Effect of six-week traditional resistance and functional training on functional performance in female netball players

Background Improving the quality of functional movements in athletes generally requires additional training targeting specific functional deficiencies. However, well-rounded, traditional strength and conditioning program should also improve player’s movement quality. Therefore, the primary aim of this study was to compare the effect of two different six-week interventions on the functional score of female netball players. Methods In a randomized controlled study, players were divided into control and intervention group. Both groups completed identical six-week strength and conditioning program, with the intervention group also completing additional corrective exercises three sessions per week during the same period. Results The FMS® score was significantly higher in the intervention group after 6-week program (f = 9.85, p = 0.004). However, the differences in total score may be attributed mainly to differences between groups in active straight leg raise (p = 0.004) and trunk stability push-up test (p = 0.02), as other individual tests demonstrated similar time and group effect. Conclusion These results indicate that although FMS® based intervention may improve overall functional movement score, the athletes in both groups have demonstrated similar improvements in most of the individual tests. Hence, a well-rounded strength and conditioning program incorporating athlete-specific exercises based on limitations identified in the functional movement screen, may result in a balanced training strategy and reduce the need for supplementary functional training sessions.

Multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures

Objectives: To retrospectively evaluate a multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures in the emergency department. Methods: The records of patients with pelvic fractures complicated with multiple fractures treated in our hospital from February 2020 to April 2021 were selected, of which 34 patients received conventional trauma first aid mode (control group) and 34 patients received multidisciplinary joint first aid mode (study group). We compared pelvic function (Majeed functional score) and fracture reduction outcomes, as well as serum inflammatory factor levels and complication rates after treatment between the two groups. Results: The Majeed score in the study group (90.15 ± 6.83) was higher than that in the control group (75. 47 ± 5.35), and the differences were statistically significant (P<0.05). The value for combined excellent and good rates of fracture reduction in the study group (85.29%, 29/34) was significantly higher than that in the control group (58.82%, 20/34), and the difference was statistically significant(P<0.05). We found similar levels of TNF-a and IL-6 between the two groups at admission (P>0.05); however, the serum levels of TNF-a and IL-6 in the study group were lower than those in the control group on the fifth day after admission, and the difference was statistically significant (P<0.05 or P<0.01). The incidence of complications in the study group (17.64%, 6/34) was significantly lower than that in the control group (61.76%, 21/34), the difference was statistically significant (P<0.05). Conclusion: The multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures can effectively shorten the treatment time, increase the excellent functional rehabilitation rate, inhibit the release of inflammatory factors, and reduce the incidence of complications (such as infections), when compared to the conventional trauma emergency system. doi: https://doi.org/10.12669/pjms.38.3.5014 How to cite this:Han Y, Peng G, Liu L, Xie X. Multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Baseline Quality of Life of Physical Function Is Highly Relevant for Overall Survival in Advanced Rectal Cancer

In advanced rectal cancer, neoadjuvant radiochemotherapy and total mesorectal excision lead to long overall survival. The quality of life (QOL) of the patients is clearly related to the prognosis. Our question was whether the prognosis can be represented with only one question or one score from the QOL questionnaires. 360 consecutively recruited patients diagnosed with advanced rectal cancer were questioned during radiochemotherapy and a follow-up of 8 years. The questionnaires QLQ-C30 and QLQ-CR38 were used; 10 functional and 17 symptom scores were calculated. The functional score “physical function” and the symptom scores “fatigue”, “nausea and vomiting”, “pain” and “appetite loss” were highly prognostic (p < 0.001) for overall survival. “Physical function” was highly prognostic at all time points up to 1 year after starting therapy (p ≤ 0.001). The baseline “physical function” score divided the cohort into a favorable group with an 8-year overall survival rate of 70.4% versus an unfavorable group with 47.5%. In the multivariable analysis, baseline “physical function”, age and distant metastases were independent predictors of overall survival. The score “physical function” is a powerful unrelated risk factor for overall survival in patients with rectal cancer. Future analyses should study whether increased “physical function” after diagnosis could improve survival.

Arthroscopic transosseous foveal footprint repair of the triangular fibrocartilage complex

Foveal disruption of the triangular fibrocartilage complex contributes to the instability of distal radioulnar joint. We have developed an arthroscopic transosseous foveal footprint repair technique, which maximizes the contact between the disrupted triangular fibrocartilage complex and its foveal footprint for better healing by using four sutures in a divergent configuration through a 1.6-mm bone tunnel. Twelve patients with triangular fibrocartilage complex foveal injuries who had undergone this repair technique were reviewed with a mean follow-up of 53 months. All patients achieved significant improvement in the modified Mayo wrist score and the Disabilities of the Arm, Shoulder and Hand score. All patients had stable distal radioulnar joints with comparable ranges of motion and grip strengths between the operated and contralateral wrists. There was no significant difference in functional score in those who were treated more than 6 months after injury. Level of evidence: IV

Wrist Arthrodesis with Vascularized Fibular Graft after Failed Allograft Replacement for Giant-Cell Tumor Resection

Giant-cell tumor (GCT) is locally aggressive bone neoplasm, with an unpredictable pattern of biological aggressiveness. The optimal treatment had to achieve a negligible local recurrence rate while maximizing musculoskeletal function. Numerous options for reconstruction are available, but in the literature there is a lack of salvage surgery data. We present a case of a 67-year-old woman who underwent complete wrist arthrodesis with vascularized fibular graft as salvage procedure for allograft necrosis, after excision of a distal radius GCT. The patient did not complain of any impairment in daily use, and the functional score was 22 points (73%) at latest follow-up of 14 months. Despite joint salvage remains the most favorable treatment with regard to functional outcome for aggressive tumors of the distal radius, vascularized fibular grafts is a valuable alternative especially in salvage procedures, where the use of another allograft could lead to higher complications rate. Keywords: Vascularized fibular graft, Wrist arthrodesis, Giant-Cell Tumor, Fibula free flap.

Oculomotor Behavior Predict Professional Cricket Batting and Bowling Performance

Importance: A new, shorter version of cricket was introduced recently (Twenty20; T20). Since its inception, T20 cricket has rapidly become a popular and exciting format of cricket. However, there is little understanding of factors such as visual-motor control that influence expert performance.Objective: The purpose of this project is to determine if a series of oculomotor measures can predict batting and bowling performance in professional cricket players.Design: This study used a cross-sectional design. Each participant took part in a suite of eye-tracking tests to measure oculomotor behavior compared to their performance data.Participants: This study used a sample of 59 male T20 league professional cricket players (30 Bowlers and 29 Batsman).Results: One-way univariate analyses of variance examined the differences in oculomotor behavior between batsman and bowlers. A series of multiple regression analyses was conducted to evaluate how well the visual variables predict bowling and batting performance variables. Results demonstrate that several oculomotor eye tracking measures were good predictors of run performance and strike rate, including sports total score, sports on-field score, and sports functional score. Likewise, several of the same metrics predicted Runs and Wicket performance for bowlers. Overall, results provided further validation to a growing body of literature supporting the use of eye-tracking technology in performance evaluation.

Bone-on-Bone Contact on Radiograph is not a Prerequisite for Successful Outcome in Fixed-Bearing Medial Unicompartmental Knee Arthroplasty—A 10-Year Follow-Up Study

Introduction Patients without bone-on-bone osteoarthritis are excluded from mobile-bearing unicompartmental knee arthroplasty due to higher revision rates and poorer outcomes. However, we do not know if the same indication applies to fixed-bearing unicompartmental knee arthroplasty implants. Our study aims to compare functional outcomes and revision rates in patients with and without bone-on-bone arthritis undergoing fixed-bearing medial unicompartmental knee arthroplasty. Materials and Methods We reviewed 153 fixed-bearing medial unicompartmental knee arthroplasties in a single institution. Patients were divided into four groups based on joint space remaining measured on preoperative radiographs. Group 1 included knees with bone-on-bone contact; group 2 included knees with less than 2 mm joint space; group 3 included knees with 2 to 4 mm joint space; group 4 included knees with more than 4 mm joint space. Patients were followed up for 10 years postoperatively and assessed using the Oxford Knee Score, the Functional Score and Knee Score from the Knee Society Clinical Rating Score, and the Short Form 36 Health Survey. Results There was no difference in terms of demographic data and preoperative scores. Postoperative Knee Society Functional Score was found to be lower in group 1 as compared with the other groups. There was no difference between the four groups of patients in terms of Knee Society Knee Score, Oxford Knee Score, and Physical Component Summary and Mental Component Summary Scores from the Short Form 36 Health Survey. There was no difference in terms of survivorship free from all-cause revision at a minimum of 10 years' follow-up. Conclusion Symptomatic patients with varying degrees of arthritis on preoperative radiographs had comparable clinical outcomes. We conclude that symptomatic patients with clinical and radiographic evidence of medial compartment osteoarthritis of any grade can benefit from a fixed-bearing medial unicompartmental knee arthroplasty.

Three-stage limb salvage in tibial fracture related infection with composite bone and soft-tissue defect

Introduction Managing critical-sized tibial defects is one of the most complex challenges orthopedic surgeons face. This is even more problematic in the presence of infection and soft-tissue loss. The purpose of this study is to describe a comprehensive three-stage surgical protocol for the reconstruction of infected tibial injuries with combined bone defects and soft-tissue loss, and report the clinical outcomes. Materials and methods A retrospective study at a specialized limb reconstruction center identified all patients with infected tibial injuries with bone and soft-tissue loss from 2010 through 2018. Thirty-one patients were included. All cases were treated using a three-stage protocol: (1) infected limb damage control; (2) soft-tissue coverage with a vascularized or local flap; (3) definitive bone reconstruction using distraction osteogenesis principles with external fixation. Primary outcomes: limb salvage rate and infection eradication. Secondary outcomes: patient functional outcomes and satisfaction. Results Patients in this series of chronically infected tibias had been operated upon 3.4 times on average before starting our limb salvage protocol. The mean soft-tissue and bone defect sizes were 124 cm2 (6–600) and 5.4 cm (1–23), respectively. A free flap was performed in 67.7% (21/31) of the cases; bone transport was the selected bone-reconstructive option in 51.7% (15/31). Local flap failure rate was 30% (3/10), with 9.5% for free flaps (2/21). Limb salvage rate was 93.5% (29/31), with infection eradicated in all salvaged limbs. ASAMI bone score: 100% good/excellent. Mean VAS score was 1.0, and ASAMI functional score was good/excellent in 86% of cases. Return-to-work rate was 83%; 86% were “very satisfied” with the treatment outcome. Conclusion A three-stage surgical approach to treat chronically infected tibial injuries with combined bone and soft-tissue defects yields high rates of infection eradication and successful limb salvage, with favorable functional outcomes and patient satisfaction.

COMPARATIVE STUDY REGARDING THE BENEFITS OF USING MEDICAL FLOSSING IN LATERAL EPICONDYLITIS

Although there are multiple published reviews about the effects of the most common techniques, such as stretching or the use of foam roller on the range of motion (Behm et al., 2016; Wilke et al., 2020) or performance parameters (Behm & Wilke, 2019; Konrad et al., 2021), there is no analysis on the effects of medical flossing. To date, two reviews have been publishedabout effectiveness of using ankle flossing to improve dorsiflexion amplitude or jump performance (Pisz et al., 2020; Kielur & Powden, 2020). This study aimed to investigate the effectiveness of medical flossing added to routine treatment in patients with epicondylitis, compared to conventional physiotherapy treatment. The study included 6 subjects who showed localized pain in the area of the lateral epicondyle exacerbated with the Cozen test. The other criteria for selecting patients were the duration of the symptoms, less than 3 months from the onset of the disease and pain intensity more than 5 on the Visual Analog scale.To monitor the evolution of the subjects involved, we used a visual analog pain scale to assess the intensity of pain at different times during the application of therapy, before and after the end of the treatment. Another tool used to measure the degree of pain and dysfunction was the PRTEE Questionnaire (Patient-Rated Tennis Elbow Evaluation). The rehabilitation program took place between August and September 2021, for 30 days, with afrequency of 3 times per week. 6 patients with lateral epicondylitis were included and medical flossing was used only in the case of 3 patients at each therapy session. The differences between groups at the time of the initial assessment, in terms of pain intensity were statistically insignificant (p=0.288, p>0.05). The results obtained in terms of decreasing pain were in favor of the use of medical flossing as an adjuvant method in specific pain existing in lateral epicondylitis. Although in both groups there was a decrease in pain after 4 weeks of treatment, the intervention group recorded significant reduced values compared to the control group (p=0.024; p<0.05). Regarding PRTEE Functional Score, at the final assesment there was a decrease in both groups, which means the functional condition of the patients has improved.

Evaluation of the clinical-radiographic results of patients undergoing arthroscopic metatarsal-phalangeal arthrodesis of the hallux

Introduction: Hallux rigidus (HR) is a frequent pathological condition of the foot, responsible for marked functional impairment. Metatarsal-phalangeal arthrodesis is an excellent treatment alternative for advanced stages of the disease, usually performed as an open surgery. Forefoot arthroscopy had its greatest development in the last decade, with a progressive expansion of indications, yielding encouraging results. Objective: To present the clinical and radiographic results of patients undergoing arthroscopic metatarsal-phalangeal arthrodesis of the hallux, depicting the technique and reporting complications. Methods: This study involves a series of cases, we operated 9 patients (10 feet), all with advanced HR (grades 3 and 4 - Coughlin-Shurnas). The patients underwent an arthroscopic procedure through two dorsal portals, small joints instruments. We assessed the results using the AOFAS functional score and the visual analogue pain scale. The radiographic parameters we used to analyze were the metatarsal-phalangeal angulation in the anteroposterior (pre- and postoperative) and lateral (post-operative) views, and we measured the radius shortening. Conclusion: Arthroscopic metatarsal-phalangeal arthrodesis is an excellent treatment option in advanced stages of hallux rigidus, with minimal disruption and providing excellent results, in addition to a low incidence of complications. Level of Evidence IV; Therapeutic Studies; Case Series