scholarly journals Sports-related lower limb muscle injuries: pattern recognition approach and MRI review

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Jaime Isern-Kebschull ◽  
Sandra Mechó ◽  
Ricard Pruna ◽  
Ara Kassarjian ◽  
Xavier Valle ◽  
...  
Keyword(s):  
Lower Limb ◽  
Elite Athletes ◽  
Imaging Modality ◽  
Clinical Importance ◽  
Classification Systems ◽  
Lower Limbs ◽  
Muscle Injuries ◽  
Mri Findings ◽  
Duke Classification ◽  
The Impact

Abstract Muscle injuries of the lower limbs are currently the most common sport-related injuries, the impact of which is particularly significant in elite athletes. MRI is the imaging modality of choice in assessing acute muscle injuries and radiologists play a key role in the current scenario of multidisciplinary health care teams involved in the care of elite athletes with muscle injuries. Despite the frequency and clinical relevance of muscle injuries, there is still a lack of uniformity in the description, diagnosis, and classification of lesions. The characteristics of the connective tissues (distribution and thickness) differ among muscles, being of high variability in the lower limb. This variability is of great clinical importance in determining the prognosis of muscle injuries. Recently, three classification systems, the Munich consensus statement, the British Athletics Muscle Injury classification, and the FC Barcelona-Aspetar-Duke classification, have been proposed to assess the severity of muscle injuries. A protocolized approach to the evaluation of MRI findings is essential to accurately assess the severity of acute lesions and to evaluate the progression of reparative changes. Certain MRI findings which are seen during recovery may suggest muscle overload or adaptative changes and appear to be clinically useful for sport physicians and physiotherapists.

scholarly journals Unilateral and Bilateral Strength Asymmetry among Young Elite Athletes of Various Sports

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 683
Author(s):  
Maros Kalata ◽  
Tomas Maly ◽  
Mikulas Hank ◽  
Jakub Michalek ◽  
David Bujnovsky ◽  
...  
Keyword(s):  
Lower Limb ◽  
Elite Athletes ◽  
Lower Limbs ◽  
Knee Extensors ◽  
Young Athletes ◽  
Lower Limb Muscles ◽  
Significant Difference ◽  
Strength Asymmetry ◽  
Main Factor ◽  
Objective Type

Background and objective: Type of physical activity may influence morphological and muscular asymmetries in the young population. However, less is known about the size of this effect when comparing various sports. The aim of this study was to identify the degree of bilateral asymmetry (BA) and the level of unilateral ratio (UR) between isokinetic strength of knee extensors (KE) and flexors (KF) among athletes of three different types of predominant locomotion in various sports (symmetric, asymmetric and hybrid). Material and methods: The analyzed group consisted of young elite athletes (n = 50). The maximum peak muscle torque of the KE and KF in both the dominant (DL) and non-dominant (NL) lower limb during concentric muscle contraction at an angular velocity of 60°·s−1 was measured with an isokinetic dynamometer. Results: Data analysis showed a significant effect of the main factor (the type of sport) on the level of monitored variables (p = 0.004). The type of sport revealed a significant difference in the bilateral ratio (p = 0.01). The group of symmetric and hybrid sports achieved lower values (p = 0.01) of BA in their lower limb muscles than those who played asymmetric sports. The hybrid sports group achieved higher UR values (p = 0.01) in both lower limbs. Conclusions: The results indicate that sports with predominantly symmetrical, asymmetrical, and hybrid types of locomotion affected the size of the BA, as well as the UR between KE and KF in both legs in young athletes. We recommend paying attention to regular KE and KF strength diagnostics in young athletes and optimizing individual compensatory exercises if a higher ratio of strength asymmetry is discovered.

scholarly journals An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems

Joints ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 039-046 ◽  
Author(s):  
Alberto Grassi ◽  
Alberto Quaglia ◽  
Gian Canata ◽  
Stefano Zaffagnini
Keyword(s):  
Prognostic Value ◽  
Muscle Injury ◽  
Clinical Signs ◽  
Classification Systems ◽  
Soccer Players ◽  
Muscle Injuries ◽  
Mri Findings ◽  
Professional Soccer ◽  
Magnetic Resonance Imaging Mri ◽  
Comprehensive Classification

Muscle injuries are recognized to be among the most frequent injuries occurring in the sporting and athletic population, and they account for more than 30% of all injuries in professional soccer players. Despite their considerable frequency and impact, there is still a lack of uniformity in the categorization, description and grading of muscle injuries.Dozens of systems based on clinical signs, ultrasound imaging (US) appearance or magnetic resonance imaging (MRI) findings have been proposed over the years. Most of them are three-grade systems that take into account pain, ROM limitation, swelling and hematoma, hypoechoic or hyperintense areas on US or MRI, and muscle gap or tendon involvement; however, they still lack evidence-based prognostic value. Recently, new comprehensive classification systems have been proposed, with the aim of developing uniform muscle injury terminology and giving each severity grade prognostic value.The systems that combine detailed MRI and US features with the clinical presentation, such as the Munich Muscle Injury Classification, the ISMuLT classification, and the British Athletic Classification, if used extensively, could improve the diagnosis, prognosis and management of muscle injuries.

scholarly journals INTRAOPERATIONAL CORRECTION OF HAEMODYNAMIC DISTURBANCES IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERY FOR HIATAL HERNIA

2017 ◽  
Vol 8 (1) ◽  
pp. 40-45
Author(s):  
M A Burikov ◽  
I I Katelnitsky ◽  
I V Skazkin ◽  
L L Timofeeva
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Technique ◽  
Hiatal Hernia ◽  
Lower Limb ◽  
Lower Limbs ◽  
Venous Diameter ◽  
The Impact

The aim of the article is to review the results of regional lower limb haemodynamics, haemostatic disturbances in patients undergoing laparoscopic surgery for hiatal hernia and intermittent pneumocompression in terms of embolism prevention. The impact of laparoscopic surgical technique on linear bloodflow velocity and venous diameter in lower limbs.

Ultrasound Diagnosis Technology for Sports Injury Detection and Prevention: A Mini Review

2021 ◽  
Vol 11 (8) ◽  
pp. 2077-2079
Author(s):  
Jiansheng Mao ◽  
Liangliang Xiang
Keyword(s):  
Lower Limb ◽  
Sports Medicine ◽  
Sports Injuries ◽  
Dynamic Assessment ◽  
Sports Injury ◽  
Lower Limbs ◽  
Ultrasound Diagnosis ◽  
Muscle Injuries ◽  
Initial Examination ◽  
Lower Limb Muscles

Ultrasound as a medical diagnosis tool, comprising the strengths of noninvasive, portable and cost-saving, and it allows the evaluation of soft tissue pathology. In sports medicine field, sonography technology is used for the detection and prevention of injuries of upper and lower limbs, mainly including elbow, shoulder, knee and ankle joints. The implement of ultrasound diagnosis technology was discussed in this narrative literature review. Sonographic images of elbows could provide a dynamic assessment of medial joint laxity. Due to the importance of ultrasound assessment in lower-limb muscles, tendons, and ligaments, this technology has been applied extensively for many types of extra-articular injuries in the lower limb. Most muscle injuries can be assessed and graded using the ultrasound apparatus. Overall, sonographic image evaluation is a reliable and handy method for the initial examination of acute or chronic sports injuries.

scholarly journals Role of ultrasound and magnetic resonance imaging in the prognosis and classification of muscle injuries in professional football players: correlation between imaging and return to sport time

2021 ◽  
Author(s):  
Christian Ossola ◽  
Marco Curti ◽  
Marco Calvi ◽  
Sofia Tack ◽  
Stefano Mazzoni ◽  
...  
Keyword(s):  
Return To Sport ◽  
Major Axis ◽  
Prognostic Indicator ◽  
Lower Limbs ◽  
Prognostic Indicators ◽  
Muscle Injuries ◽  
Mri Findings ◽  
Professional Soccer ◽  
Longitudinal Extension ◽  
Grading Scales

Abstract Purpose To study distractive muscle injuries applying US and MRI specific classifications and to find if any correlation exists between the results and the return to sport (RTS) time. The second purpose is to evaluate which classification has the best prognostic value and if the lesions extension correlates with the RTS time. Methods A total of 26 male, professional soccer players (age 21.3 ± 5.6), diagnosed with traumatic muscle injury of the lower limbs, received ultrasound and MRI evaluation within 2 days from the trauma. Concordance between US and MRI findings was investigated. The relationships between MRI and US based injury grading scales and RTS time were evaluated. Correlation between injuries’ longitudinal extension and RTS time was also investigated. Results The correlation between US and MRI measurements returned a Spearman value of rs = 0.61 (p = .001). Peetrons and Mueller-Wohlfahrt grading scales correlations with RTS time were r = 0.43 (p = .02) and r = 0.83 (p =  < .001). The lesion’s extension correlation with RTS time was r = 0.63 (p < .001). The correlation between the site of the lesion and its location with the RTS time were rs = 0.2 and rs = 0.25. Conclusions Both US and MRI can be used as prognostic indicators along with the Peetrons (US) and the Mueller-Wohlfahrt (MRI) classifications. MRI is more precise and generates more reproducible results. The lesion craniocaudal extension must be considered as a prognostic indicator, while the injury location inside the muscle or along its major axis has doubtful significance.

scholarly journals Effects of Whole-Body Vibration Training on Lower Limb Blood Flow in Children with Myelomeningocele—A Randomized Trial

2021 ◽  
Vol 10 (18) ◽  
pp. 4273
Author(s):  
Małgorzata Domagalska-Szopa ◽  
Andrzej Szopa ◽  
Andrzej Siwiec ◽  
Ilona Kwiecień-Czerwieniec ◽  
Lutz Schreiber ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lower Limb ◽  
Whole Body Vibration ◽  
Lower Limbs ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Conventional Physiotherapy ◽  
Whole Body Vibration Training ◽  
The Impact

The objective of the present study was to determine the effectiveness of a three-week Whole-Body Vibration (WBV) training on the vascular blood flow of the lower limbs in children with myelomeningocele. The secondary goal was to evaluate the effect of WBV on the ROM of lower limb joints in this population. A total of 30 children with MMC (7–16 years old) were enrolled in the study. Children were randomly allocated to two groups of equal numbers, using an envelope code. The experimental group underwent a 3-week WBV training, while the control group received a 3-week conventional physiotherapy (PT) program. The examination consisted of two parts: (1) Doppler USG examination of the lower limb vascular blood flow; (2) evaluation of ROM. The results obtained revealed three main findings. First, WBV training effectively improved blood flow by increasing flow velocities in all tested arteries, while the impact of the PT program was limited to a single parameter. Second, WBV training effectively improved vascular resistance in arteries of the lower legs, while the PT program did not achieve any significant differences. Third, both types of treatment intervention significantly improved ROM in all joints of the lower limbs in MMC participants.

scholarly journals Impact of Self-Selected Customized Orthotics on Lower Limbs Biomechanics

2021 ◽  
Author(s):  
Benjamin Dourthe ◽  
Judith Osterloh ◽  
Vinzenz Von Tscharner ◽  
Sandro Nigg ◽  
Benno M. Nigg
Keyword(s):  
Isometric Contraction ◽  
Lower Limb ◽  
Statistical Significance ◽  
Lower Limbs ◽  
Patient Specific ◽  
Emg Activity ◽  
Post Intervention ◽  
Walking Intervention ◽  
Foot Arch ◽  
The Impact

Customized insoles are commonly prescribed to prevent or treat a variety of foot pathologies and to reduce foot and lower limb fatigue. Due to the patient-specific design and production of such orthotics, the concept of self-selected customized orthotics (SSCO) has recently been developed. The goal of this study was to assess the impact of SSCO technology on several physiological and biomechanical variables during uphill power walking. Thirty male participants underwent an uphill power walking intervention at constant speed in two insoles conditions (control and SSCO). The electromyographic (EMG) activity of their right gastrocnemii and vastii muscles was measured. Perceived fatigue was assessed every 5 minutes and the intervention stopped when the targeted fatigue level was reached. Baseline and post-intervention assessments were also performed. Sixty-three percent of the participants experienced an improvement in foot fatigue while wearing the SSCO. The foot arch seemed to collapse less when participants wore the SSCO, but statistical significance was not reached. The changes in mean EMG activity was not consistent between the 50% isometric contraction and the walking trial. In conclusion, while some interesting trends were observed when wearing SSCO, further investigations should be performed to try and reach statistical significance.

scholarly journals The impact of exercise of lower limbs on dynamic balance and valgus of the knees among young footballers

2019 ◽  
Author(s):  
Bartosz Wilczyński ◽  
Katarzyna Zorena ◽  
Piotr Wąż
Keyword(s):  
Lower Limb ◽  
Dynamic Balance ◽  
Intervention Group ◽  
Lower Limbs ◽  
Football Players ◽  
Valgus Knee ◽  
Balance Test ◽  
And Control ◽  
The Impact ◽  
Dynamic Valgus

Abstract Background Participation of children and youth in sporting activities, among others in training and football competitions, is an optimistic manifestation of activation in the current trend of computerization. Unfortunately, this is also often associated with musculoskeletal injuries. An example is the association of dynamic valgus and disturbed dynamic balance with lower limb injuries. The main purpose of the studies is to determine the impact of three strengthening exercises on the parameters of dynamic knee valgus and balance of lower limbs. The secondary objectives are to investigate the dominant influence and the length of lower limb on the valgus values and to determine risk of injury to young football players. Methods 134 young footballers training at the Arka Gdynia SI club were invited to first stage of the research in order to examine anthropometric features and kinematics of the lower limb. Single Leg Squat Test was used, which was recorded. The samples were analyzed video to determine exact knee angle of valgus. During the second stage, to which players with valgus knee were qualified (≥15˚), the Y-Balance Test was additionally used. Intervention group underwent an exercise program to strengthen gluteus medius, popliteal and tibialis posterior muscles for 6 weeks to repeat tests in the third stage. Results Statistical methods used at the assumed level of significance allow to conclude that there are no differences in results of dynamic valgus (≥15˚) and dynamic balance between the intervention group and control group during the 6 week period between stages. In addition, there were results confirming the lack of influence of length and dominant lower limb on valgus. Results of composite direction in the Y-Balance Test test determine the low risk of injury in both intervention and control groups. Conclusions Intervention did not affect the dynamic valgus and knee balance in young football players. Both the length and the dominant limb did not affect the results. The "low risk" occurrence of injuries among the examined participants with valgus knee due to the values of dynamic balance was determined.

scholarly journals Effects of active muscle forces on driver’s lower-limb injuries due to emergency brake in various frontal impacts

2019 ◽  
Vol 234 (7) ◽  
pp. 2014-2024
Author(s):  
Fan Li ◽  
Wei Huang ◽  
Xingsheng Wang ◽  
Xiaojiang Lv ◽  
Fuhao Mo
Keyword(s):  
Muscle Contraction ◽  
Lower Limb ◽  
Injury Risk ◽  
Muscle Activation ◽  
Bending Moment ◽  
Lower Limbs ◽  
Lower Limb Injuries ◽  
Lower Limb Injury ◽  
Limb Injuries ◽  
The Impact

Accident data shows that driver’s kinematics response in real accidents can be significantly different from that in dummy or cadaver tests because of driver’s muscle contraction. In this study, a finite element human-body model consisting of an upper body of a dummy model and a lower limb–pelvis biomechanical model with three-dimensional active muscles was developed to investigate in depth the lower-limb injuries. Driver’s emergency reaction during frontal impact was simulated by modelling muscle active contraction based on a series of volunteer experimental tests. Besides, a realistic impact environment with the response of the restraint system and the invasion of the driver’s compartment was established in this study. The results show that muscle contraction can cause extra loads on lower limbs during the impact, which can increase the injury risk of lower limbs. As for the femur injury, muscle contraction caused an additional 1 kN axial load on the femur, and the femur resultant bending moment of active models was also higher by about 10–40 N m. Besides, the tibial index of the model with muscle activation was about 0.1 higher. In addition, the results indicate that the femur injury is strongly related to the combined action of both axial force and bending moment. The variation of the injury tolerance along the tibia shaft should be considered when evaluating the tibia injury. Overall, the current lower-limb injury criteria can be still the lack of robustness.

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