32 research outputs found
Stili di personalità, preoccupazioni principali e credenze patogene: una ricerca italiana sulla validazione empirica delle diagnosi di personalità per adulti del PDM
No full textHigher Body Mass Index Adversely Affects Knee Function After Anterior Cruciate Ligament Reconstruction in Individuals Who Are Recreationally Active
No full textObjective: Our aim was to investigate the effect of body mass index (BMI) levels on quadriceps and hamstring strength and functional outcomes up to 6 months after anterior cruciate ligament reconstruction (ACLR) with hamstring tendon autograft (HTG). Design: Prospective, controlled study. Setting: University clinical laboratory. Patients: Ninety-one participants who had undergone unilateral ACLR with HTG were divided into 2 groups according to their BMI. The participants whose BMI were between 18.5 and 24.9 kg/m(2) were included in group 1 (n = 50, age: 27.2 +/- 6.7 years, BMI: 22.3 +/- 1.6 kg/m(2)) and those whose BMI > 24.9 kg/m(2) were included in group 2 (n = 41, age: 30.2 +/- 6.9 years, BMI: 28.0 +/- 2.4 kg/m(2)). Interventions: Quadriceps and hamstring strength, functional performance including hop, jump, and balance performance, and IKDC score. Main Outcome Measures: Maximum voluntary isometric contraction of the quadriceps and hamstring muscles and the body mass were measured at 1, 3, and 6 months after surgery. Absolute peak torques and normalized peak torques to body weight for both limbs were recorded. Functional outcomes were evaluated at 6 months after surgery. Results: Normalized quadriceps strength improvement was lower in group 2 when compared with group 1 (F-(2,F-178) = 6.23, P = 0.003). Group 2 also demonstrated lower scores in functional performance (P 0.05). Conclusions: Higher BMI levels adversely affect quadriceps strength capacity and performance in patients who have undergone ACLR with HTG. Clinicians should consider BMI levels of patients when assessing and targeting muscle recovery because it could negatively affect the success of the ACLR rehabilitation
Comparing Responsiveness of Six Common Patient-Reported Outcomes to Changes Following Autologous Chondrocyte Implantation: A Systematic Review and Meta-Analysis of Prospective Studies
No full textObjective: To compare the responsiveness of six common patient-reported outcomes (PROs) following autologous chondrocyte implantation (ACI). Design: A systematic search was conducted to identify reports of PROs following ACI. Study quality was evaluated using the modified Coleman Methodology Score (mCMS). For each outcome score, pre- to postoperative paired Hedge\u27s g effect sizes were calculated with 95% confidence intervals (CIs). Random effects meta-analyses were performed to provide a summary response for each PRO at time points (TP) I (\u3c1 year), II (1 year to \u3c2 years), III (2 years to \u3c4 years), IV (\u3e= 4 years), and overall. Results: The mean mCMS for the 42 articles included was 50.9 +/- 9.2. For all evaluated instruments, none of the mean effect size CIs encompassed zero. The International Knee Documentation Committee Subjective Knee Form (IKDC) had increasing responsiveness over time with TP-IV, demonstrating greater mean effect size [confidence interval] (1.78 [1.33, 2.24]) than TP-I (0.88 [0.69, 1.07]). The Knee Injury and Osteoarthritis Outcome Score-Sports and recreation subscale (KOOS-Sports) was more responsive at TP-III (1.76 [0.87, 2.64]) and TP-IV (0.98 [0.81, 1.15]) than TP-I (0.61 [0.44, 0.78]). Overall, the Medical Outcomes Study 36-Item Short Form Health Survey Physical Component Scale (0.60 [0.46, 0.74]) was least responsive. Both the Lysholm Scale (1.42 [1.14, 1.72]) and the IKDC (1.37 [1.13, 1.62]) appear more responsive than the KOOS-Sports (0.90 [0.73, 1.07]). All other KOOS subscales had overall effect sizes ranging from 0.90 (0.74, 1.22) (Symptoms) to 1.15 (0.76, 1.54) (Quality of Life). Conclusions: All instruments were responsive to improvements in function following ACI. The Lysholm and IKDC were the most responsive instruments across time. IKDC and KOOS-Sports may be more responsive to long-term outcomes, especially among active individuals
Effects of 2 Ankle Fatigue Models on the Duration of Postural Stability Dysfunction
No full textCONTEXT: Muscle fatigue is generally categorized in 2 ways: that caused by peripheral weakness (peripheral fatigue) and that caused by a progressive failure of voluntary neural drive (central fatigue). Numerous variables have been studied in conjunction with fatigue protocols, including postural stability, maximum voluntary contraction force, and reaction time. When torque recordings fall below 50% of a maximum voluntary contraction, the muscle is described as fatigued, but whether this value is a good indicator of fatigue has not been studied.
OBJECTIVE: To compare the effects of 2 ankle musculature fatigue protocols (30% and 50%) on the duration of postural stability dysfunction.
DESIGN: To assess differences between the 30% and 50% fatigue protocols, we calculated a 1 between-groups factor (subjects) and 2 within-groups factors (fatigue, test) analysis of variance.
SETTING: E.J. Nutter Athletic Training Facility.
PATIENTS OR OTHER PARTICIPANTS: Twenty subjects (10 men, 10 women; age = 21.15 +/- 2.23 years; height = 172.97 +/- 9.86 cm; mass = 70.62 +/- 14.60 kg) volunteered for this study. Subjects had no history of lower extremity injury, vestibular or balance disorders, functional ankle instability, or head injury in the past 6 months.
INTERVENTION(S): On separate days, subjects performed isokinetic fatiguing contractions of the plantar flexors and dorsiflexors in a 30% protocol (70% decrease in strength) and a 50% protocol (50% decrease in strength).
MAIN OUTCOME MEASURE(S): Baseline and postfatigue postural stability scores were determined before and after the isokinetic fatiguing contractions. Plantar-flexion peak-torque measurements were obtained for the 2 fatiguing protocols. Three prefatigue and 12 postfatigue postural stability trials were recorded. Velocities for testing were 60 degrees /s for plantar flexion and 120 degrees /s for dorsiflexion.
RESULTS: Sway velocity was significantly greater when the ankle was fatigued to 30% (1.56 degrees /s) than in the 50% condition (1.36 degrees /s). For the 30% protocol, sway was significantly impaired when the pretest condition (1.19 degrees /s) was compared with posttest trial 1 (2.34 degrees /s), trial 2 (2.37 degrees /s), and trial 3 (1.71 degrees /s). For the 50% protocol, sway was significantly impaired when the pretest condition (1.27 degrees /s) was compared with posttest trial 1 (2.02 degrees /s).
CONCLUSIONS: The 30% fatigue protocol resulted in significantly longer impairment of postural stability than the 50% protocol. Because the 30% protocol resulted in a greater effect but was relatively short-lived (approximately 75 to 90 s), it is more useful for research purposes
Comparison of Transcutaneous Electrical Nerve Stimulation and Cryotherapy for Increasing Quadriceps Activation in Patients With Knee Pathologies
No full textProper neuromuscular activation of the quadriceps muscle is essential for maintaining quadriceps strength and lower extremity function. Quadriceps activation failure is a common characteristic observed in patients with knee pathologies, and it is defined as an inability to voluntarily activate the entire alpha motor neuron pool innervating the quadriceps. One of the more popular techniques used to assess quadriceps activation is the superimposed burst (SIB) technique. The SIB technique is a force-based technique which uses a supramaximal, percutaneous electrical stimulation to activate all of the motor units in the quadriceps during a maximal, voluntary isometric contraction of the quadriceps. Central activation ratio (CAR) is the formula used to calculate quadriceps activation level (CAR = voluntary force/SIB force) with the SIB technique. People who can voluntary active 95% or more (CAR = 0.95 - 1.0) of their motor units are defined as being fully activated. Therapeutic exercises aimed at improving quadriceps strength in patients with knee pathologies are limited in their effectiveness due to a failure to fully activate the muscle. Within the past decade, several disinhibitory interventions have been introduced to treat quadriceps activation failure in patients with knee pathologies. Transcutaneous electrical nerve stimulation (TENS) and cryotherapy are sensory-targeted modalities traditionally used to treat pain, but they have been shown to be two of the most successful treatments for increasing quadriceps activation levels in patients with quadriceps activation failure. Both modalities are hypothesized to positively affect voluntary quadriceps activation by disinhibiting the motor neuron pool of the quadriceps. In essence, these modalities provide excitatory afferent stimuli to the spinal cord, which thereby overrides the inhibitory afferent signaling that arises from the involved joint.6 However, it remains unknown as to whether one is more effective than the other for restoring quadriceps activation levels in patients with knee pathologies. By knowing the capabilities of each disinhibitory modality, clinicians can tailor treatments based on the rehabilitation goals of their patients
Reliability and Minimal Detectable Change of Serum Cartilage Oligomeric Matrix Protein in an Athletic Population
No full textUse of Response Shift to Improve Agreement between Patient-Reported and Performance-Based Outcomes in Knee Patients
No full textThe purpose of this study was to determine whether the implementation of performance-based tasks (PBTs) prior to completion of patient-reported outcome measures (PROs) would create a change, or a response shift, in PROs in patients with knee injuries. A randomized controlled trial was implemented to examine the effectiveness of a response-shift based interventions to enhance the correlation between PBTs and PROs. Participants (n=20) were knee-injured patients who were removed from activity for a minimum of 1-week. Participants were randomly assigned to complete PBTs (intervention) or to watch videos detailing an injury prevention program (control). The International Knee Documentation Committee Subjective Form (IKDC) and the Knee Injury and Osteoarthritis Outcome Score Recreational and Sports Subscale (KOOSsports) were completed both pre- and post-testing. The independent variable was Group. Dependent variables included raw change scores and absolute change scores on the IKDC and KOOSsports. Mann-Whitney U tests were used to examine between Group differences. Changes in PRO scores were not considered statistically significant or clinically meaningful (IKDC Raw p = 0.14, Absolute p = 0.74; KOOSsports Raw p = 0.85 Absolute p = 0.32). Implementation of PBTs prior to PROs did not induce a response shift. PROs may better evaluate symptoms and/or confidence in a patient, while PBTs evaluate physical function
Effects of Cool-Water Immersion and High-Voltage Electric Stimulation for 3 Continuous Hours on Acute Edema in Rats.
No full textOBJECTIVE: Cool-water immersion (CWI) at 12.8 degrees C (55 degrees F), cathodal high-voltage pulsed current (CHVPC) at 120 pulses per second and 90% of visible motor threshold, or the combination of CWI and CHVPC, applied 30 minutes on, 30 minutes off for 4 hours, are known to curb edema formation after blunt trauma to the hind limbs of rats. Our purpose was to examine the effects of extending treatment times to 3 continuous hours after blunt trauma to the hind limbs of rats.
DESIGN AND SETTING: A randomized, parallel-groups design of 22 subjects was used. Volumes of traumatized limbs, randomly assigned to CWI (n = 7), CHVPC (n = 8), or CWI followed by CHVPC (n = 7) were compared with those of injured but untreated limbs with analysis of variance. SUBJECTS: Twenty-two anesthetized Zucker lean rats (mass = 293 +/- 27 g).
MEASUREMENTS: We measured limb volumes immediately before and after trauma and every 30 minutes over the 4-hour experiment.
RESULTS: Volumes of treated limbs of all 3 experimental groups were smaller than those of untreated limbs (P \u3c .05). No treatment was more effective than another.
CONCLUSIONS: Exposure to either 3 hours of CWI or CHVPC or to 1 hour of CWI followed by 2 hours of CHVPC effectively curbed edema after blunt injury. These results suggest that these common treatments are effective only during application and hint that application should be maintained throughout the period during which edema is forming
Serum Cartilage Oligomeric Matrix Protein Levels in Collegiate Soccer Athletes over the Duration of an Athletic Season: A Pilot Study
No full textOBJECTIVE: The primary objective of this study was to measure serum cartilage oligomeric matrix protein (sCOMP) levels weekly in a group of collegiate soccer athletes over the duration of a spring soccer season and 2 weeks following the conclusion of the season while documenting minutes of exercise participation as a measure of exercise intensity.
DESIGN: A repeated-measures study design was employed. A volunteer sample of 6 female soccer athletes participated in this study. Serum samples were collected on 10 separate occasions, 1 week prior to the start of the season (baseline), once a week during the 8-week season (PX1-PX8), and once a week for 2 weeks following the conclusion of the season (postseason; PS1 and PS2). Minutes of participation were documented following all spring soccer activities for each week. Once all samples were collected, sCOMP concentrations were determined using a commercially available enzyme-linked immunosorbent assay.
RESULTS: The results of Friedman test revealed a significant effect for time (P = 0.003). Post hoc analysis revealed no significant differences between baseline and practice or postseason levels. A qualitative analysis of the sCOMP levels and minutes indicated higher sCOMP levels occurred when the athletes\u27 participation in soccer-related activities was higher.
CONCLUSIONS: Qualitatively, our findings suggest that as minutes of participation increased, sCOMP levels increased. However, no statistically significant differences were identified. We speculate these increases were an increase in cartilage turnover and an interesting observation related to increases in physical activity. However, the implications are unclear as there was a return to near baseline levels
Determination of the Interday and Intraday Reliability of Serum Cartilage Oligomeric Matrix Protein in a Physically Active Population
No full textOBJECTIVE: To determine the intraday and interday reliability of serum cartilage oligomeric matrix protein (sCOMP) in a physically active population with no history of lower extremity surgery.
DESIGN: A repeated-measures reliability study was employed to determine the intraday and interday reliability of sCOMP in a physically active cohort. A total of 23 subjects were recruited to the laboratory on 3 separate occasions for nonfasting serum collection. Subjects had no history of lower extremity surgery and were free from acute injury within the last 3 months.
RESULTS: Our results indicate strong reliability for both intraday intraclass correlation coefficient (ICC) (0.76) and interday ICC (0.74) sCOMP values.
CONCLUSION: Our results demonstrate that following 30 minutes of inactivity, nonfasting serum samples remain stable over the course of 1 day and between 2 consecutive days in a healthy population with no history of lower extremity surgery. Future research studies are needed to further investigate the magnitude of change in this biomarker for patients with acute articular cartilage damage to determine its appropriateness for use in this population and for varying degrees of articular cartilage severity
