Musculoskeletal Regeneration, Rehabilitation, and Plasticity Following Traumatic Injury

2020 ◽  
Vol 41 (08) ◽  
pp. 495-504
Author(s):  
Sarah M. Greising ◽  
Benjamin T. Corona ◽  
Jarrod A. Call

AbstractThe musculoskeletal system has an integral role throughout life, including structural support to the body, protection, and allowing a range of fine to complex movements for daily living to elite sporting events. At various times, injuries to the musculoskeletal system occur resulting in varying levels of impact to the person both acutely and chronically. Specifically, there is a spectrum of complexity in orthopedic injuries, with some such as common muscle strains, that while burdensome will have no impact on life-long functional ability, and others that can result in long lasting disability. Focusing on extremity injuries, this review highlights: i)the current impact of orthopedic injuries in sport and daily life; ii) the foundation of bone and skeletal muscle repair and regeneration; and iii) the disruptions in regenerative healing due to traumatic orthopedic injuries. This review seeks to maximize the broad and collective research impact on sport and traumatic orthopedic injuries in search of promoting ongoing innovation for treatment and rehabilitation approaches aimed to improve musculoskeletal health throughout life.

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.


2020 ◽  
Author(s):  
Taner Sahin ◽  
Sabri Batin

Abstract Background During parachute jumping in soldiers, minör or life-threatining majör injuries may be occur in various parts of the body. Various trauma scoring systems have been developed to determine the severity of these injuries. The aim of this study is to determine orthopedic injuries and other injuries due to parachute jumping for military training who admitted to ED and the severity of their injuries using by anatomical and physiological trauma scores (AIS and ISS), to examine applied treatment methods, their hospitalization conditions and the length of hospital stay prospectively over a 44-month period between January 2016 and August 2019. Methods 200 military personnel were included in the study, between the ages of 18-52, who were injured as a result of daytime static parachute jumping for military training. Demographic data such as age, gender, ISS trauma region classification, anatomical injury sites, AIS and ISS scores, diagnosis, treatment methods applied, hospitalization status and duration of hospitalization were examined prospectively in a total of 185 patients. Results Among 184 individuals included in the study, 184 were male and 1 was female. The most common injured body site were 33.5% foot. and the most common diagnosis was 64.3% soft tissue trauma. Considering the treatment methods applied, 51.4% was determined as medication cold application, 42.7% as splint plaster, and 5.9% as surgery. The mean ISS of the patients was 5.16 ± 3.92. The hospitalization rate of patients with a critical AIS score was significantly higher than those with a severe AIS score (p <0.001). Conclusions The use of trauma scoring systems in determining the severity of injury to patients who come to ED due to parachute injury may facilitate treatment selection. Key words: Parachuting injuries, Abbreviated Injury Scale ve Injury Severity Score


Morphologia ◽  
2021 ◽  
Vol 15 (3) ◽  
pp. 175-179
Author(s):  
I.V. Chelpanova ◽  
O.Z. Masna-Chala ◽  
A.M. Yashchenko ◽  
Z.Z. Masna ◽  
Kh.I. Rudnytska

Background. The problem of restoration the integrity of the dentition after tooth loss remains one of the most problematic dental issues. Мodern dental technologies open a promising direction in its solution, in particular - the method of dental implantation. Objective. The aim of our work was to study the changes that occur in the bone tissue of the mandible after implantation of titanium foam and to determine the effect of shock wave therapy (SWT) on its structure restoration. Methods. The study was performed on 15 adult rabbits aged 6-7 months, weighing 2.5-3 kg. The animals from the experimental groups were implanted with titanium pin, 3 mm long. The pin was implanted under combined anesthesia bilaterally into the body of the mandible. One day after the operation, the animals received SWT 500 pulses with a frequency of 5 Hz and a maximum pressure at the wavefront of 1.2 Bar per implantation site using the device Storz Medical Master Plus MP 100. The animals were removed from the experiment on 15-th day, after which the mandible was disarticulated and radiographically performed. The obtained results were statistically significant. The differences at p<0.05 were considered significant. Results. The results showed that the bone tissue of the jaws during implantation undergoes traumatic injury, the results of which, two weeks after surgery on radiographs we can clearly see a violation of the bone tissue structure and a significant increase in its density. Using the SWT method, we obtained a positive dynamics of bone density after titanium pin implantation and slight Rh-changes in bone structure compared with normal. Conclusion. Аfter implantation with titanium pin the bone density of the rabbit lower jaw body is significantly reduced, X-ray shows the heterogeneity of bone structure, areas of sclerosis are expressed. Shock wave therapy helps to restore the quality of bone tissue, this is confirmed by the fact that the density indicators are close to the norm and X-ray shows some separate small areas of restructuring of bone tissue heterogeneity, mainly due to merging the pattern of the bone trabeculae of the bone cancellous part.


2021 ◽  
pp. 63-74
Author(s):  
E. V. Basieva ◽  
Yu. A. Milutka ◽  
N. A. Tarasov ◽  
A. V. Silin ◽  
D. E. Mokhov

Introduction. The influence of the dental apparatus on the balance of the body in an upright position has been widely discussed in the literature for several decades. Examination of the patient taking into account his postural balance makes it possible to clarify the reasons for the low effectiveness of pain syndromes treatment of the craniocervical region caused by malocclusion, as well as ineffective correction of musculoskeletal dysfunction of the temporomandibular joint (MSD TMJ) associated with posture disorders.The aim of the study is to evaluate the effectiveness of treatment of patients with dental anomalies and musculoskeletal dysfunctions of the temporomandibular joint and concomitant somatic dysfunctions (if any) by methods of orthodontic and osteopathic correction.Materials and methods. The study involved 102 patients aged from 18 to 45 years with TMJ. All patients underwent orthodontic and osteopathic examination. 3 groups of patients were formed: № 1 — exclusively with dental anomalies TMJ (occlusive dysfunction), who received only orthodontic treatment, № 2 with concomitant somatic (extra-occlusive) dysfunctions, who received only orthodontic treatment, and №3 with concomitant somatic (extra-occlusive) dysfunctions, who received both orthodontic and osteopathic treatment. Orthodontic treatment of musculoskeletal dysfunction of the TMJ consisted of the occlusive kappa manufacturing. Osteopathic correction was carried out individually, taking into account the identified somatic dysfunctions, on average 3 sessions. Patients also received drug therapy, and they performed myohymnastics for the masticatory muscles. The clinical dysfunction index (Helkimo M.) was used to control the elimination dynamics of the TMJ's musculoskeletal dysfunction symptoms. The assessment of the pain dynamics in the TMJ was carried out by a visual-analog scale (VAS). The evaluation of the osteopathic treatment effectiveness was carried out on the basis of computer stabilometry data and osteopathic examination data. A stabilometric study was performed on the «ST-150» («Biomera») stabiloplatform in the Romberg sample (European foot installation) with open and closed eyes in two positions of the lower jaw: 1) in a state of physiological rest (tooth rows are separated); 2) in the kappa with closed tooth rows.Results. The MSD TMJ symptoms were eliminated 10 weeks after the start of treatment in all (100 %) patients of group № 1 and group № 3. Among the patients in group № 2, only 12,1 % of patients had complete absence of MSD TMJ symptoms, while all patients in this group had a statistically significant decrease in the clinical index of Helkimo dysfunction. In one third of the group № 2 patients on the 12th week of orthodontic treatment, headaches and/or pains in other parts of the musculoskeletal system (neck, back, shoulders, arms) prevailed among complaints and which were previously indicated in the anamnesis. This occurred after the elimination of the MSD TMJ symptoms. The absolute majority of patients in group № 3 (97,1 %) noted the complete disappearance of headaches and/or pains in other parts of the musculoskeletal system (neck, back, shoulders, arms). Also, in patients of this group, stabilometric indicators were normalized in a state of physiological rest and in the kappa.Conclusion. Patients with somatic dysfunctions need complex treatment with the participation of an osteopath and a dentist. When assessing the osteopathic status of a patient, it is important to determine whether the patient has only occlusive dysfunctions or there are also extra-occlusive ones. Additional osteopathic correction is recommended for patients with extraocclusive dysfunctions in order to achieve treatment results comparable in effectiveness and timing.


2013 ◽  
Vol 9 (2) ◽  
Author(s):  
Tia Dafnos

Front-line police operations are deeply entwined with less visible activities &ndash; or practices not commonly identified as policing &ndash; that are carried out by a wide range of participants as strategies of settler-colonial pacification operating through the organizing logics of security and liberal legalism. Using open source texts and records obtained through access to information requests, this article unmaps some of the contemporary strategies employed by Canadian institutions to pacify Indigenous resistance. As a contribution to the body of work seeking to develop the politics of anti-security, the analysis disrupts the binary categories that animate security logic by examining the public order policing approach of the Ontario Provincial Police, the framing of Indigenous resistance as a security threat, and the integral role of Indian Affairs in securing the settler-state.


2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Martina Steinmaurer ◽  
Blanche Cupido ◽  
Matthew Hannington ◽  
Rodgers Manganyi

Abstract Background Right ventricular aneurysms (RVAs) are rare. We present a case with a combined RVA and right ventricular pericardial fistula resulting in a pericardial effusion and cardiac tamponade. The RVA was detected 47 days after the patient suffered a gunshot wound. This report adds to the body of scarce literature on RVA aetiology, diagnoses, and treatment. Case summary A 30-year-old male patient presented with worsening respiratory distress over a 7-day period with clinical signs of cardiac tamponade following a history of a gunshot (with associated liver laceration, pulmonary embolism, right nephrectomy, and sepsis) 47 days prior. Transthoracic echocardiography showed a large circumferential pericardial effusion and an RVA. The patient was emergently taken for surgical repair of the RVA. Discussion Our case presents a delayed presentation of a gunshot heart and an aetiology with indications of and against a true aneurysm. It brings attention to possible complications of penetrating precordial injuries, with the need for consideration and possible evaluation at follow-up. The literature on the operative excision of RVA is reviewed and various aetiological factors and consequences are discussed.


2016 ◽  
Vol 33 (2) ◽  
pp. 142-159 ◽  
Author(s):  
David Bamford ◽  
Benjamin Dehe

Purpose – The purpose of this paper is to report on aspects of service quality at the London 2012 Paralympic Games, from a rather unusual perspective, the athletes. To date there has been little evidence captured about athlete’s satisfaction at sporting events, and specifically about their perceptions of the service quality provided. Design/methodology/approach – Unique “full” access to the London 2012 Paralympics allowed to the collection of data directly from the athletes. The study reports the questionnaire findings from a sample of 250 respondents. Findings – From this study an operational assessment and performance framework has been generated composed of ten criteria and 73 items or sub-criteria, which can be used as a benchmarking tool to plane, design and compare future sport mega-event. Moreover, the study evidence based the high quality of the 2012 Paralympics Games, as he athletes rated, on a five point Likert scale, 64 items in the “very satisfied” category, a very positive set of feedback for the Games organisers. Research limitations/implications – The methodology applied was appropriate, generating data to facilitate discussion and draw specific conclusions from. A perceived limitation is the single case approach; however, this can be enough to add to the body of knowledge where very little evidence has been captured so far and where the objectives were to explore the Paralympics games service quality and performance. Practical implications – This research provides a tangible evidence base to support future sport event decision makers, planners and designers in this highly complex “arena”. In any system there are always areas for improvement, these are highlighted within the paper for further investigation. Originality/value – This is the first paper to identify and synthesize aspects of sport mega event service quality from the athletes viewpoint and informs how well designed, organised and managed the London 2012 Games were from a primary user perspective. The paper makes a defined contribution by developing evidence based recommendations for this important yet under researched area.


2007 ◽  
Vol 362 (1484) ◽  
pp. 1437-1443 ◽  
Author(s):  
Adrian H Chester ◽  
Patricia M Taylor

The cells that reside within valve cusps play an integral role in the durability and function of heart valves. There are principally two types of cells found in cusp tissue: the endothelial cells that cover the surface of the cusps and the interstitial cells (ICs) that form a network within the extracellular matrix (ECM) within the body of the cusp. Both cell types exhibit unique functions that are unlike those of other endothelial and ICs found throughout the body. The valve ICs express a complex pattern of cell-surface, cytoskeletal and muscle proteins. They are able to bind to, and communicate with, each other and the ECM. The endothelial cells on the outflow and inflow surfaces of the valve differ from one another. Their individual characteristics and functions reflect the fact that they are exposed to separate patterns of flow and pressure. In addition to providing a structural role in the valve, it is now known that the biological function of valve cells is important in maintaining the integrity of the cusps and the optimum function of the valve. In response to inappropriate stimuli, valve interstitial and endothelial cells may also participate in processes that lead to valve degeneration and calcification. Understanding the complex biology of valve interstitial and endothelial cells is an important requirement in elucidating the mechanisms that regulate valve function in health and disease, as well as setting a benchmark for the function of cells that may be used to tissue engineer a heart valve.


Author(s):  
Svitlana Тymchik ◽  
Оleksandr Bryksin ◽  
Eugenia Omelyanchuk

In the modern world with the advent of devices that facilitate work (computer, technical equipment) has decreased sharply motor activity of people compared to previous decades. This, in the end, leads to a decrease in human functionality, as well as various diseases. Today, purely physical work does not play a significant role, it is replaced by mental. Intellectual work dramatically reduces the efficiency of the body. Lack of human energy expenditure leads to inconsistencies in the functioning of individual systems (muscular, skeletal, respiratory, cardiovascular) and the body as a whole with the environment, as well as reduced immunity and impaired metabolism. Exercise affects all muscle groups, joints, ligaments, which become strong, increase muscle volume, elasticity, strength and rate of contraction. Increased muscle activity forces the heart, lungs and other organs and systems of our body to work with additional load, thereby increasing the functional capabilities of man, his resistance to adverse environmental influences. Regular exercise primarily affects the musculoskeletal system, muscles. When you exercise, the muscles generate heat, to which the body responds by increased sweating. During exercise, blood flow increases: the blood brings oxygen and nutrients to the muscles, which in the process of life break down, releasing energy. When movements in the muscles additionally open reserve capillaries, the amount of circulating blood increases significantly, which causes an improvement in metabolism. In response to the reaction of the human body to exercise, the first place is occupied by the influence of the cerebral cortex on the regulation of the functions of the basic systems: there is a change in the cardiorespiratory system, gas exchange, metabolism, and others. Exercises enhance the functional restructuring of all parts of the musculoskeletal system, cardiovascular and other systems, improve tissue metabolism. Under the influence of moderate physical activity increases the efficiency of the heart, hemoglobin and red blood cell count, increases the phagocytic function of the blood. Improves the function and structure of the internal organs, improves chemical processing and promotion of food in the intestine. The combined activity of muscles and internal organs is regulated by the nervous system, the function of which is also improved by regular exercise. If the muscles do not work - their nutrition deteriorates, volume and strength decrease, elasticity and resilience decrease, they become weak, sluggish. Restrictions in movement (hypodynamia), passive lifestyle lead to various pre-pathological and pathological changes in the human body. So, the American doctors, having deprived volunteers of movements by imposing of high plaster and having kept to them a normal diet, were convinced that in 40 days at them muscle atrophy began and fat has accumulated. At the same time increased the reactivity of the cardiovascular system and decreased basal metabolism. However, during the next 4 weeks, when the subjects began to move actively (with the same diet), the above phenomena were eliminated, the muscles were strengthened and hypertrophied. Thus, due to physical exertion, recovery was possible both in functional and structural terms. Exercise has a multifaceted effect on the human body, increasing its resistance to adverse environmental influences. For example, physically trained people have better tolerance to oxygen starvation than untrained people. High ability to work at increase of body temperature over 38 ° C during physical exertions is noted. It has been noticed that radiologists who exercise have a lower degree of influence of penetrating radiation on the morphological composition of the blood. Animal experiments have shown that regular muscle training slows the development of malignant tumors. Regular exercise in physical education promotes good health and affects the various physiological adaptations of the neuromuscular, cardiovascular and respiratory systems of the human body. Types of physical activities are considered: aerobic, anaerobic, interval and hypoxic physical activities.


On the basis of a systematic analysis of the scientific literature, it was found that the increased sensitivity of a modern human being to the negative effects of the cold natural environment is due to its passage from the shrouds of East Africa with characteristic high ambient temperatures, primarily atmospheric air. At the same time, in comparative terms, the extinct Neanderthal, with his Eurasian apprehension in the conditions of glacial periods, was on the contrary sufficiently well adapted to the cold environment. The subsequent adaptation of a modern human type at the genetic level with the formation of the main races (Caucasoid, Negroid, Mongoloid) could not sufficiently compensate for its insufficient resistance to the cold environment. According to the results of the research, the main ways of solving the problem of the negative influence of the cold natural environment on the ecological health of athletes were determined: the rationing of the order of sporting activities of athletes depending on the degree of low-temperature environment, diagnosing the athletes' hypersensitivity of the respiratory tract to cold atmospheric air, degree of tension of the processes of thermoregulation of the body. The conclusions are drawn according to which the prevention of the negative impact of extreme conditions of the cold environment (primarily cold atmospheric air) on the ecological health of athletes should be systemic, integrated. The system of preventive measures should include an early diagnosis of the development of airway hyperresponsiveness of athletes to the effects of cold atmospheric air, as well as an assessment of the degree of tension of the body's thermoregulatory system to the effect of cold. In the system of preventing the negative impact of the cold environment on the body of athletes engaged in winter sports in the open space, it is necessary to include regulation (normalization) of the temperature regime of cold atmospheric air when determining the possibility of holding sporting events. If necessary (the presence of hypersensitivity of the airways to the action of cold atmospheric air), it is advisable to use special means of protecting the respiratory tract of athletes from the negative influence of cold atmospheric air.


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