scholarly journals MOVEMENT PATTERNS DIFFER BETWEEN ATHLETES AFTER SPORT-RELATED CONCUSSION COMPARED TO HEALTHY CONTROLS DURING JUMP LANDING TASK

2021 ◽  
Author(s):  
Bobby Jean Lee ◽  
Damond Blueitt ◽  
Joseph Hannon ◽  
Shiho Goto ◽  
J. Craig Garrison
Keyword(s):  
Lower Extremity ◽  
Sports Medicine ◽  
Sagittal Plane ◽  
Return To Sport ◽  
Knee Extension ◽  
Cross Sectional Study ◽  
Return To Play ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Jump Landing

ABSTRACT Context: A relationship between a positive history of sport-related concussion (SRC) and lower extremity (LE) injury has been well established in the literature. Objective: The purpose of this study was to determine if biomechanical differences exist during a double limb jump landing (DLJ) between athletes who had been released for return to play after SRC and healthy matched controls (Healthy). Design: Cross-Sectional Study Setting: Health system-based Outpatient Sports Medicine Center Participants: 21 participants (16.33±12.7 days out from being released to return to sport after SRC) (age: 15.38±1.77; height: 169.23±8.59; mass: 63.43±7.39) were compared to 21 age, sex, activity-matched healthy controls (age: 15.36±1.73; height: 169.92±11.1; mass: 65.62±12.08). No significant differences existed between groups for descriptive data. Main Outcome Measure(s): Biomechanical performance during DLJ was assessed using Motion Capture System and force plates. The average of five consecutive trials was used to calculate lower extremity joint kinetic and kinematics. Variables of interest included internal knee extension moment, internal varus moment, and total sagittal plane knee displacement for both the dominant and non-dominant limbs. Independent t-tests were performed to examine the differences between SRC and Healthy groups for variables of interest. Results: The SRC group demonstrated greater internal knee extension moments on their dominant (KEDomDiff=–.028±.009; p=.003) and non-dominant (KENonDomDiff=–.018±.007, p=.019) limbs. The SRC group also demonstrated greater internal varus moments on their dominant (VDomDiff=.012±.004, p=.005) and non-dominant (VNonDomDiff=.010±.003, p=.005) limbs. For sagittal plane knee displacement, the SRC group demonstrated less knee flexion displacement on their dominant (DispDomDiff=–12.56±4.67, p=.011) but not their non-dominant limb (DispNonDomDiff=–8.30±4.91, p=.099). Conclusions: Athletes who have been released for return to sport after SRC land in greater knee valgus compared to healthy matched controls.

scholarly journals The Effects of Angular Velocity and Training Status on the Dynamic Control Equilibrium

2017 ◽  
Vol 01 (01) ◽  
pp. E23-E29 ◽  
Author(s):  
Tobias Alt ◽  
Axel Knicker ◽  
Heiko Strueder
Keyword(s):  
Angular Velocity ◽  
Dynamic Control ◽  
Return To Sport ◽  
Knee Extension ◽  
Cross Sectional Study ◽  
Thigh Muscle ◽  
Training Status ◽  
Cross Sectional ◽  
Muscle Balance ◽  
And Training

AbstractThigh muscle imbalances may impair sports performance and cause injuries. Common diagnostic parameters of knee muscle balance lack practical applicability. This cross-sectional study aimed to evaluate the effects of angular velocity and training status on the dynamic control ratio at the equilibrium point representing the intersection of eccentric knee flexion and concentric knee extension moment-angle curves. 58 trained and 58 untrained male participants (22.1 years, 82.4 kg) performed concentric and eccentric knee flexions (prone position) and extensions (supine position) on an isokinetic dynamometer operating at 30 and 150°/s. Trained participants had significantly higher DCRe moments at all angular velocities compared with their untrained counterparts (trained30,150: 1.86, 1.90 Nm/kg; untrained30,150: 1.56, 1.60 Nm/kg; p<0.001, partial η²=0.345). Dynamic control equilibrium moments rose with increasing velocity (p=0.001, partial η²=0.095), whereas dynamic control equilibrium angles (trained30,150: 28.9, 30.8°; untrained30,150: 26.1, 27.0°) were influenced by training status (p=0.004, partial η²=0.072), but not by angular velocity (p=0.241, partial η²=0.012). Dynamic control equilibrium parameters detect thigh muscle balance and reflect the trained participants’ capacity to resist high eccentric knee flexor moments, especially during fast movements. Direct links to muscular loading during sprinting are conceivable, but warrant further investigation. The assessment of dynamic control equilibrium moments and angles might help physiotherapists and coaches to improve functional muscle screening, injury prevention and purposeful return to sport.

scholarly journals Impaired muscle capacity of the hip and knee in individuals with isolated patellofemoral osteoarthritis: a cross-sectional study

2021 ◽  
Vol 12 ◽  
pp. 204062232110287
Author(s):  
Cristiano Carvalho ◽  
Fábio Viadanna Serrão ◽  
Letícia Mancini ◽  
Paula Regina Mendes da Silva Serrão
Keyword(s):  
Physical Functioning ◽  
Average Power ◽  
Peak Torque ◽  
Knee Extension ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Patellofemoral Osteoarthritis ◽  
Total Work ◽  
Sectional Study ◽  
Cross Sectional

Aims: The aims of this study were to compare the capacity of the knee and hip muscles between individuals with and without isolated patellofemoral osteoarthritis (PFOA) and to evaluate the impact of PFOA on pain, stiffness, and physical function. Methods: This cross-sectional study evaluated muscle capacity of the hip and knee using an isokinetic dynamometer. The isokinetic variables used in the statistical analysis were peak torque, total work, and average power. Pain, stiffness, and physical function were assessed using questionnaires. Results: A total of 26 individuals participated in the study (13 with PFOA and 13 controls). The PFOA group exhibited lower peak torque, total work, and average power for knee extension and flexion in the concentric mode ( p ⩽ 0.01) as well as lower peak torque and total work for knee extension ( p ⩽ 0.005) and lower total work for knee flexion ( p = 0.05) in the eccentric mode. The PFOA group exhibited lower peak torque of the extensor, abductor, adductor, and internal rotator muscles of the hip ( p ⩽ 0.05), less total work of the abductor and adductor muscles ( p ⩽ 0.04), and lower average power of eccentric adduction of the hip ( p = 0.01) compared with the healthy controls. Compared with the control group, the PFOA group had a higher level of pain, stiffness, and compromised physical functioning self-reported ( p ⩽ 0.005). Conclusion: Participants with PFOA exhibited impairments regarding muscle capacity of the hip and knee, higher level of pain and stiffness as well as compromised physical functioning in comparison with healthy controls.

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

Symmetry ◽  
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.

scholarly journals Systematic Review of Orthopaedic and Sports Medicine Injuries and Treatment Outcomes in Women's National Basketball Association and National Basketball Association Players

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098207
Author(s):  
Sachin Allahabadi ◽  
Favian Su ◽  
Drew A. Lansdown
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Achilles Tendon ◽  
Sports Medicine ◽  
Direct Consequence ◽  
National Basketball Association ◽  
Return To Play ◽  
Level Of Evidence ◽  
Cartilage Injuries ◽  
Women's National Basketball Association

Background: Athletes in the Women’s National Basketball Association (WNBA) and National Basketball Association (NBA) are subject to high injury rates given the physical demands of the sport. Comprehensive data regarding injury patterns and rates in these athletes are limited. Purpose: To summarize available data on orthopaedic and sports medicine–related injuries through 2020 in professional female and male basketball players. Study Design: Systematic review; Level of evidence, 4. Methods: A search was conducted using PubMed and Embase through April 5, 2020, to identify injury studies regarding WNBA and NBA players. Studies were included if the injury or surgery was considered a direct consequence of game play including musculoskeletal/orthopaedic, concussion, ophthalmologic, and craniomaxillofacial injuries. Systematic reviews, screening studies, or studies without sufficient WNBA or NBA player subgroup analysis were excluded. Results: A total of 49 studies met inclusion criteria, 43 (87.8%) of which detailed musculoskeletal injuries. The lower extremity represented 63.3% of studies. A majority (59.2%) of studies were level 4 evidence. The source of data was primarily comprehensive online search (n = 33; 67.3%), followed by official databases (n = 11; 22.4%). Only 3 studies concerned WNBA athletes compared with 47 that concerned NBA athletes. The lowest return-to-play rates were cited for Achilles tendon repairs (61.0%-79.5%). Variability in return-to-play rates existed among studies even with similar seasons studied. Conclusion: The majority of literature available on orthopaedic and sports medicine–related injuries of NBA and WNBA athletes is on the lower extremity. The injuries that had the greatest effect on return to play and performance were Achilles tendon ruptures and knee cartilage injuries treated using microfracture. The reported outcomes are limited by heterogeneity and overlapping injury studies. There are limited available data on WNBA injuries specifically.

scholarly journals Choroidal vascularity index in thyroid-associated ophthalmopathy: a cross-sectional study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Pasquale Loiudice ◽  
Marco Pellegrini ◽  
Michele Marinò ◽  
Barbara Mazzi ◽  
Ilaria Ionni ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Activity Score ◽  
Enhanced Depth Imaging ◽  
Clinical Activity ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Clinical Activity Score ◽  
Significant Difference ◽  
Thyroid Associated Ophthalmopathy ◽  
Imagej Software

Abstract Background Hemodynamic changes have been observed in patients with Graves’ disease. The aim of our study was to evaluate choroidal vascular change using the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO). Methods In this cross-sectional observational study, 40 patients affected by TAO were recruited. Forty healthy individuals, matched for age and sex, served as controls. Foveal enhanced-depth imaging optical coherence tomography scans were obtained from all participants. Images were binarized using the ImageJ software and luminal area (LA) and total choroidal area (TCA) were measured. CVI was calculated as the proportion of LA to TCA. The relation between CVI or subfoveal choroidal thickness (SFCT) and clinical activity score, exophthalmometric value, diplopia status, gender, and age was evaluated. Results CVI was significantly higher in patients with TAO (P = 0.004). No significant difference was observed in SFCT (P = 0.200) and TCA (P = 0.153) comparing TAO patients and healthy controls. LA was significantly higher in TAO group (P = 0.045). On multiple regression analysis, CVI was associated with TCA (P = 0.043). No association was found between SFCT or CVI and TCA, clinical activity score, exophthalmometric value, Inami value, diplopia status, gender or age (P > 0.05). Conclusions This is the first study that has demonstrated an increase in CVI in eyes with TAO compared with healthy controls and has assessed its association with clinical features.

scholarly journals In Response to COVID-19: Current Trends in Orthopaedic Surgery Sports Medicine Fellowships

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098700
Author(s):  
Jordan L. Liles ◽  
Richard Danilkowicz ◽  
Jeffrey R. Dugas ◽  
Marc Safran ◽  
Dean Taylor ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Skills Training ◽  
Cross Sectional Study ◽  
Surgical Skills ◽  
Human Interaction ◽  
Third Party ◽  
Service Needs ◽  
Case Volume ◽  
Cross Sectional ◽  
Sports Coverage

Background: The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs. Purpose/Hypothesis: Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease. Study Design: Cross-sectional study. Methods: In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server. Results: In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were “redeployed” to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%). Conclusion: Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows’ exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.

Central neuropathic pain in multiple sclerosis is associated with impaired innocuous thermal pathways and neuronal hyperexcitability

Pain Medicine ◽  
2021 ◽  
Author(s):  
Michal Rivel ◽  
Anat Achiron ◽  
Mark Dolev ◽  
Yael Stern ◽  
Gaby Zeilig ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neuropathic Pain ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Sensory Testing ◽  
Cross Sectional ◽  
Central Neuropathic Pain ◽  
Body Regions ◽  
Thermal Grill Illusion

Abstract Objective About a third of patients with multiple sclerosis (MS) suffer from chronic and excruciating central neuropathic pain (CNP). The mechanism underlying CNP in MS is not clear, since previous studies are scarce and their results are inconsistent. Our aim was to determine whether CNP in MS is associated with impairment of the spinothalamic-thalamocortical pathways (STTCs) and/or increased excitability of the pain system. Design Cross sectional study Setting General hospital Subjects 47 MS patients with CNP, 42 MS patients without CNP, and 32 healthy controls. Methods Sensory testing included the measurement of temperature, pain, and touch thresholds and the thermal grill illusion (TGI) for evaluating STTCs function, and hyperpathia and allodynia as indicators of hyperexcitability. CNP was characterized using interviews and questionnaires. Results The CNP group had higher cold and warm thresholds (p &lt; 0.01), as well as higher TGI perception thresholds (p &lt; 0.05), especially in painful body regions compared to controls, whereas touch and pain thresholds values were normal. The CNP group also had a significantly greater prevalence of hyperpathia and allodynia. Regression analysis revealed that whereas presence of CNP was associated with a higher cold threshold, CNP intensity, and the number of painful body regions were associated with allodynia and hyperpathia, respectively. Conclusions CNP in MS is characterized by a specific impairment of STTC function; the innocuous thermal pathways, and by pain hyperexcitability. Whereas CNP presence is associated with STTC impairment, its severity and extent are associated with pain hyperexcitability. Interventions that reduce excitability level may therefore mitigate CNP severity.

scholarly journals Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
R. Meier ◽  
C. Emch ◽  
C. Gross-Wolf ◽  
F. Pfeiffer ◽  
A. Meichtry ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cross Sectional Study ◽  
Sensorimotor System ◽  
Healthy Controls ◽  
Low Back ◽  
Sectional Study ◽  
Clinical Tests ◽  
Body Perception ◽  
Cross Sectional

Abstract Background Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. Methods A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. Results MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. Conclusions Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. Trial registration No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015–243.

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