Early rehabilitation protocol after Achilles tendon tenorraphy: ultrasonography and elastosonography difference with immobilization in cast: an observational study.

Abstract Background The incidence of Achilles tendon (AT) rupture increased, but there is no gold standard treatment. The aim of this study is to compare clinical and functional results of standard and fast rehabilitation program (immobilization and no weight bearing for 4 weeks vs early joint mobility and weight bearing). Methods 33 patients underwent to open achilles tenorraphy between January and July 2018 using Krackow suture.15 patients were enrolled and underwent fast rehabilitation program. A control group of 18 patients underwent surgery and standard protocol. The degree of sural triceps hypotrophy compared with the controlateral leg (calf circumference 4 cm below the anterior tibial tuberosity and the tibial length), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score [8], the Victorian Institute of Sports Assesement - Achilles Questionnaire (VISA-A) [9] and The Achilles tendon Total Rupture Score (ATRS) [10] were recorded at 12 months follow up. Ultrasonography and elastosonography were used to calculate different parameters both on the operated tendon and on the contralateral. Discussion Using ultrasonography, the only significant difference was recorded in the distal depth in both groups. We detected an increase of all measures in both groups comparing surgical side to the contralateral one. Using the elastosonography, the stiffness on healthy side was increased at the proximal and medial third in standard group, even if the distal third was major in fast group. On the operated side, stiffness was more on the proximal third in fast group (not statistically significant). There was an increase of tendon size on the surgical side compared to the “basal” one using US. The only statistically significant result was at distal third, and it could be due to the fact that giving an accelerated mobilization stimulates more collagen deposition, which could be a protective factor. Furthermore, at distal third of tendon we observed a greater reduction of stiffness in the fast group compared of the standard one. The results of the post-operative assessment scales are overlapping in the two groups. Clinical and functional evidence suggest that fast rehabilitation after AT surgical repair may be a first choice of treat, especially in young and active patients, because of minor local complications and higher level of satisfaction.

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The Effect of Hippotherapy on Posture and Trunk Control in Children with Spastic Diplegic Cerebral Palsy-A quasi-experimental study

10.22541/au.161156651.10500011/v1 ◽

2021 ◽

Author(s):

Filiz Özdemir ◽

Faruk Arslan

Keyword(s):

Cerebral Palsy ◽

Age Groups ◽

Functional Results ◽

Rehabilitation Program ◽

Control Group ◽

Trunk Control ◽

Postural Alignment ◽

Significant Difference ◽

Quasi Experimental ◽

Experimental Group

Background: Hippotherapy is recognized as an integrative therapy in rehabilitation programs as it provides a basis for neurological function and sensory processing. The aim of this study is to evaluate the effects of hippotherapy on posture and trunk control in children with spastic diplegic cerebral palsy. Materials and Methods: This study which a pre-test/post-test quasi experimental model with a control group was included 24 participants aged 7-12 years. In addition to routine physiotherapy and rehabilitation program for participants in experimental group, hippotherapy training sessions lasting 30 minutes were given once a week for 12 weeks each, under the direction of a physiotherapist. Postural alignment changes were evaluated by using New York Posture Rating Chart (NYPR). Trunk Impairment Scale (TIS) was used to evaluate trunk control. Results: The mean age was 13.62 ± 3.17 years. Mean body mass index (BMI) was 23.34 ± 3.38 kg / m2. There was no statistically significant difference between groups in terms of age, gender, BMI, and GMFCS (p> 0.05 for all). There was no difference in NYPR results between the groups (p> 0.05). Total TIS score and static sub-parameter scores were higher in experimental group, after the treatment (p <0.05), whereas there was no difference in terms of dynamic and coordination sub-parameters. Conclusions: We concluded that hippotherapy is a viable treatment strategy to obtain functional results in children with spastic diplegic cerebral palsy. However, we emphasize that effectiveness of hippotherapy in different age groups should be investigated with larger sample groups.

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Effects of Self-Myofascial Release Using a Foam Roller on the Stiffness of the Gastrocnemius-Achilles Tendon Complex and Ankle Dorsiflexion Range of Motion

Frontiers in Physiology ◽

10.3389/fphys.2021.718827 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tian-Tian Chang ◽

Zhe Li ◽

Yuan-Chun Zhu ◽

Xue-Qiang Wang ◽

Zhi-Jie Zhang

Keyword(s):

Achilles Tendon ◽

Range Of Motion ◽

Weight Bearing ◽

Group Analysis ◽

Intervention Group ◽

Ankle Dorsiflexion ◽

Muscle Stiffness ◽

Control Group ◽

Myofascial Release ◽

Significant Difference

Increased muscle stiffness can contribute to reduced range of motion (ROM) and impaired function. Reduced ankle dorsiflexion ROM has been associated with increased injury risk in the ankle. Self-myofascial release (SMR) has been widely used in clinical and sports settings, but the effects of SMR on gastrocnemius and Achilles tendon (AT) stiffness are unclear. Therefore, we investigated the effects of self-myofascial release using a foam roller (FR) on the stiffness of the gastrocnemius–AT complex and ankle dorsiflexion ROM. Fifty healthy, untrained, and non-sedentary participants (age=22.5±2.6years) were randomly divided into an intervention group (FR group) and a control group. The subjects in the intervention group received a single foam roller intervention (three sets of 1min), while the subjects in the control group performed a 5-min sedentary rest. Stiffness of the gastrocnemius–AT complex was evaluated using MyotonPRO and the ankle dorsiflexion ROM was assessed using the weight-bearing lunge test. For the foam roller and control groups, the between-group analysis revealed a statistically significant difference in gastrocnemius stiffness and ankle dorsiflexion ROM after intervention (p<0.05). Within-group analysis revealed a significant increase in ROM and a significant decrease in medial and lateral gastrocnemius (LG) stiffness for the foam roller group after the intervention (p<0.05). In addition, further analysis of the preintervention data revealed a significant negative correlation between ankle dorsiflexion ROM and AT stiffness (r=−0.378 and p=0.007). These results suggest that self-myofascial release using a foam roller on the calf is an effective method for decreasing the stiffness of the gastrocnemius and increasing ankle dorsiflexion ROM.

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Influence of the Thermal Treatment to Address a Better Osseointegration of Ti6Al4V Dental Implants: Histological and Histomorphometrical Study in a Rabbit Model

BioMed Research International ◽

10.1155/2018/2349698 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Antonio Scarano ◽

Ezio Crocetta ◽

Alessandro Quaranta ◽

Felice Lorusso

Keyword(s):

Thermal Treatment ◽

Dental Implants ◽

Bone Healing ◽

Rabbit Model ◽

Titanium Implants ◽

Control Group ◽

Left Femur ◽

Bone Response ◽

First Choice ◽

Significant Difference

Background. Pure titanium continues to be the first choice for dental implants and represents the gold standard for their biocompatibility and physical and mechanical characteristics, while the titanium alloy (Ti6Al4V) has good mechanical properties. The surface structure of the titanium oxide layer formation on the surface influences and improves the bone response around dental implants. Purpose. The purpose of this study is to evaluate the influence of a thermal treatment of Ti6Al4V implant surfaces and the bone healing response in a rabbit model. Methods. Altogether sixteen implants with same design were inserted into the distal femoral metaphysis. A screw (13 mm long, 4 mm in diameter) was inserted in an implant bed. Each rabbit received two implants, one in the left femur and one in the right femur. The samples were histologically and histomorphometrically evaluated at 8 weeks. Results. A statistically significant difference (p = 0.000034) was present histologically in the percentages of bone-implant contact (BIC) between the test group (BIC = 69.25±4.49%.) and control group (BIC = 56.25 ± 4.8%) by one-way analysis of variance (ANOVA). Significance was set at p ≤ 0.05. Conclusions. The outcome of the present study indicates a novel approach to improving bone healing around titanium implants.

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Objective assessment of stiffness in Achilles tendinopathy: a novel approach using the MyotonPRO

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2018-000446 ◽

2018 ◽

Vol 4 (1) ◽

pp. e000446 ◽

Cited By ~ 3

Author(s):

Gafin Ericson Morgan ◽

Rhodri Martin ◽

Lisa Williams ◽

Owen Pearce ◽

Keith Morris

Keyword(s):

Dynamic Stiffness ◽

Objective Assessment ◽

Weight Bearing ◽

Achilles Tendinopathy ◽

Control Group ◽

Asymptomatic Group ◽

Musculotendinous Junction ◽

Significant Difference ◽

Group 2 ◽

Group 1

ObjectivesThe aim of this study was to establish quantitative values for asymptomatic and symptomatic Achilles tendons.DesignCohort study with a single (cross-sectional) time point of patients diagnosed with unilateral Achilles tendinopathy and an asymptomatic group with comparative homogeneity.MethodsA sample of 50 participants: 25 diagnosed with symptomatic unilateral Achilles tendinopathy (AT group) and 25 with asymptomatic Achilles tendons (control group 2). The asymptomatic side of the AT group was used as a control (control group 1). Measurements at 2 cm intervals on the tendon from its insertion at the calcaneum up to the musculotendinous junction were taken non-weight bearing (NWB) and weight bearing (WB) using the MyotonPRO.ResultsThere was a significant (p<0.005) decrease in natural oscillation frequency (F) at points 2, 3 and 4 of the AT group (NWB condition) and points 2 and 3 for the WB condition. There was a significant (p<0.005) increase in logarithmic decrement (D) at points 2 and 3 signifying a decrease in elasticity. Dynamic stiffness (S) was significantly (p<0.005) reduced in the AT group at points 2 and 3 WB and point 3 WB. There was no significant difference in creep (C) observed between the symptomatic and asymptomatic tendons. There was a significant (p<0.005) increase in mechanical stress relaxation time (R) at point 2 NWB.There was a correlation between body weight and gender on tendon mechanics, with the symptomatic tendons. No significant differences were observed between the control group 1 and control group 2.ConclusionsThe MyotonPRO measured decreased stiffness over a section of the tendon corresponding clinically with Achilles tendinopathy. This may have potential in identifying risk of injury and informing rehabilitation, however further extensive research is required to generate baseline data for specific population groups monitoring variables over time. Age, gender and body mass index appear to have some bearing on the mechanical properties of the tendon but mainly in the tendinopathy group.

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Multiple Gene Polymorphisms Associated with Exfoliation Syndrome in the Uygur Population

Journal of Ophthalmology ◽

10.1155/2019/9687823 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yi-Nu Ma ◽

Ting-Yu Xie ◽

Xue-Yi Chen

Keyword(s):

Protective Factor ◽

Lysyl Oxidase ◽

Direct Sequencing ◽

Control Group ◽

Exfoliation Syndrome ◽

Nucleotide Polymorphisms ◽

Age And Gender ◽

Protective Allele ◽

Significant Difference ◽

And Gender

Background. Our previous data suggested that three single-nucleotide polymorphisms (SNPs), rs1048661, rs3825942, and rs2165241, of the lysyl oxidase-like 1 gene (LOXL1) are significantly associated with exfoliation syndrome (XFS) and exfoliation glaucoma (XFG). The following study investigated other SNPs that potentially effect XFS/XFG. Methods. A total of 216 Uygur patients diagnosed with XFS/XFG, and 297 Uygur volunteers were admitted to the First Affiliated Hospital at Xinjiang Medical University between January 2015 and October 2017. Blood samples were collected by venipuncture. Alleles and genotypes of LOXL1, TBC1D21, ATXN2, APOE, CLU, AFAP1, TXNRD2, CACNA1A, ABCA1, GAS7, and CNTNAP2 were analyzed by direct sequencing. Results. The allele G of rs41435250 of LOXL1 was a risk allele for XFS/XFG (P<0.001), whereas the allele G of rs893818 of LOXL1 was a protective allele for XFS/XFG (P<0.001). After adjusting all data for age and gender, the following results were obtained: the frequency of genotype CC for rs7137828 of ATXN2 was significantly higher in XFS/XFG patients than in controls (P=0.027), while no significance was found with reference to the frequency of genotype TT. The frequency of genotype GG for rs893818 of LOXL1 (P<0.001) and the frequency of genotype AA were both significantly higher in XFS/XFG groups compared to the control group (P<0.001). In addition, the frequency of genotype TT for rs41435250 of LOXL1 was higher in XFS/XFG patients than in controls (P=0.003), while no significant difference was found with reference to the frequency of genotype GG after adjusting for age and gender. In addition, the haplotypes G-A/T-G/G-G for rs41435250 and rs893818 were significantly associated with XFS/G. Conclusions. With reference to LOXL1, the rs41435250 resulted as a risk factor and rs893818 as a protective factor for XFS/XFG in the Uygur populations. Meanwhile, the rs16958445 of TBC1D21 and the rs7137828 of ATXN2 have also shown to be associated with pathogenesis of XFS/XFG.

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Reeducation of pelvic floor muscles in volleyball athletes

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.60.05.010 ◽

2014 ◽

Vol 60 (5) ◽

pp. 428-433 ◽

Cited By ~ 16

Author(s):

Silvia Ferreira ◽

Margarida Ferreira ◽

Alice Carvalhais ◽

Paula Clara Santos ◽

Paula Rocha ◽

...

Keyword(s):

Pelvic Floor ◽

Female Athletes ◽

Rehabilitation Program ◽

Pelvic Floor Muscles ◽

Control Group ◽

Abdominal Pressure ◽

Assessment Instruments ◽

Urinary Leakage ◽

Significant Difference ◽

Before And After

Objective: to verify the effectiveness of the pelvic floor muscles rehabilitation program (PFMRP) in female volleyball athletes, analyzing the amount and frequency of urinary leakage. Methods: experimental study. The sample consisted of 32 female athletes from Famalicão Athletic Volleyball Club (Portugal). The athletes were selected by convenience and distributed randomly into two groups: experimental group (EG = 16 athletes) and the control group (CG = 16 athletes). The EG underwent PFMRP for three months. The PFMRP was the awareness and identification of the pelvic floor muscles (PFM), pre-timed PFM contraction prior to occasions of increased intra-abdominal pressure, and 30 daily contractions of MPP at home. The CG had only access to the pamphlet. The assessment instruments included the questionnaires, the Pad Test (amount of urinary leakage) and frequency record of urinary leakage (7-day diary) before and after PFMRP. Results: the amount of urine leakage decreased in 45.5% of athletes under PFMRP intervention, and in 4.9% of athletes in CG, with statistical differences between the groups (p < 0.001). The reduction in the frequency of urinary leakage was 14.3% in EG, and 0.05% in CG, a statistically significant difference between the groups (p < 0.001). Conclusion: PFMRP in this study was effective to reduce stress urinary incontinence in female volleyball athletes. The program allowed significant improvement of symptoms of quantity and frequency of urinary leakage.

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A genetic variant in the promoter of lncRNA MALAT1 is related to susceptibility of ischemic stroke

10.21203/rs.2.19452/v1 ◽

2019 ◽

Author(s):

yan wang ◽

Xi-Xi Gu ◽

Hua-Tuo Huang ◽

Chun-Hong Liu ◽

Gui-Jiang Wei ◽

...

Keyword(s):

Ischemic Stroke ◽

Lung Adenocarcinoma ◽

Protective Factor ◽

Genetic Variant ◽

Blood Lipid ◽

Control Group ◽

Lipid Levels ◽

Lncrna Malat1 ◽

Significant Difference ◽

Blood Lipid Levels

Abstract Metastasis-associated lung adenocarcinoma transcript-1 (MALAT1) was aberrantly expressed in diverse diseases including ischemic stroke (IS). This study aimed to investigate the association between MALAT1 polymorphism and IS risk. We performed the genotyping of rs600231, rs1194338, rs4102217 and rs591291 in the promoter of MALAT1 by SNPscan method. Quantitative PCR was used to determine the levels of MALAT1 relative expression. We found the rs1194338 C>A variant in MALAT1 promoter was associated with IS risk (AC vs. CC: adjusted OR = 0.623, 95% CI, 0.417-0.932, P = 0.021; AA vs. CC: adjusted OR = 0.474, 95% CI, 0.226-0.991, P = 0.047; AC/AA vs. CC: adjusted OR = 0.596, 95% CI, 0.406-0.874, P = 0.008; A vs. C adjusted OR = 0.658, 95% CI, 0.487-0.890, P = 0.007). The IS patients showed higher expression levels of MALAT1 compared with the control group ( P < 0.05), but patients with AC/AA genotypes of rs1194338 have no significant difference compared to CC genotype ( P > 0.05). In addition, no significant differences were observed in blood lipid levels among SNPs of MALAT1 ( P > 0.05). These results suggest that the rs1194338 AC/AA genotypes may be a protective factor for IS, which mechanism needs to be further explored.

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Augmented Rehabilitation Program for Young Patients Following Total Hip Arthroplasty- Feasibility Study

10.21203/rs.3.rs-510945/v1 ◽

2021 ◽

Author(s):

Ahmed M. Negm ◽

Milad Yavarai ◽

Gian S. Jhangri ◽

Robert Haennel ◽

C. Allyson Jones

Keyword(s):

Physical Activity ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Intervention Group ◽

Young Patients ◽

Rehabilitation Program ◽

Control Group ◽

Total Hip ◽

Significant Difference

Abstract Background: The increase rate seen in total hip arthroplasty (THA) for younger patients (< 60) has implications for future rehabilitation demands for primary and revision THA surgery. The primary objective is to examine the feasibility of a study comparing a 6-week post-operative rehabilitation program to usual care in patients ≤ 60 years undergoing elective unilateral THA. The secondary objectives are: 1) to explore the effect of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA), function and participants’ satisfaction compared to age- and sex-matched control group received usual postoperative care at 12-week post-THA. 2) to examine the correlation between physical activity and self-reported pain and function.Methods: In this study, a cohort of THA candidates were recruited during their 6-week postoperative visit to their surgeons at a central intake clinic. The out-patient rehabilitation program, which was designed to improve function and increase activity, consisted of 12 structured exercise classes (2 hrs/class) on land and water over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention.Results: Of the 24 participants recruited, 14 participants received the augmented rehabilitation, and 10 participants were in the control group. All the study participants in the control and intervention groups completed the baseline and follow-up assessments without adverse events. Thirteen out of the fourteen intervention group participants completed at least 80% of the intervention sessions. The intervention group took significantly more steps/day (mean difference = 2,440 steps/day, 95% CI= 1678, 4712) (p<0.05), at the follow-up compared to baseline. The intervention group had a higher mean change of number of weekly PA bouts than the control group. Within the intervention group, all HOOS subscales were significantly higher at the follow-up compared to baseline. However, the ADL subscale was the only significant difference seen with the control group.Conclusion: The study intervention and assessments were feasible and safe in patients ≤ 60 years undergoing elective unilateral THA.

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Resilience of Adolescents Diagnosed with Anxiety and Their Parents in Clinical Sample

European Journal of Natural Sciences and Medicine ◽

10.26417/931obr58v ◽

2021 ◽

Vol 4 (1) ◽

pp. 58

Author(s):

Krisztina Törő ◽

Szabolcs Takács ◽

Gábor Csikós

Keyword(s):

Anxiety Disorders ◽

Positive Relationship ◽

Protective Factor ◽

Clinical Sample ◽

Control Group ◽

Clinical Group ◽

Psychiatric Problem ◽

Resilience Scale ◽

Significant Difference ◽

Psychological Difficulties

Anxiety disorder is the most frequent psychiatric problem among children and adolescents. Research proved that resilience can be a protective factor in coping with psychological difficulties. Our research focuses on these aspects of resilience. Aims: We aimed to investigate the resilience and anxiety level of families with adolescents who were diagnosed with anxiety disorders. The clinical sample included 40 adolescents who were diagnosed with anxiety disorders and who received ambulant treatment. (18 boys and 22 girls; age: M=13.37 years, SD=1.46). Members of the control group were recruited from schools and they were normally developing adolescents without any psychiatric diagnosis. (18 boys and 19 girls, age: M=13.7 years; SD=1.56) DASS-21, Ten items Connor-Davidson Resilience Scale and self-made demographic sheet were used. Regarding the resilience, a Significant difference was found between the clinical and the sample group both among the mothers and their children. However, in the case of fathers, no discrepancy was found. Our results suggest that there is a significant, moderate positive relationship between the resilience of the mother and their children. Nevertheless, similar mechanisms in the fathers’ case cannot be registered. In the control group, the fathers’ perception of their child’s resilience proved to be the strongest predictive factor (beta=0,495). On the contrary in the clinical group, the maternal perception was more accurate. (beta=0,06). Resilience can serve as a protective factor against anxiety. Our results can be useful for practitioners and draw attention to the importance of intrafamily mechanisms in coping with anxiety and mood disorders.

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Water Hyacinth (Eichhorniacrassipes) Ethanolic Extract Anti Platelet Activity

KnE Life Sciences ◽

10.18502/kls.v6i1.8773 ◽

2021 ◽

pp. 969-978

Author(s):

Perdina Nursidika

Keyword(s):

Cardiovascular Diseases ◽

Blood Vessel ◽

Effective Dose ◽

Water Hyacinth ◽

Ethanolic Extract ◽

Negative Control ◽

Control Group ◽

Standard Group ◽

Group I ◽

Significant Difference

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. CVDs are responsible for 37% of deaths in Indonesia. Thrombosis is the main factor causing blood vessel clost in CVDs. Blood vessel clots then affect narrowed blood vessel. This causes strokes. The aim of this study is to determine the antithrombotic effect of water hyacinth ethanolic extract, the effective dose, and the potential to become anticoagulant agent. The water hyacinth was extracted by ethanol 96%. The extract was tested on five groups of mice, each group containing five mice. Each group was tested for fourteen days. Group I and II are fed by extract suspension with varied dose 1 mg/BW and 2 mg/BW. Group III is fed by warfarin as standard. Group IV and V are the positive and negative group, the mice were fed by NaCMC. On the 7th and 14th days, prothrombin time (PT) and activated partial thromboplastin time (aPTT) were conducted. The plasma of group 1-IV mixed with adenosine diphosphate (ADP) as inducer, except plasma of group V used for negative control, did not mixed with ADP. Data analysed by ANOVA and LSD to obtain effective dose. The results showed the difference between PTT and aPTT among the tested groups. Group I and II showed prolonged PT which is 22 and 32 seconds respectively. The control positive showed PT 9.48 seconds on day 7th and 8.22 seconds on day 14th. LSD analysis showed that there is the significant difference between positive control and the other groups. It showed platelet aggregation performed due to the addition of ADP as inducer. There was a significant difference between dose 2 and the negative control group, and there is no significant difference of dose 1. In conclusion, water hyacinth has the antithrombotic activity, the effective dose is 1 mg/BW, and it potential to further developed as anticoagulant agent. Keywords: antiplatelet, cardiovascular diseases, water hyacinth.

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