activity, and accentuated spasticity. A forced 9-week home confinement related to COVID-19 in Spain may have worsened these symptoms. However, no study has demonstrated the impact of home confinement on neuromuscular mechanisms in the MS population. This study was aimed at analyzing the effects of a 9-week home confinement on central activation, muscle activity, contractile function, and spasticity in MS patients. Methods: Eighteen participants were enrolled in the study. Left and right knee extensor maximum voluntary isometric contraction (MVIC), maximal neural drive via peak surface electromyography (EMG) of the vastus lateralis, central activation ratio (CAR), and muscle contractile function via electrical stimulation of the knee extensor muscles, as well as spasticity using the pendulum test, were measured immediately before and after home confinement. Results: Seventeen participants completed the study. CAR significantly decreased after lockdown (ES = 1.271, p < 0.001). Regarding spasticity, there was a trend to decrease in the number of oscillations (ES = 0.511, p = 0.059) and a significant decrease in the duration of oscillations (ES = 0.568, p = 0.038). Furthermore, in the left leg, there was a significant decrease in the first swing excursion (ES = 0.612, p = 0.027) and in the relaxation index (ES = 0.992, p = 0.001). Muscle contractile properties, MVIC, and EMG variables were not modified after confinement. Conclusions: The results suggest that a home confinement period of 9 weeks may lead to an increase in lower limb spasticity and a greater deficit in voluntary activation of the knee extensors.


Assuntos
COVID-19 , Esclerose Múltipla/fisiopatologia , Músculo Esquelético/fisiopatologia , Controle de Doenças Transmissíveis , Estimulação Elétrica , Eletromiografia , Feminino , Humanos , Contração Isométrica , Joelho/fisiologia , Masculino , Pessoa de Meia-Idade , Contração Muscular , Espasticidade Muscular , Músculo Esquelético/fisiologia , Músculo Quadríceps/fisiologia
9.
J Sports Med Phys Fitness ; 61(10): 1333-1338, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34652086

RESUMO

BACKGROUND: The aim of the study is to compare a 16-week tai chi and Iyengar yoga program effects on muscle strength, static and dynamic balance, and balance confidence in elderly people. METHODS: A total of 48 participants (≥60 years old) without mobility-impairing neurological disease, dementia, cardiovascular disease/symptoms during moderate exercise, poorly controlled hypertension, or balance-impairing drug use. Participants were divided into a tai chi group, an Iyengar yoga group, and a control group (eight males and eight females per group), using a restricted randomization scheme generated by software. While the former two undertook 16-week exercise programs, the control group received general education. Maximum concentric strength was measured with an isokinetic dynamometer. The one-legged stand with eyes closed, "8 feet up and go," and Activities-specific Balance Confidence (ABC) scale were used to assess static balance, dynamic balance, and balance confidence in daily activities, respectively. RESULTS: Both programs improved all measures significantly with tai chi being more effective for increasing knee flexor strength (P=0.045) and extensor strength (P=0.032) and ABC score (P=0.034); Iyengar yoga was more effective for improving static balance (P=0.014) and dynamic balance (P=0.025; all P values here vs. the other program). CONCLUSIONS: Tai chi and Iyengar yoga can improve strength, balance, and balance confidence among older people. Both are suitable exercise choices for older adults.


Assuntos
Tai Ji , Ioga , Idoso , Feminino , Humanos , Joelho , Masculino , Pessoa de Meia-Idade , Força Muscular , Equilíbrio Postural
10.
Nutrients ; 13(10)2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34684661

RESUMO

Patients with multiple sclerosis (MS) are characterized by, among other symptoms, impaired functional capacity and walking difficulties. Polyunsaturated fatty acids (PUFAs) have been found to improve MS patients' clinical outcomes; however, their effect on other parameters associated with daily living activities need further investigation. The current study aimed to examine the effect of a 24-month supplementation with a cocktail dietary supplement formula, the NeuroaspisTM PLP10, containing specific omega-3 and omega-6 PUFAs and specific antioxidant vitamins on gait and functional capacity parameters of patients with MS. Fifty-one relapsing-remitting MS (RRMS) patients with low disability scores (age: 38.4 ± 7.1 years; 30 female) were randomized 1:1 to receive either a 20 mL daily dose of the dietary formula containing a mixture of omega-3 and omega-6 PUFAs (12,150 mg), vitamin A (0.6 mg), vitamin E (22 mg), and γ-tocopherol (760 mg), the OMEGA group (n = 27; age: 39 ± 8.3 years), or 20 mL placebo containing virgin olive oil, the placebo group (n = 24; age: 37.8 ± 5.3 years). The mean ± SD (standard deviation) Expanded Disability Status Scale (EDSS) score for the placebo group was 2.36 and for the OMEGA group 2.22. All enrolled patients in the study were on Interferon-ß treatment. Spatiotemporal gait parameters and gait deviation index (GDI) were assessed using a motion capture system. Functional capacity was examined using various functional tests such as the six-minute walk test (6MWT), two sit-to-stand tests (STS-5 and STS-60), and the Timed Up and Go test (TUG). Isometric handgrip strength was assessed by a dynamometer. Leg strength was assessed using an isokinetic dynamometer. All assessments were performed at baseline and at 12 and 24 months of supplementation. A total of 36 patients completed the study (18 from each group). Six patients from the placebo group and 9 patients from the OMEGA group dropped out from the study or were lost to follow-up. The dietary supplement significantly improved the single support time and the step and stride time (p < 0.05), both spatiotemporal gait parameters. In addition, while GDI of the placebo group decreased by about 10% at 24 months, it increased by about 4% in the OMEGA group (p < 0.05). Moreover, performance in the STS-60 test improved in the OMEGA group (p < 0.05) and there was a tendency for improvement in the 6MWT and TUG tests. Long-term supplementation with high dosages of omega-3 and omega-6 PUFAs (compared to previous published clinical studies using PUFAs) and specific antioxidant vitamins improved some functional capacity and gait parameters in RRMS patients.


Assuntos
Antioxidantes/farmacologia , Ácidos Graxos Ômega-3/farmacologia , Ácidos Graxos Ômega-6/farmacologia , Marcha/fisiologia , Esclerose Múltipla Recidivante-Remitente/fisiopatologia , Vitaminas/farmacologia , Adulto , Composição Corporal/efeitos dos fármacos , Feminino , Marcha/efeitos dos fármacos , Força da Mão , Humanos , Joelho/fisiopatologia , Masculino , Fatores de Tempo
11.
Am J Sports Med ; 49(13): 3561-3568, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34612705

RESUMO

BACKGROUND: Patient-reported outcomes (PROs) measure progression and quality of care. While legacy PROs such as the International Knee Documentation Committee (IKDC) survey are well-validated, a lengthy PRO creates a time burden on patients, decreasing adherence. In recent years, PROs such as the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function and Pain Interference surveys were developed as computer adaptive tests, reducing time to completion. Previous studies have examined correlation between legacy PROs and PROMIS; however, no studies have developed effective prediction models utilizing PROMIS to create an IKDC index. While the IKDC is the standard knee PRO, computer adaptive PROs offer numerous practical advantages. PURPOSE: To develop a nonlinear predictive model utilizing PROMIS Physical Function and Pain Interference to estimate IKDC survey scores and examine algorithm sensitivity and validity. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: The MOTION (Military Orthopaedics Tracking Injuries and Outcomes Network) database is a prospectively collected repository of PROs and intraoperative variables. Patients undergoing knee surgery completed the IKDC and PROMIS surveys at varying time points. Nonlinear multivariable predictive models using Gaussian and beta distributions were created to establish an IKDC index score, which was then validated using leave-one-out techniques and minimal clinically important difference analysis. RESULTS: A total of 1011 patients completed the IKDC and PROMIS Physical Function and Pain Interference, providing 1618 complete observations. The algorithms for the Gaussian and beta distribution were validated to predict the IKDC (Pearson = 0.84-0.86; R2 = 0.71-0.74; root mean square error = 9.3-10.0). CONCLUSION: The publicly available predictive models can approximate the IKDC score. The results can be used to compare PROMIS Physical Function and Pain Interference against historical IKDC scores by creating an IKDC index score. Serial use of the IKDC index allows for a lower minimal clinically important difference than the conventional IKDC. PROMIS can be substituted to reduce patient burden, increase completion rates, and produce orthopaedic-specific survey analogs.


Assuntos
Traumatismos do Joelho , Estudos de Coortes , Documentação , Humanos , Joelho , Traumatismos do Joelho/cirurgia , Medidas de Resultados Relatados pelo Paciente
12.
Artigo em Inglês | MEDLINE | ID: mdl-34605774

RESUMO

OBJECTIVES: To determine the location and stage of the tibial nailing procedure where infrapatellar saphenous nerve (IPSN) injury may occur. METHODS: Fourteen fresh-frozen right cadaveric knees underwent tibial nailing. Six knees underwent a suprapatellar approach and 8 a medial parapatellar approach. Two proximal medial-to-lateral screws were placed using the aiming guide. The incisions were then closed. After the procedure, medial retinacular and saphenous nerves were dissected under surgical 2.5× loupe magnification from a proximal to distal direction. The branch of the IPSN closest to the locking screws was measured, as was the distance between the IPSN branch and the inferior pole of the patella. RESULTS: Twelve of 14 cadavers had prominent IPSN (main branch from the saphenous proper) with an average of 2.5 sub-branches. The mean (SD) distance from the main branch of the IPSN to the inferior pole of the patella was 40.9 (24.4) mm. Four medial retinacular nerve branches, branching from the femoral nerve and not IPSN, were identified proximal to the patella during the medial parapatellar approach. All were cut after the medial parapatellar arthrotomy. The mean (SD) distance from the IPSN to the nearest locking screw was 10.2 (14.1) mm. Seven of 14 had IPSN injuries, and one had hamstring injury. Two direct screw entrapments occurred, whereas two IPSNs were lacerated by the incision. Suture closure entrapped three nerve branches, and one specimen had injured fibers of the hamstring tendinous insertion. CONCLUSIONS: Injury to the IPSN can occur at different locations and stages of tibial nailing, including approach, proximal locking screw insertion, and closure.


Assuntos
Fixação Intramedular de Fraturas , Humanos , Joelho , Articulação do Joelho , Patela/cirurgia , Tíbia/cirurgia
13.
Nat Med ; 27(10): 1783-1788, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34635852

RESUMO

Above-knee amputation severely reduces the mobility and quality of life of millions of individuals. Walking with available leg prostheses is highly inefficient, and poor walking economy is a major problem limiting mobility. Here we show that an autonomous powered hip exoskeleton assisting the residual limb significantly improves metabolic walking economy by 15.6 ± 2.9% (mean ± s.e.m.; two-tailed paired t-test, P = 0.002) in six individuals with above-knee amputation walking on a treadmill. The observed metabolic cost improvement is equivalent to removing a 12-kg backpack from a nonamputee individual. All participants were able to walk overground with the exoskeleton, including starting and stopping, without notable changes in gait balance or stability. This study shows that assistance of the user's residual limb with a powered hip exoskeleton is a viable solution for improving amputee walking economy. By significantly reducing the metabolic cost of walking, the proposed hip exoskeleton may have a considerable positive impact on mobility, improving the quality of life of individuals with above-knee amputations.


Assuntos
Amputados/reabilitação , Exoesqueleto Energizado , Próteses e Implantes , Caminhada/fisiologia , Adulto , Amputação/tendências , Fenômenos Biomecânicos , Extremidades/fisiopatologia , Extremidades/cirurgia , Feminino , Marcha/fisiologia , Quadril/fisiopatologia , Quadril/cirurgia , Humanos , Joelho/fisiopatologia , Joelho/cirurgia , Masculino , Qualidade de Vida
14.
Nutrients ; 13(10)2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34684368

RESUMO

The present study uniquely examined the effect of 3 mg·kg-1 chronic caffeine consumption on training adaptations induced by 7-weeks resistance training and assessed the potential for habituation to caffeine's ergogenicity. Thirty non-specifically resistance-trained university standard male rugby union players (age (years): 20 ± 2; height (cm): 181 ± 7; body mass (kg): 92 ± 17) completed the study), who were moderate habitual caffeine consumers (118 ± 110 mg), completed the study. Using a within-subject double-blind, placebo-controlled experimental design, the acute effects of caffeine intake on upper and lower limb maximal voluntary concentric and eccentric torque were measured using isokinetic dynamometry (IKD) prior to and immediately following a resistance training intervention. Participants were split into strength-matched groups and completed a resistance-training program for seven weeks, consuming either caffeine or a placebo before each session. Irrespective of group, acute caffeine consumption improved peak eccentric torque of the elbow extensors (p < 0.013), peak concentric torque of the elbow flexors (p < 0.005), total eccentric work of the elbow flexors (p < 0.003), total concentric work of the knee extensors (p < 0.001), and total concentric and eccentric work of the knee flexors (p < 0.046) following repeated maximal voluntary contractions. Many of these acute caffeine effects were still prevalent following chronic exposure to caffeine throughout the intervention. The training intervention resulted in significant improvements in upper and lower body one-repetition maximum strength (p < 0.001). For the most part, the effect of the training intervention was equivalent in both the caffeine and placebo groups, despite a small but significant increase (p < 0.037) in the total work performed in the participants that consumed caffeine across the course of the intervention. These results infer that caffeine may be beneficial to evoke acute improvements in muscular strength, with acute effects prevalent following chronic exposure to the experimental dose. However, individuals that consumed caffeine during the intervention did not elicit superior post-intervention training- induced adaptations in muscular strength.


Assuntos
Cafeína/farmacologia , Suplementos Nutricionais , Futebol Americano , Treinamento de Força , Nível de Alerta , Cotovelo/fisiologia , Humanos , Joelho/fisiologia , Masculino , Esforço Físico/fisiologia , Placebos , Amplitude de Movimento Articular/fisiologia , Torque , Adulto Jovem
15.
Medicine (Baltimore) ; 100(37): e27183, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664844

RESUMO

ABSTRACT: The aim of this study was to identify genes and functional pathways associated with damaged cartilage tissues of knee using microarray analysis.The gene expression profile GSE129147 including including 10 knee cartilage tissues from damaged side and 10 knee nonweight-bearing healthy cartilage was downloaded and bioinformatics analysis was made.A total of 182 differentially-expressed genes including 123 up-regulated and 59 down-regulated genes were identified from the GSE129147 dataset. Gene ontology and pathway enrichment analysis confirmed that extracellular matrix organization, collagen catabolic process, antigen processing and presentation of peptide or polysaccharide antigen, and endocytic vesicle membrane were strongly associated with cartilage injury. Furthermore, 10 hub differentially-expressed genes with a higher connectivity degree in protein-protein interactions network were found such as POSTN, FBN1, LOX, insulin-like growth factor binding proteins3, C3AR1, MMP2, ITGAM, CDKN2A, COL1A1, COL5A1.These hub genes and pathways provide a new perspective for revealing the potential pathological mechanisms and therapy strategy of cartilage injury.


Assuntos
Cartilagem/lesões , Joelho/anormalidades , Biomarcadores/análise , Cartilagem/patologia , Biologia Computacional/métodos , Humanos , Joelho/fisiopatologia , Análise Serial de Tecidos/métodos
16.
Medicina UPB ; 40(2): 33-40, 13 oct. 2021. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1342178

RESUMO

Objetivo: caracterizar desde el punto de vista microbiológico las infecciones periprotesicas (IP) de los pacientes sometidos a remplazo articular de rodilla o cadera, en la IPS universitaria Clínica León XIII, y evidenciar los patrones más comunes de resistencia a los antibióticos, en el periodo 2015-2018. Metodología: se recolectó información de 25 pacientes llevados a remplazo articular de rodilla o cadera en la IPS universitaria, sede Clínica León XIII, durante el periodo de 2015-2018, que desarrollaron IP. Se obtuvo información sobre características demográfica, clínicas y patrones de resistencia (según antibiograma), y sobre los criterios usados para diagnosticarla. Los datos se registraron, según la naturaleza y distribución de la variable, en medias o medianas para las variables cuantitativas, y en frecuencias para las cualitativas. Resultados: entre 2015 y 2018 se realizaron 541 remplazos articulares, la incidencia de infección periprotésica fue de 4.6% (25 pacientes), 22 casos (88%) con crecimiento microbiológico. El germen más frecuente fue el S. aureus, con patrón alto de resistencia para meticilina (SAMR), en el 44%. Seguido por K. pneumoniae, con un patrón de resistencia por producción de betalactamasas de espectro extendido (BLEE) de 83%. Ninguno tuvo resistencia a los carbapenémicos. Conclusiones: los resultados son similares a los reportados en la literatura internacional. Sigue siendo el S. aureus el principal causante de la infección periprotésica, seguido de los gérmenes gram negativos.


Objective: to microbiologically characterize the periprosthetic infections (PI) of patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIIIin the period 2015-2018, and to demonstrate the most common antibiotic resistance patterns. Methodology: the information was collected from 25 patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIII during the period 2015-2018 who developed PI. Data was obtained on demographic, clinical characteristics, and antibiotic resistance patterns (according to antibiograms), as well as on the diagnostic criteria used to diagnose it. The data was recorded, according to the nature and distribution of the variable, in means or medians for the quantitative variables, and in frequencies for the qualitative variables.Results:between 2015-2018, 541 joint replacements were performed. There was an incidence of periprosthetic infection in 25 patients (4.6%), 22 of whom (88%) had micro-biological growth. The most frequent germ was S. aureus, which had a high resistance pattern for methicillin-resistant S. aureus (MRSA) in 44%, followed by K. pneumoniaewith a positive extended spectrum beta-lactamase (ESBL) in 83%. None of them showed resistance to carbapenems.Conclusions: the results found are similar to those reported in the international lite-rature. This investigation evidenced that S. aureus continues to be the main cause of periprosthetic infection, followed by gram-negative germs.


Objetivo: caracterizar do ponto de vista microbiológico as infecções periprotéticas (IP) dos pacientes submetidos à artroplastia articular do joelho ou do quadril, na IPS universitário, Clínica León XIII, e demonstrar os padrões mais comuns de resistência aos antibióticos, em o período 2015-2018.Metodologia: foram coletadas informações de 25 pacientes encaminhados para prótese de joelho ou quadril no IPS universitário, sede da Clínica León XIII, no período 2015-2018, que desenvolveram IP. Foram obtidas informações sobre as características demográfi-cas, clínicas e padrões de resistência (de acordo com antibiograma) e sobre os critérios usados para diagnosticá-la. Os dados foram registrados, de acordo com a natureza e distribuição da variável, em médias ou medianas para as variáveis quantitativas e em frequências para as qualitativas.Resultados: entre 2015 e 2018, foram realizadas 541 substituições articulares, a incidência de infecção periprotética foi de 4,6% (25 pacientes), 22 casos (88%) com crescimento microbiológico. O germe mais frequente foi S. aureus, com alto padrão de resistência à meticilina (MRSA), em 44%. Seguido por K. pneumoniae, com padrão de resistência devido à produção de beta-lactamase de espectro estendido (ESBL) de 83%. Nenhum apresentou resistência aos carbapenêmicos.Conclusões: os resultados são semelhantes aos relatados na literatura internacional. S. aureus continua a ser a principal causa de infecção periprotética, seguido por germes gram-negativos.


Assuntos
Humanos , Próteses e Implantes , Resistência Microbiana a Medicamentos , Staphylococcus aureus Resistente à Meticilina , Articulação do Quadril , Infecções , Articulações , Joelho , Antibacterianos
17.
BMC Musculoskelet Disord ; 22(1): 829, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579696

RESUMO

BACKGROUND: In aging, muscle stiffness is considered as one of the factors associated with the reduction of force generation capability. There have been inconsistent findings on age-related alteration in the passive stiffness of quadriceps muscle in the female adults. Thus, the aim of this study was to determine the effect of aging on the shear moduli of the superficial muscle heads of the quadriceps and to explore its relationship with knee extension force. METHODS: Passive shear moduli of the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) were measured at rest using shear wave elastography in 20 young and 20 senior female adults. Measurements were repeated at four knee joint positions, that is, 30°, 60°, 90°, and 105° of knee flexion. Maximal isometric voluntary knee extension force was assessed at 30°, 60°, and 90° of knee flexion. RESULTS: As per our findings, senior adults were determined to have significantly higher passive muscle shear moduli in the RF (by 34% - 68%; all p < 0.05) and the VL muscle heads (by 13%-16%, all p < 0.05) at and beyond 60° of knee flexion. Age-related increase in the VM was evident at 105° knee flexion (by11%, p = 0.020). The RF shear modulus was negatively correlated to the maximal isometric voluntary contraction force measured at 60° (r = - 0.485, p = 0.030) in senior adults. CONCLUSIONS: Senior female adults had greater passive stiffness at the superficial muscle heads of the quadriceps muscles when measured at long muscle length. Among the senior female adults, the passive stiffness of RF has been determined to have a negative association with the knee extensor force only at 60° knee flexion. No significant association was noted for other angles and muscles.


Assuntos
Contração Isométrica , Músculo Quadríceps , Adulto , Eletromiografia , Feminino , Humanos , Joelho , Articulação do Joelho/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Músculo Quadríceps/diagnóstico por imagem , Torque
18.
BMC Musculoskelet Disord ; 22(1): 827, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579703

RESUMO

BACKGROUND: Identifying populations with poor muscle recovery after total hip arthroplasty (THA) is important for postoperative physical therapy. Preoperative muscle strength is a strong factor that determines postoperative muscle strength. However, this effect may depend on other factors. Thus, predictive models with interaction terms are important for accurately predicting postoperative muscle strength. This study aimed to develop a predictive model for lower muscle strength 12 months after THA which incorporates interaction terms. METHODS: Subjects were female patients with hip osteoarthritis who underwent unilateral THA. Patients with locomotor disorders, neurological disorders, or postoperative complications were excluded. Hip abductor and knee extensor strength were measured, and a generalized linear model approach with preoperative muscle strength, age, body weight, height, disease duration, physical activity, and leg extension as explanatory variables was used to identify factors that determine muscle strength 12 months after THA. Models with interaction terms between preoperative muscle strength and other explanatory variables were also examined. RESULTS: A total of 82 patients were analyzed. Preoperative muscle strength, age, body weight, physical activity, and disease duration were extracted as factors that significantly and independently determine hip abductor and knee extensor strength. The interaction term between preoperative muscle strength and age was identified as a factor that significantly determines knee extensor strength. Regression coefficients for preoperative knee extensor strength and postoperative muscle strength were significant when age was +1 SD, but not when age was -1 SD. CONCLUSIONS: The predictive model demonstrated that lower muscle strength 12 months after THA is determined by preoperative muscle strength, age, weight, physical activity, disease duration, and preoperative muscle strength, with the effect of preoperative muscle strength on knee extensor strength being dependent on age. When predicting postoperative knee extensor strength using preoperative muscle strength, it is important to consider the effect of age.


Assuntos
Artroplastia de Quadril , Osteoartrite do Quadril , Artroplastia de Quadril/efeitos adversos , Feminino , Humanos , Lactente , Joelho , Articulação do Joelho , Força Muscular , Osteoartrite do Quadril/cirurgia
19.
Biomed Res Int ; 2021: 3454475, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34527735

RESUMO

We analyzed tunnel length, graft bending angle, and stress of the graft according to tunnel entry position and aspect ratio (ASR: ratio of anteroposterior depth to mediolateral width) of the articular surface for the distal femur during single-bundle outside-in anterior cruciate ligament reconstruction (ACLR) surgery. We performed multiflexible body dynamic analyses with four ASR (98, 105, 111, and 117%) knee models. The various ASRs were associated with approximately 1 mm changes in tunnel length. The graft bending angle increased when the entry point was far from the lateral epicondyle and was larger when the ASR was smaller. The graft was at maximum stress, 117% ASR, when the tunnel entry point was near the lateral epicondyle. The maximum stress value at a 5 mm distance from the lateral epicondyle was 3.5 times higher than the 15 mm entry position, and the cases set to 111% and 105% ASR showed 1.9 times higher stress values when at a 5 mm distance compared with a 15 mm distance. In the case set at 98% ASR, the low-stress value showed a without-distance difference from the lateral epicondyle. Our results suggest that there is no relationship between the ASR and femoral tunnel length. A smaller ASR causes a higher graft bending angle, and a larger ASR causes greater stress in the graft.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirurgia , Articulação do Joelho/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Fenômenos Biomecânicos , Bases de Dados Factuais , Fêmur/cirurgia , Humanos , Imageamento Tridimensional/métodos , Joelho/cirurgia , Tomografia Computadorizada por Raios X/métodos
20.
Ned Tijdschr Geneeskd ; 1652021 09 08.
Artigo em Holandês | MEDLINE | ID: mdl-34523844

RESUMO

A 14-year-old adolescent presented with pain in his left knee for two years, without an evident cause. MRI showed a typical soft-tissue lesion. Arthroscopic removal was performed. Pathology confirmed the diagnosis of a focal pigmentedvillonodularsynovitis.


Assuntos
Articulação do Joelho , Joelho , Adolescente , Artroscopia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética , Dor/etiologia
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