Landing Biomechanics in Adolescent Athletes With and Without a History of Sports-Related Concussion

2020 ◽  
Vol 36 (5) ◽  
pp. 313-318
Author(s):  
Jason M. Avedesian ◽  
Tracey Covassin ◽  
Janet S. Dufek
Keyword(s):  
Knee Flexion ◽  
Injury Risk ◽  
Multivariate Analyses ◽  
Three Dimensional ◽  
Group Differences ◽  
Adolescent Athletes ◽  
Landing Biomechanics ◽  
Drop Landing ◽  
History Of

Recent evidence suggests previously concussed athletes are at greater risk for lower-extremity (LE) injuries than are controls. However, little is known regarding the influence of sports-related concussion (SRC) on landing biomechanics that may provide a mechanistic rationale for LE injury risk. The purpose of this investigation was to examine LE drop-landing biomechanics in adolescent athletes with and without a previous SRC history. Participants included 10 adolescent athletes with an SRC history and 11 controls from multiple sports. Three-dimensional kinematic and kinetic data associated with LE injury risk were analyzed across 5 trials for 30- and 60-cm landing heights. Multivariate analyses indicated group differences in landing patterns from the 30- (P = .041) and 60-cm (P = .015) landing heights. Follow-up analyses indicated that concussed adolescent athletes demonstrated significantly less ankle dorsiflexion and knee flexion versus controls when performing drop landings. Our findings suggest that previously concussed adolescent athletes complete drop-landing maneuvers with ankle and knee joint kinematic patterns that suggest greater risk for LE injury. While limitations such as sport variety and explicit LE injury history are present, the results of this study provide a possible biomechanical rationale for the association between SRC and LE injury risk.

scholarly journals Patellar Maltracking Persists in Adolescent Females With Patellofemoral Pain

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668677 ◽  
Author(s):  
Victor R. Carlson ◽  
Barry P. Boden ◽  
Aricia Shen ◽  
Jennifer N. Jackson ◽  
Katharine E. Alter ◽  
...  
Keyword(s):  
Natural History ◽  
Pain Score ◽  
Three Dimensional ◽  
Patellofemoral Pain ◽  
Adolescent Females ◽  
Physical Activities ◽  
Symptom Improvement ◽  
Patellar Maltracking ◽  
History Of

Background: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. Purpose: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. Study Design: Cohort study; Level of evidence, 3. Methods: Three-dimensional patellofemoral kinematic data were acquired during active knee extension-flexion using dynamic magnetic resonance imaging in 6 girls (10 knees; mean age, 14.0 years) with clinically diagnosed patellofemoral pain. The subjects then returned as late adolescents (mean age, 18.5 years) for follow-up scanning. Three-dimensional patellofemoral kinematic parameters were evaluated across the range of motion, but comparison between time points was restricted to 10° of flexion. Participation in impact and nonimpact physical activities, pain score based on the visual analog scale, and the anterior knee pain score were also compared across initial and follow-up visits. Results: All subjects reported improved patellofemoral pain symptoms at follow-up, and one subject reported complete resolution. However, relative to the initial visit, no differences were found in patellar maltracking. There was a decrease in hours engaged in impact physical activities for all subjects at follow-up. Conclusion: This study provides insight into the natural history of patellofemoral pain in adolescent females. The relatively unchanged patellofemoral maltracking across subjects suggests that potential anatomic and kinematic abnormalities contributing to patellofemoral pain during mid-adolescence persist during skeletal maturation. Symptom improvement for these subjects did not result from a change in patellofemoral tracking, but rather from other causes.

scholarly journals Y-Balance test asymmetry is greater in collegiate athletes with a history of concussion

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S26.1-S26
Author(s):  
Hoch Matthew ◽  
Curry Nicole ◽  
Hartley-Gabriel Emily ◽  
Heebner Nicholas ◽  
Hoch Johanna
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Collegiate Athletes ◽  
Lower Extremity Injury ◽  
Absolute Difference ◽  
Group Differences ◽  
Extremity Injury ◽  
Balance Test ◽  
Increased Risk ◽  
History Of

Athletes with a history of concussion (HC) are at an increased risk of sustaining lower extremity injuries. It is unclear if these individuals exhibit dynamic postural control deficits associated with lower extremity injury risk. The purpose of this study was to determine if collegiate athletes with a HC demonstrate differences in Y-Balance Test (YBT) performance compared to athletes with no history of concussion (NHC). A total of 116 varsity and club athletes from a Division-I university participated. Forty participants reported a HC (female/male: 31/9, age: 20.0 ± 1.4 years, height: 169.3 ± 13.1 cm, mass: 68.4 ± 14.0 kg) while 76 reported NHC (female/male: 60/16, age: 20.0 ± 1.7 years, height: 168.5 ± 12.9 cm, mass: 68.7 ± 14.6 kg). Individuals with a current concussion or lower extremity injury, or a history of lower extremity surgery were excluded. Participants completed the YBT anterior reach direction barefoot on both limbs. The YBT was completed by maximally reaching anteriorly, maintaining balance, and returning to the starting position without errors. Participants completed 4 practice trials and 3 test trials. Reach distances were averaged and normalized to leg length. Between-limb asymmetry was calculated as the absolute difference between the left and right limbs. Separate independent t-tests examined group differences in normalized reach distances and asymmetry. The proportion of participants in each group with >4 cm of asymmetry was compared using a χ2 test. Alpha was set at 0.05 for all analyses. No group differences were identified in normalized reach distances for the left (HC: 61.4% ± 9.2%, NHC: 60.8% ± 6.2%, p = 0.88, ES = 0.08) or right (HC: 61.4% ± 6.2%, NHC: 60.2% ± 6.8%, p = 0.51, ES = 0.17) limbs. However, a greater proportion of HC participants demonstrated >4 cm asymmetry (HC: 40.0%, NHC: 19.7%; p = 0.02) and these participants exhibited greater asymmetry (HC: 3.87 ± 3.69 cm, NHC: 2.40 ± 2.13 cm, p = 0.03; ES = 0.53). Athletes with a HC exhibited greater asymmetry compared to athletes with NHC. Anterior reach asymmetries of >4 cm are associated with greater lower extremity injury risk. The YBT may provide a clinical technique to further explore the relationship between concussion and lower extremity injury.

scholarly journals Incidentally identified ductus arteriosus aneurysm in eight adults: a case series

2021 ◽  
pp. 20200097
Author(s):  
Mayo Yukimoto ◽  
Tomohisa Okuma ◽  
Etsuji Sohgawa ◽  
Mariko M Nakano ◽  
Taro Shimono ◽  
...  
Keyword(s):  
Ductus Arteriosus ◽  
Three Dimensional ◽  
Case Series ◽  
Risk Of Rupture ◽  
Radiographic Screening ◽  
Dimensional Reconstruction ◽  
History Of ◽  
Ductus Arteriosus Aneurysm ◽  
Lost To Follow Up

Ductus arteriosus aneurysm (DAA) in adulthood is a rare entity. We retrospectively reviewed our medical records from the past ten years and identified eight cases of adult DAA (six males and two females aged between 69 and 89 years; mean, 76 years), using multi planar reconstruction and three-dimensional reconstruction computed tomography (CT) images. The aneurysm was suspected incidentally in all cases based on the results of chest radiographic screening or postoperative follow-up CT for lung or colon cancer. All eight patients were asymptomatic but had a history of or concurrent hypertension (n = 5, 62.5%), diabetes mellitus (n = 3, 37.5%), cerebrovascular disease (n = 3, 37.5%), ischemic heart disease (n = 1, 12.5%), and cardiac failure (n = 1). All patients had no history of trauma (n = 8, 100%). Six had a history of cigarette smoking. The aneurysm size ranged from 2.0 × 4.0 to 6.3 × 5.3 cm (mean, 3 × 5 cm). The surgical procedures used were four cases of total arch replacement and two cases of thoracic endovascular aortic repair. Two patients were not surgically treated. The median follow-up was 14.5 months (range, 2 months to 9 years). In the two patients who were not surgically treated, the aneurysm enlarged in one, and remained unchanged in the other. Of the six cases surgically-managed cases, one was lost to follow-up, and another patient died of an unrelated cause. The remaining four cases had no enlargement of the aneurysm. No ruptures were reported in any of the cases. DAA should be considered when a saccular aneurysm is located in the minor curvature of the aortic arch and extending toward the left pulmonary trunk in adult patients. Differentiating adult DAA is important, because it is associated with a high risk of rupture due to the fragile nature of true aneurysms.

Drop Landing Biomechanics in Individuals With and Without a Concussion History

2021 ◽  
Vol 37 (5) ◽  
pp. 450-457
Author(s):  
Eric J. Shumski ◽  
Tricia M. Kasamatsu ◽  
Kathleen S. Wilson ◽  
Derek N. Pamukoff
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Knee Flexion ◽  
Abduction Angle ◽  
Knee Flexion Angle ◽  
Ground Contact ◽  
Landing Biomechanics ◽  
Drop Landing ◽  
External Moment ◽  
Concussion History

Research has identified an increased risk of lower extremity injury postconcussion, which may be due to aberrant biomechanics during dynamic tasks. The purpose of this study was to compare the drop landing biomechanics between individuals with and without a concussion history. Twenty-five individuals with and 25 without a concussion history were matched on age (±3 y), sex, and body mass index (±1 kg/m2). Three-dimensional landing biomechanics were recorded to obtain dependent variables (peak vertical ground reaction force, loading rate, knee flexion angle and external moment, knee abduction angle and external moment, and knee flexion and abduction angle at ground contact). A 1-way multivariate analysis of variance compared outcomes between groups. There was no difference in drop landing biomechanics between individuals with and without a concussion history (F10,39 = 0.460, P = .877, Wilk Λ = .918). There was an effect of time since concussion on knee flexion characteristics. Time since most recent concussion explained a significant amount of variation in both peak (ΔR2 = .177, β = −0.305, ΔP = .046) and initial ground contact (ΔR2 = .292, β = −0.204, ΔP = .008) knee flexion angle after covarying for sex and body mass index. Therefore, time since concussion should be considered when evaluating biomechanical patterns.

A Follow-up Study of Traumatized Children

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Elizabeth Elmer
Keyword(s):  
Lower Class ◽  
Group Differences ◽  
Entire Sample ◽  
Abused Children ◽  
Clinical Assessments ◽  
Health History ◽  
Traumatized Children ◽  
History Of ◽  
Surprising Finding

This study compared 17 abused children with 17 children who had been in accidents, matched for age, race, sex, and socioeconomic status, eight years after all had been studied as infants. Each traumatized group was also compared with a matched untraumatized group with no known history of abuse or infantile accident. The majority of all children were lower-class. Hypotheses were that the abused children would fall below the nonabused in health history and physical development, intellectual functioning, language, and self-concept; and that the abused children would score higher in impulsivity and aggression. Clinical assessments revealed few group differences. The surprising finding was the extent of various problems across the entire sample Seventy percent of the children had speech problems; over 50% showed some degree of disturbance; and 39% were achieving poorly in school. However, these disabilities were distributed randomly among abuse, accident, and comparison children. Most of the children appeared sad and fearful of personal attack by adults or other children. Many mothers' reports indicated that the families, whether abuse, accident, or comparison, experienced constant violence, both environmental and personal. It was concluded that the effects on child development of lower-class membership may be as powerful as abuse.

Abstract 19766: Prediction of Clinical Atrial Fibrillation induced during Typical Atrial Flutter Ablation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jorge Romero ◽  
Rodolfo Estrada ◽  
Anthony Holmes ◽  
David Goodman ◽  
Norman Roth ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Multivariate Analyses ◽  
Strong Predictor ◽  
Univariate Analysis ◽  
Anticoagulation Management ◽  
Drug Induced ◽  
Typical Atrial Flutter ◽  
History Of

Background: Atrial fibrillation (AF) and isthmus dependent atrial flutter (AFL) are two separate entities that in many patients coexist. We sought to investigate whether AF inducibility (spontaneous or drug induced) during isthmus AFL ablation predicted the occurrence of AF at follow up after successful AFL ablation. Methods: Two hundred seventy three consecutive patients with isthmus dependent AFL undergoing ablation of AFL at our institution were enrolled in this study. 119 (43%) patients were excluded since they had evidence of AF prior to AFL ablation. Univariate and multivariate analyses were performed. Results: A total of 154 patients (male: 72%, age: 61 ±13) with AFL and without history of AF composed our patient population. All patients underwent successful AFL ablation. During ablation, AF was induced in 28 (18%) patients. After a mean follow up of 34 ± 23.5 months a total of 50 (32%) experienced AF. Univariate and multivariate analyses showed that only age and AF inducibility during AFL ablation were predictors of AF. Univariate analysis (age: p=0.038 and inducible AF p=0.032 and multivariate analysis (age: p=0.011 inducible AF: p=0.016) ) with and adjusted odds ratio of 3.3 [95% CI (1.250-8.676)] (Table 1). A total of 169 (62%) patients experienced AF before or after AFL ablation. Conclusion: AF inducibility in patients undergoing isthmus dependent AFL without history of AF is a strong predictor of AF recurrence. This has an important clinical relevance on anticoagulation management of these patients.

scholarly journals Orthodontics First in Hemimandibular Hyperplasia. “Mind the Gap”

2020 ◽  
Vol 17 (19) ◽  
pp. 7087
Author(s):  
Stefania Perrotta ◽  
Giorgio Lo Giudice ◽  
Tecla Bocchino ◽  
Luigi Califano ◽  
Rosa Valletta
Keyword(s):  
Three Dimensional ◽  
Facial Asymmetry ◽  
Torque Control ◽  
Open Bite ◽  
Orthodontic Appliances ◽  
Anterior Open Bite ◽  
History Of ◽  
Orthognatic Surgery ◽  
The University

A 32-year-old man was referred to the Division of Orthodontics of the University of Naples “Federico II”, with a 15-year history of gradually increasing right-sided facial asymmetry. Clinical and radiological examinations was consistent to hemimandibular hyperplasia, a rare developmental asymmetry characterized by three-dimensional enlargement of one-half of the mandible. The standard surgical-orthodontic management was proposed to the patient. However, he refused to undergo bimaxillary orthognatic surgery. Therefore, a different treatment was proposed based on the orthodontic technique of pre-surgical decompensation and post-surgical refinement used in bimaxillary orthognatic surgery planning, and surgical intervention with a condylectomy. The dental arches were evenly levelled out with a multi-bracket treatment and then the condylectomy was performed. Orthodontic treatment continued with a levelling and torque control by 0.19 × 0.25 SS arch and physiotherapy. At the three-month follow-up, the patient showed anterior and posterior bite rebalancing, arch intercuspation recovery, and anterior open bite closure due to muscular self-rebalancing. The two-year follow-up showed regular mandibular dynamic, orthodontic appliances were removed, and the patient was instructed to wear retainer for the following months. The final result was aesthetically reasonable for the patient, although slight asymmetry of the chin persisted.

Factors associated with long-term haemoptysis recurrence after transarterial embolisation for haemoptysis

2020 ◽  
Vol 24 (6) ◽  
pp. 606-611
Author(s):  
Y. Li ◽  
Z. Jia ◽  
S. Li ◽  
Y. Huang ◽  
X. Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Multivariate Analyses ◽  
Fresh Blood ◽  
Factors Associated ◽  
Transarterial Embolisation ◽  
History Of ◽  
The Mean

OBJECTIVE: To assess factors associated with long-term haemoptysis recurrence after transarterial embolisation (TAE) for haemoptysis due to bronchiectasis.METHODS: Patients with haemoptysis due to bronchiectasis who underwent TAE between May 2010 and May 2019 were included in this retrospective study. Long-term haemoptysis recurrence was defined as the expectoration of >10 mL/day of fresh blood (for at least 1 day) 1 month after TAE. Univariate and multivariate analyses were performed to identify risk factors for long-term haemoptysis recurrence after TAE.RESULTS: A total of 197 patients (108 women; mean age, 61.0 ± 12.2 years) were included in the study. TAE was performed successfully in all patients. Side effects occurred in 43 (21.8%) patients, and all patients recovered uneventfully. During 37.6 ± 11.6 months of follow-up, long-term haemoptysis recurrence occurred in 41 (20.8%) patients; the mean interval between the TAE and haemoptysis recurrence was 21.4 ± 16.3 months. Long-term haemoptysis recurrence after TAE was associated with a history of haemoptysis (OR 3.483, 95% CI 1.373–8.836; P = 0.009).CONCLUSIONS: Approximately one fifth patients with bronchiectasis had long-term haemoptysis recurrence after TAE. Risk factor for long-term haemoptysis recurrence after TAE was a history of haemoptysis.

scholarly journals Ankle-Dorsiflexion Range of Motion and Landing Biomechanics

2011 ◽  
Vol 46 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Chun-Man Fong ◽  
J. Troy Blackburn ◽  
Marc F. Norcross ◽  
Melanie McGrath ◽  
Darin A. Padua
Keyword(s):  
Range Of Motion ◽  
Knee Flexion ◽  
Injury Risk ◽  
Acl Injury ◽  
Ankle Dorsiflexion ◽  
Ground Reaction Forces ◽  
Knee Valgus ◽  
Landing Biomechanics ◽  
Reaction Forces ◽  
Acl Injury Risk

Abstract Context: A smaller amount of ankle-dorsiflexion displacement during landing is associated with less knee-flexion displacement and greater ground reaction forces, and greater ground reaction forces are associated with greater knee-valgus displacement. Additionally, restricted dorsiflexion range of motion (ROM) is associated with greater knee-valgus displacement during landing and squatting tasks. Because large ground reaction forces and valgus displacement and limited knee-flexion displacement during landing are anterior cruciate ligament (ACL) injury risk factors, dorsiflexion ROM restrictions may be associated with a greater risk of ACL injury. However, it is unclear whether clinical measures of dorsiflexion ROM are associated with landing biomechanics. Objective: To evaluate relationships between dorsiflexion ROM and landing biomechanics. Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: Thirty-five healthy, physically active volunteers. Intervention(s): Passive dorsiflexion ROM was assessed under extended-knee and flexed-knee conditions. Landing biomechanics were assessed via an optical motion-capture system interfaced with a force plate. Main Outcome Measure(s): Dorsiflexion ROM was measured in degrees using goniometry. Knee-flexion and knee-valgus displacements and vertical and posterior ground reaction forces were calculated during the landing task. Simple correlations were used to evaluate relationships between dorsiflexion ROM and each biomechanical variable. Results: Significant correlations were noted between extended-knee dorsiflexion ROM and knee-flexion displacement (r  =  0.464, P  =  .029) and vertical (r  =  −0.411, P  =  .014) and posterior (r  =  −0.412, P  =  .014) ground reaction forces. All correlations for flexed-knee dorsiflexion ROM and knee-valgus displacement were nonsignificant. Conclusions: Greater dorsiflexion ROM was associated with greater knee-flexion displacement and smaller ground reaction forces during landing, thus inducing a landing posture consistent with reduced ACL injury risk and limiting the forces the lower extremity must absorb. These findings suggest that clinical techniques to increase plantar-flexor extensibility and dorsiflexion ROM may be important additions to ACL injury-prevention programs.

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