Lower Limb and Trunk Biomechanics After Fatigue in Competitive Female Irish Dancers

Context: Because of the increasing popularity of participation in Irish dance, the incidence of lower limb injuries is high among this competitive population. Objective: To investigate the effects of fatigue on the peak lower limb and trunk angles as well as the peak lower limb joint forces and moments of competitive female Irish dancers during the performance of a dance-specific single-limb landing. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: Fourteen healthy, female, competitive Irish dancers (age = 19.4 ± 3.7 years, height = 165.3 ± 5.9 cm, mass = 57.9 ± 8.2 kg). Intervention(s): Participants performed an Irish dance–specific leap before and after a dance-specific fatigue protocol. During each landing movement, 3-dimensional lower limb kinematics (250 Hz) and ground reaction forces (1000 Hz) were collected. Paired t tests were performed to determine the differences (P ≤ .05) in lower limb and trunk biomechanics prefatigue and postfatigue. Main Outcome Measure(s): Peak lower limb and trunk angles as well as peak lower limb joint reaction forces and external moments. Results: Compared with the prefatigue trials, dancers landed with reduced ankle plantar flexion (P = .003) and hip external rotation (P = .007) and increased hip-adduction alignment (P = .034) postfatigue. Dancers displayed greater anterior shear (P = .003) and compressive (P = .024) forces at the ankle and greater external knee-flexion moments (P = .024) during the postfatigue compared with the prefatigue landing trials. Conclusions: When fatigued, dancers displayed a decline in landing performance in terms of aesthetics as well as increased ankle- and knee-joint loading, potentially exposing them to a greater risk of injuries.

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Acute Effects of 2 Consecutive Simulated Badminton Matches on the Shoulder Range of Motion and Isometric Strength of Elite Youth Players

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2020-0659 ◽

2020 ◽

pp. 1-7

Author(s):

Jaime Fernandez-Fernandez ◽

Alejandro Lopez-Valenciano ◽

Jose Vicente Garcia-Tormo ◽

David Cabello-Manrique ◽

Juan García-López

Keyword(s):

Range Of Motion ◽

External Rotation ◽

Cross Sectional Study ◽

Cross Sectional ◽

Shoulder Range Of Motion ◽

Recovery Strategies ◽

Before And After ◽

Shoulder Strength ◽

Shoulder Range ◽

Dominant Side

Purpose: To analyze the influence of playing 2 consecutive prolonged badminton matches on the shoulder strength and range of motion (ROM) of young players. Methods: Sixteen elite junior badminton players (12 males and 4 females; mean (SD): age 16.2 [0.8] years, body mass 63.5 [6.6] kg, height 173.2 [6.3] cm) participated in a cross-sectional study. Shoulder internal (IR)/external rotation (ER) ROM and IR/ER strength measures were conducted before and after 2 consecutive prolonged (ie, 35 min) matches and 12 hours after the second match. Results: After consecutive matches, IR strength of the dominant side and ER strength of the dominant and nondominant sides (effect size [ES] = 0.20–0.57) were reduced. Shoulder total ROM of the dominant side was decreased (ES = 0.80), while on the nondominant side, IR (ES = 0.66) was also decreased. After 12 hours, results showed decreased values in the IR/ER strength of the dominant side (ES = 0.36–1.00), as well as ER of both dominant and nondominant sides (ES = 0.30–0.59). IR ROM of the nondominant side (ES = 0.69) was also decreased. Conclusion: Present results showed that 2 consecutive matches on the same day with brief rest periods led to significant impairments in shoulder strength and ROM levels. These data can potentially elucidate the need for shoulder-specific training and recovery strategies prior to or during competitions.

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Effect of total-contact orthosis on medial longitudinal arch and lower extremities in flexible flatfoot subjects during walking

Prosthetics and Orthotics International ◽

10.1177/0309364617691621 ◽

2017 ◽

Vol 41 (6) ◽

pp. 579-586 ◽

Cited By ~ 1

Author(s):

Tulaya Prachgosin ◽

Wipawan Leelasamran ◽

Pruittikorn Smithmaitrie ◽

Surapong Chatpun

Keyword(s):

Lower Limb ◽

External Rotation ◽

Reaction Force ◽

Frontal Plane ◽

Knee Extension ◽

Cross Sectional Study ◽

Cross Sectional ◽

Positive Effects ◽

Flexible Flatfoot ◽

Peak Knee

Background: Total-contact orthosis (TCO) is one kind of foot orthosis (FO) that is used to adjust biomechanics in flexible flatfoot. Objective: To determine the effects of a TCO on the MLA moment, MLA deformation angle and lower limb biomechanics. Study Design: Cross-sectional study. Methods: Seven-flatfoot and thirteen-normal foot subjects were recruited by footprint and radiographs. The biomechanics of subjects with normal foot (NF), flatfoot with shoe only (FWOT) and flatfoot with TCO (FWT) were collected in a 3D motion analysis laboratory and force plates. The MLA and lower limb biomechanics in each condition during specific sub-phases of stance were analyzed. Results: The NF had larger MLA eversion moment after shod walking ( p = 0.001). The FWT condition compared with the FWOT condition had a significantly larger peak MLA upward moment ( p = 0.035) during pre-swing, larger peak knee external rotation angle ( p = 0.040) during mid stance, smaller peak knee extension moment during terminal stance ( p = 0.035) and a larger ground reaction force in the anterior-posterior direction during early stance ( p < 0.05). Conclusion: Our study found positive effects from the customized TCOs which included an increased TCO angle that led to a decreased peak MLA moment in the frontal plane in flexible flatfoot subjects during walking. Clinical relevance Lower limb biomechanics is different from normal in subjects with flexible flatfoot. The design of a TCO affects MLA, ankle and knee biomechanics and may be used to clinically correct biomechanical changes in flexible flatfoot.

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Which of the five classical ballet positions is the most demanding for the dancer’s body? An electromyography-based study to determine muscular activity

Acta of Bioengineering and Biomechanics ◽

10.37190/abb-01650-2020-02 ◽

2020 ◽

Vol 22 (4) ◽

Author(s):

Joanna Gorwa ◽

Jarosław Kabaciński ◽

Michał Murawa ◽

Anna Fryzowicz

Keyword(s):

Lower Limb ◽

Sagittal Plane ◽

External Rotation ◽

Muscular Activity ◽

Cross Sectional Study ◽

Electromyographic Activity ◽

Cross Sectional ◽

Figure Skaters ◽

Foot Progression Angle ◽

Classical Ballet

Purpose: The study aimed to determine which of the five classical ballet positions is the most demanding regarding muscular activity, values of external rotation in the hip joints, angular values of foot progression as well as the inclination (tilt) of the pelvis in the sagittal plane. Methods: In this cross-sectional study, 14 female pre-professional ballet dancers (aged 11–16) participated. Participants were tasked with the sequential adoption of five classical ballet positions (CP1–CP5). The electromyographic activity of the muscles of the trunk and the lower limb was recorded with surface electrodes. Kinematic data including hip and knee external rotation, foot progression angle and pelvic tilt were collected using a motion capture system. Results: Symmetric positions CP1 and CP2 were not as demanding as asymmetric CP3–CP5. Higher values of hip and foot external rotation without greater muscular effort in CP2 than CP1 was noticed. Considering asymmetric positions, CP3 did not trigger a greater activity of hip or foot muscular groups than CP4 and CP5. CP4 was characterised by the greatest pelvic anterior tilt and the lowest activity of GM in the forward lower limb. In CP5, forward lower limb entailed a higher activity of muscles supporting the foot than in the remaining positions. Conclusion: In terms of biomechanics, the most demanding classical ballet position in pre-professional dancers is CP4, followed by CP5, CP3, CP1 and CP2. This finding can be applied in educational methodology of dancers, figure skaters, synchronized swimmers, acrobatic gymnasts, rhythmic gymnasts or cheerleaders.

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Self-Managed Exercises, Fitness and Strength Training, and Multifidus Muscle Size in Elite Footballers

Journal of Athletic Training ◽

10.4085/1062-6050-52.3.13 ◽

2017 ◽

Vol 52 (7) ◽

pp. 649-655 ◽

Cited By ~ 3

Author(s):

Julie A. Hides ◽

Jazmin C. Walsh ◽

Melinda M. Franettovich Smith ◽

M. Dilani Mendis

Keyword(s):

Motor Control ◽

Strength Training ◽

Lower Limb ◽

Exercise Program ◽

Cross Sectional Study ◽

Muscle Size ◽

Lower Limb Injuries ◽

Multifidus Muscle ◽

Cross Sectional ◽

Limb Injuries

Context: Low back pain (LBP) and lower limb injuries are common among Australian Football League (AFL) players. Smaller size of 1 key trunk muscle, the lumbar multifidus (MF), has been associated with LBP and injuries in footballers. The size of the MF muscle has been shown to be modifiable with supervised motor-control training programs. Among AFL players, supervised motor-control training has also been shown to reduce the incidence of lower limb injuries and was associated with increased player availability for games. However, the effectiveness of a self-managed MF exercise program is unknown.Objective: To investigate the effect of self-managed exercises and fitness and strength training on MF muscle size in AFL players with or without current LBP.Design: Cross-sectional study.Setting: Professional AFL context.Patients or Other Participants: Complete data were available for 242 players from 6 elite AFL clubs.Intervention(s): Information related to the presence of LBP and history of injury was collected at the start of the preseason. At the end of the preseason, data were collected regarding performance of MF exercises as well as fitness and strength training. Ultrasound imaging of the MF muscle was conducted at the start and end of the preseason.Main Outcome Measure(s): Size of the MF muscles.Results: An interaction effect was found between performance of MF exercises and time (F = 13.89, P ≤ .001). Retention of MF muscle size was greatest in players who practiced the MF exercises during the preseason (F = 4.77, P = .03). Increased adherence to fitness and strength training was associated with retained MF muscle size over the preseason (F = 5.35, P = .02).Conclusions: Increased adherence to a self-administered MF exercise program and to fitness and strength training was effective in maintaining the size of the MF muscle in the preseason.

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Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽

10.3390/healthcare9060747 ◽

2021 ◽

Vol 9 (6) ◽

pp. 747

Author(s):

Sahbanathul Missiriya Jalal ◽

Fahima Akhter ◽

Amal Ismael Abdelhafez ◽

Ahmed Mansour Alrajeh

Keyword(s):

Work Experience ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Demographic Variables ◽

Cross Sectional ◽

Biomedical Waste ◽

Respiratory Therapists ◽

Global Pandemic ◽

Before And After ◽

Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

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Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽

10.3390/sym13040598 ◽

2021 ◽

Vol 13 (4) ◽

pp. 598

Author(s):

Massimiliano Pau ◽

Bruno Leban ◽

Michela Deidda ◽

Federica Putzolu ◽

Micaela Porta ◽

...

Keyword(s):

Multiple Sclerosis ◽

Lower Limb ◽

Sagittal Plane ◽

Cross Sectional Study ◽

Camera Motion ◽

Cross Sectional ◽

Temporal Parameters ◽

Wide Range ◽

Edss Score ◽

Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

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To Study the Clinical Profile and Management of Cellulitis of Lower Limb in Northern India

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620986679 ◽

2021 ◽

pp. 153473462098667

Author(s):

Tripta S. Bhagat ◽

Luv Kumar ◽

Prakhar Garg ◽

Apoorv Goel ◽

Amit Aggarwal ◽

...

Keyword(s):

Bacterial Infection ◽

Lower Limb ◽

Surgical Intervention ◽

Significant Risk ◽

Cross Sectional Study ◽

Common Complication ◽

Cross Sectional ◽

Medical College ◽

Northern India ◽

Working Age

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.

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732. Evaulation of Micafungin Treatment at Pediatric Patients: A cross-sectional Study from Tertiary Pediatric Centre

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.924 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S416-S417

Author(s):

Kamile Arıkan ◽

Nuri Bayram ◽

İlker devrim ◽

Ayküke Akaslan-Kara

Keyword(s):

Amphotericin B ◽

Liver Function Tests ◽

Cross Sectional Study ◽

Resistance Rate ◽

Sectional Study ◽

Candida Spp ◽

Cross Sectional ◽

Median Serum ◽

Before And After ◽

Resistance Patterns

Abstract Background Micafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia. Methods Children who were treated for micafungin for possible or proven invasive Candidia infection between May 2017 and October 2019 were included. Results In this cross-sectional study, totally 78 children with a median age of 3 months (8 days -17 years), 50 (64.1%, F/M: 0.56) male were included. Thirty four (43.6%) patients were neonate, 26 (76 %) of them were premature. Thirty seven patients (47.4%) received micafungin for candidemia and 41 (52.6%) patients received micafungin empirically for IC. Twelve (32.4%) Candida spp cultured were C. albicans, the rest twenty five (67.6%) Candida spp were non-albicans Candida spp. The most commonly cultured Candida spp was Candida parapsilosis (C. parapsilosis) (n=13) followed by C. albicans (n=12), C. glabrata (n=3), C. tropicalis (n=3), C. guilliermondii (n=3), C. krusei (n=2) respectively. Resistance rate of C. parapsilosis (n=13) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 66.7%, 100%, 69.2%, 90.9%, 37.5% respectively. Resistance rate of C. albicans (n=11) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 50%, 50%, 12.5%, 42.9%, 0% respectively. None of the C. tropicalis, C. guilliermondii and C. krusei isolates were resistant to micafungin. Culture negativity could not be achieved at the end of 14th day of micafungin treatment in the 15 (16.9%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=7), the other species were; C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=1) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. Median serum AST, ALT and creatinin levels didn’t increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to micafungin usage. Characteristics of patients who received micafungin.and cultured Candida spp Antifungal resistance patterns of Candida spp. Laboratory change before and after micafungin treatment Conclusion Increase in fluconazole resistant Candida spp makes micafungin a reasonable and effective choice for suspected or proven invasive candidiasis Disclosures All Authors: No reported disclosures

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Six ultraviolet minutes for cleaner operating theatres

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.580 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Bosco ◽

S Gambelli ◽

V Urbano ◽

G Cevenini ◽

G Messina

Keyword(s):

Cross Sectional Study ◽

Cross Sectional ◽

Before And After ◽

Operating Theatres ◽

Cleaning Procedures ◽

The Difference ◽

Contamination Levels ◽

Different Levels ◽

Better Than ◽

Final Cleaning

Abstract Background Sanitizing the operating theatres (OT) is important to minimize risk of post-operative infections. Disinfection procedures between one operation and another is less aggressive than final cleaning procedures, at the end of the day. Aim was assessing the difference of contamination: i) between different levels of disinfection; ii) before and after the use of a UVC Device (UVC-D). Methods Between December 2019/February 2020 a cross sectional study was conducted in OT in a real clinical context. 94 Petri dishes (PD) were used in 3 OT. Three different sanitation levels (SL1-3) were compared pre- and post-use of UVC-D: i) No cleaning after surgery (SL1); ii) after in-between cleaning (SL2); iii) after terminal cleaning (SL3). UVC-D was employed for 6 minutes, 3 minutes per bed side. PD were incubated at 36 °C and colony forming unit (CFU) counted at 48h. Descriptive statistic, Wilcoxon and Mann-Whitney tests were performed to assess the contamination levels in total, pre/post use of UVC-D, and between different sanitation levels, respectively. Results In total we had a mean of 3.39 CFU/PD (C.I. 2.05 - 4.74) and a median of 1 CFU/PD (Min. 0 - Max. 39), after UVC-D use we had a mean of 2.20 CFU/PD (C.I. 0.69 - 5.09) and a median of 0 CFU/PD (Min. 0 - Max. 133). The UVC-D led to a significant reduction of CFU (p < 0.001). Without UVC-D we had a significant CFU drop (p < 0.05) between SL1 and SL3. Using UVC-D, we observed significant reductions of contamination (p < 0.05) between SL3 and SL1. Comparing SL1 (median 0) post UVC-D use vs SL2 pre UVC-D use (median 0.5), and SL2 post UVC-D use (median 0) vs SL3 pre UVC-D use (median 1) we had a significant reduction of contamination (p < 0.05). Conclusions UVC-D improved environmental contamination in any of the three sanitation levels. Furthermore, the use of UVC-D alone was better than in-between and terminal cleaning. Although these encouraging results, the cleaning procedures executed by dedicated staff has to be considered. Key messages UVC are efficient to decrease contamination in operating theatres regardless of sanitation levels. The additional use of UVC technology to standard cleaning procedures significantly improves sanitation levels.

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The Impact of Bariatric Surgery on Menstrual Abnormalities—a Cross-Sectional Study

Obesity Surgery ◽

10.1007/s11695-020-04840-6 ◽

2020 ◽

Vol 30 (11) ◽

pp. 4505-4509

Author(s):

Anna Różańska-Walędziak ◽

Paweł Bartnik ◽

Joanna Kacperczyk-Bartnik ◽

Krzysztof Czajkowski ◽

Maciej Walędziak

Keyword(s):

Bariatric Surgery ◽

Menstrual Cycle ◽

Cross Sectional Study ◽

Reproductive Age ◽

Obese Women ◽

Sectional Study ◽

Cross Sectional ◽

Contraception Use ◽

Before And After ◽

The Impact

Abstract Introduction Obesity is associated with hyperestrogenism along with other hormonal abnormalities affecting the menstrual cycle. The most effective and decisive method of obesity treatment is bariatric surgery. The aim of this study was to analyze the impact of bariatric surgery on menstrual cycle, the incidence of menstrual abnormalities, hyperandrogenism manifestation, and contraception use. Materials and Methods It was a cross-sectional study of 515 pre-menopausal women who had undergone bariatric surgery between 1999 and 2017 in a bariatric center. Data was collected via anonymous questionnaire, and the questions covered a 1-year period before the surgery and the last year before questionnaire completion. Results Before the surgery, 38.6% of the patients reported irregular menstruations in comparison with 25.0% after bariatric surgery (RR = 0.65; 95%CI 0.53–0.79). The mean number of menstruations per year did not differ before and after surgery (10.2 ± 3.9 vs 10.4 ± 3.3; p < .45). There were no statistically significant differences in terms of prolonged menstruations, acne, and hirsutism prevalence. A total of 14.4% of patients before surgery reported estrogen-based contraception use in comparison with 15.0% after the surgery (p < .95). There were no significant differences in the frequency of OC use (11.0% before surgery vs 13.6% 12 months after the surgery vs 11.5% at the moment of survey administration; p < 0.46). Conclusion Bariatric surgery improves the regularity of the menstrual cycle in obese women in reproductive age. The lack of any changes in the combined hormonal contraception (CHC) use, especially OC, before and after bariatric surgery may be a result of a possibly low level of contraception counseling.

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