Achilles Tendon Adaptation During Transition to a Minimalist Running Style

2017 ◽  
Vol 26 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Michael F. Joseph ◽  
Katherine Histen ◽  
Julia Arntsen ◽  
Lauren L’Hereux ◽  
Carmine Defeo ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Injury Risk ◽  
Transition Program ◽  
Triceps Surae ◽  
Laboratory Assessment ◽  
Isokinetic Dynamometry ◽  
Type Design ◽  
Tendon Adaptation ◽  
Time Point

Context:Achilles tendons (ATs) adapt to increased loading generated by long-term adoption of a minimalist shoe running style. There may be difference in the chronology and extent of adaptation between the sexes.Objective:To learn the chronology of AT adaptations in female and male runners who transitioned to a minimalist running style through a planned, progressive 12-wk transition program.Design:Prospective cohort study of well-trained, traditionally shod runners who transitioned to minimalist shoe running.Setting:Repeated laboratory assessment at baseline and 3, 12, and 24 wk after initiating transition program.Participants:Fifteen women and 7 men (of 29 enrolled) completed the study.Main Outcome Measures:The authors used diagnostic ultrasound and isokinetic dynamometry to generate a force elongation curve and its derivatives at each time point.Results:Greater adaptations were observed in men than in women, with men generating more force and having greater increases in CSA, stiffness, and Young’s modulus and less elongation after 12 wk of training.Conclusion:Men demonstrated changes in AT properties that were consistent with increased loading of the triceps surae during exercise. The women demonstrated far smaller changes. Further investigation is warranted to understand when adaptations may occur in women and the implications of altered AT mechanical properties for performance and injury risk.

Effects of Altering Intensity during 1-MHz Ultrasound Treatment on Increasing Triceps Surae Temperature

2004 ◽  
Vol 13 (4) ◽  
pp. 275-286 ◽  
Author(s):  
Phillip O. Burr ◽  
Timothy J. Demchak ◽  
Mitchell L. Cordova ◽  
Christopher D. Ingersoll ◽  
Marcus B. Stone
Keyword(s):  
Healthy Volunteers ◽  
Outcome Measures ◽  
Research Laboratory ◽  
Sports Injury ◽  
Ultrasound Treatment ◽  
Triceps Surae ◽  
Physiological Effects ◽  
Type Design ◽  
Injury Research ◽  
Optimal Heating

Context:It has been suggested that to obtain optimal physiological effects of heating, musculoskeletal temperature (TEMP) should be elevated 3 °C above baseline and maintained for at least 5 min.Objective:To identify a multi-intensity ultrasound protocol that will achieve optimal heating.Design:1 × 2 between-subjects.Setting:Sports-injury research laboratory.Participants:20 healthy volunteers.Interventions:A 2.5-min treatment at 2.4 W/cm2 immediately followed by a 7.5-min treatment at 1.0 W/cm2 (T1) and a 10-min treatment at 1.5 W/cm2 (T2).Outcome Measures:TEMP change during the first 2.5 min of ultrasound treatment (°C), time the TEMP was ≥3 °C above baseline during and after the treatment.Results:T1 increased TEMP during the first 2.5 min of the ultrasound treatment (3.22 ± 1.25 °C) more than T2 did (1.68 ± 0.72 °C). No difference was found for the remaining measures.Conclusions:The multi-intensity protocol (2.4 W/cm2 and 1.0 W/cm2) did not result in optimal heating.

Progression of Secondary Injury After Musculoskeletal Trauma—A Window of Opportunity?

2010 ◽  
Vol 19 (4) ◽  
pp. 380-388 ◽  
Author(s):  
Mark A. Merrick ◽  
Nicole M. McBrier
Keyword(s):  
Cytochrome C ◽  
Cytochrome C Oxidase ◽  
Outcome Measures ◽  
Oxidase Activity ◽  
Triceps Surae ◽  
Secondary Injury ◽  
Window Of Opportunity ◽  
Triphenyltetrazolium Chloride ◽  
Injury Status ◽  
Time Point

Context:Acute musculoskeletal-injury management largely focuses on inhibiting secondary injury, although the data describing secondary injury and the timeline for its progression are sparse.Objective:To describe the timeline and early progression of secondary injury in skeletal muscle over the first 5 h after blunt trauma.Design:A controlled laboratory study with 2 independent variables (injury status and postinjury time point) in a 2 × 21 factorial.Setting:University research laboratory.Subjects:168 male Sprague Dawley rats (250 to 275 g).Interventions:Uniform blunt-contusion injury was caused to the right triceps surae using a drop-weight method; the contralateral limb served as an uninjured control. Both triceps surae were excised and flash frozen at 21 intervals across 5 h postinjury (8 animals, each 15 min).Main Outcome Measures:Cytochrome-c oxidase activity via reduction of triphenyltetrazolium chloride (TTC) to triphenyl-formazan.Results:There was an interaction effect (P = .041) between and main effects for both injury status (P < .0005) and postinjury time point (P = .038). In the first 30 min after injury, uninjured tissues did not differ from injured tissues, and both displayed TTC reduction rates in the vicinity of 7.1 ± 0.94 μg · mg−1 · h−1. Statistical differences between uninjured and injured tissues became evident starting at 30 min. TTC reduction for uninjured tissues did not change, but injured tissues declined in a roughly linear fashion across the entire 5-h period to 4.8 ± 1.04 μg · mg−1 · h−1.Conclusions:Cytochrome-c oxidase activity, an indicator of oxidative phosphorylation and mitochondrial viability, is diminished by events that follow muscle trauma. Loss of this enzymatic activity becomes statistically evident at 30 min postinjury and continues linearly for at least 5 h. This suggests that secondary injury is a slowly developing problem of more than 5 h duration. A window of opportunity for intervention may lie somewhere within the first 30 min after injury.

The Effects of Local Vibration on Balance, Power, and Self-Reported Pain After Exercise

2017 ◽  
Vol 26 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Lisa Custer ◽  
Kimberly S. Peer ◽  
Lauren Miller
Keyword(s):  
Outcome Measures ◽  
Muscle Soreness ◽  
Dynamic Balance ◽  
Triceps Surae ◽  
Local Vibration ◽  
Type Design ◽  
Active Vibration ◽  
Single Blind ◽  
Blind Crossover Study ◽  
Full Body

Context:Muscle fatigue and acute muscle soreness occur after exercise. Application of a local vibration intervention may reduce the consequences of fatigue and soreness.Objective:To examine the effects of a local vibration intervention after a bout of exercise on balance, power, and self-reported pain.Design:Single-blind crossover study.Setting:Laboratory.Participants:19 healthy, moderately active subjects.Interventions:After a 30-min bout of full-body exercise, subjects received either an active or a sham vibration intervention. The active vibration intervention was performed bilaterally over the muscle bellies of the triceps surae, quadriceps, hamstrings, and gluteals. At least 1 wk later, subjects repeated the bout, receiving the other vibration intervention.Main Outcome Measures:Static balance, dynamic balance, power, and self-reported pain were measured at baseline, after the vibration intervention, and 24 h postexercise.Results:After the bout of exercise, subjects had reduced static and dynamic balance and increased self-reported pain regardless of vibration intervention. There were no differences between outcome measures between the active and sham vibration conditions.Conclusions:The local vibration intervention did not affect balance, power, or self-reported pain.

scholarly journals Long-term improvements following a residential combined physical and psychological programme for chronic low back pain

2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Low Back ◽  
Residential Setting ◽  
Wide Range

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.

scholarly journals Determining transition readiness in Swiss childhood cancer survivors – a feasibility study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Otth ◽  
Patrick Wechsler ◽  
Sibylle Denzler ◽  
Henrik Koehler ◽  
Katrin Scheinemann
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
Self Management ◽  
Transition Readiness ◽  
Long Term Follow Up ◽  
Time Point

Abstract Background The successful transition of childhood cancer survivors (CCSs) from pediatric to adult long-term follow-up care is a critical phase, and determining the right time point can be challenging. We assessed the feasibility of the use of existing transition readiness tools in the context of the Swiss health care system, assessed partly transition readiness in Swiss CCSs, and compared our findings with Canadian CCSs for which these tools were originally developed. Methods We officially translated the Cancer Worry Scale (CWS) and Self-Management Skill Scale (SMSS) into German and integrated them into this cross-sectional study. We included CCSs attending the long-term follow-up (LTFU) clinic in the Division of Oncology-Hematology, Department of Pediatrics, Kantonsspital Aarau. We used descriptive statistics to describe transition readiness. Results We randomly recruited 50 CCSs aged ≥18 years at participation. The CCSs had a median CWS score of 62 (interquartile range 55–71), indicating a moderate level of cancer-related worry. Despite high self-management skills, some answers showed a dependency of CCSs on their parents. Our experience shows that the CWS and SMSS are easy for Swiss CCSs to use, understand, and complete. The interpretation of the results must take differences in health care systems between countries into account. Conclusions The translated CWS and SMSS are appropriate additional measures to assess transition readiness in CCSs. These scales can be used longitudinally to find the individual time point for transition and the completion by CCSs enables the health care team to individualize the transition process and to support the CCSs according to their individual needs.

scholarly journals Debridement, Antibiotics, and Implant Retention Is a Viable Treatment Option for Early Periprosthetic Joint Infection Presenting More Than 4 Weeks After Index Arthroplasty

2019 ◽  
Vol 71 (3) ◽  
pp. 630-636 ◽  
Author(s):  
Claudia A M Löwik ◽  
Javad Parvizi ◽  
Paul C Jutte ◽  
Wierd P Zijlstra ◽  
Bas A S Knobben ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Viable Option ◽  
Time Intervals ◽  
Implant Retention ◽  
Time Point ◽  
Viable Treatment

Abstract Background The success of debridement, antibiotics, and implant retention (DAIR) in early periprosthetic joint infection (PJI) largely depends on the presence of a mature biofilm. At what time point DAIR should be disrecommended is unknown. This multicenter study evaluated the outcome of DAIR in relation to the time after index arthroplasty. Methods We retrospectively evaluated PJIs occurring within 90 days after surgery and treated with DAIR. Patients with bacteremia, arthroscopic debridements, and a follow-up &lt;1 year were excluded. Treatment failure was defined as (1) any further surgical procedure related to infection; (2) PJI-related death; or (3) use of long-term suppressive antibiotics. Results We included 769 patients. Treatment failure occurred in 294 patients (38%) and was similar between time intervals from index arthroplasty to DAIR: the failure rate for Week 1–2 was 42% (95/226), the rate for Week 3–4 was 38% (143/378), the rate for Week 5–6 was 29% (29/100), and the rate for Week 7–12 was 42% (27/65). An exchange of modular components was performed to a lesser extent in the early post-surgical course compared with the late course (41% vs 63%, respectively; P &lt; .001). The causative microorganisms, comorbidities, and durations of symptoms were comparable between time intervals. Conclusions DAIR is a viable option in patients with early PJI presenting more than 4 weeks after index surgery, as long as DAIR is performed within at least 1 week after the onset of symptoms and modular components can be exchanged.

scholarly journals Core outcome measures for opioid abuse liability laboratory assessment studies in humans: IMMPACT recommendations

Pain ◽  
2012 ◽  
Vol 153 (12) ◽  
pp. 2315-2324 ◽  
Author(s):  
Sandra D. Comer ◽  
James P. Zacny ◽  
Robert H. Dworkin ◽  
Dennis C. Turk ◽  
George E. Bigelow ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Abuse Liability ◽  
Opioid Abuse ◽  
Core Outcome ◽  
Laboratory Assessment ◽  
Core Outcome Measures

scholarly journals Functional Long-Term Outcome after Left- versus Right-Sided Intracerebral Hemorrhage

2017 ◽  
Vol 43 (3-4) ◽  
pp. 117-123 ◽  
Author(s):  
Vanessa D. Beuscher ◽  
Joji B. Kuramatsu ◽  
Stefan T. Gerner ◽  
Julia Köhn ◽  
Hannes Lücking ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Outcome Measures ◽  
A Priori ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Excellent Outcome ◽  
Confounding Variables ◽  
Baseline Characteristics

Background and Purpose: Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings. Methods: Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014. Data were retrieved from institutional databases. Outcome was assessed using the modified Rankin Scale (mRS) score. Outcome measures (long-term mortality and functional outcome at 12 months) were correlated with ICH location and hemisphere, and the imbalances of baseline characteristics were addressed by propensity score matching. Results: A total of 831 patients with supratentorial ICH (429 left and 402 right) were analyzed. Regarding clinical baseline characteristics in the unadjusted overall cohort, there were differences in disfavor of right-sided ICH (antiplatelets: 25.2% in left ICH vs. 34.3% in right ICH; p < 0.01; previous ischemic stroke: 14.7% in left ICH vs. 19.7% in right ICH; p = 0.057; and presence/extent of intraventricular hemorrhage: 45.0% in left ICH vs. 53.0% in right ICH; p = 0.021; Graeb-score: 0 [0-4] in left ICH vs. 1 [0-5] in right ICH; p = 0.017). While there were no differences in mortality and in the proportion of patients with favorable vs. unfavorable outcome (mRS 0-3: 142/375 [37.9%] in left ICH vs. 117/362 [32.3%] in right ICH; p = 0.115), patients with left-sided ICH showed excellent outcome more frequently (mRS 0-1: 64/375 [17.1%] in left ICH vs. 43/362 [11.9%] in right ICH; p = 0.046) in the unadjusted analysis. After adjusting for confounding variables, a well-balanced group of patients (n = 360/hemisphere) was compared showing no differences in long-term functional outcome (mRS 0-3: 36.4% in left ICH vs. 33.9% in right ICH; p = 0.51). Sub-analyses of patients with deep vs. lobar ICH revealed also no differences in outcome measures (mRS 0-3: 53/151 [35.1%] in left deep ICH vs. 53/165 [32.1%] in right deep ICH; p = 0.58). Conclusion: Previously described differences in clinical end points among patients with left- vs. right-hemispheric ICH may be driven by different baseline characteristics rather than by functional deficits emerging from different hemispheric functions affected. After statistical corrections for confounding variables, there was no impact of hemispheric location on functional outcome after ICH.

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