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Biomedical subjects

E Witvrouw

Publications and source records attributed to E Witvrouw.

At least 19 recordsLinked to original sources
PubMed2006

A prospective study on knee proprioception after meniscal allograft transplantation.

The meniscus plays an important role in the proprioceptive ability of the knee joint. The aim of this prospective study was to assess the short-term influence of a meniscus replacement on the proprioception of the knee. Fourteen patients who had undergone a fresh meniscal allograft transplantation between May 2001 and June 2003 were tested pre-operatively and 6 months post-operatively. Disability regarding pain, stiffness and functionality of the affected knee during daily activities was measured by the Western Ontario and McMaster Universities Arthritis (WOMAC) scale. The knee joint position sense was assessed using the Biodex System 3 isokinetic dynamometer. The results of the WOMAC scale showed no significant differences concerning pain, stiffness or knee function between the pre- and post-operative condition of the knee. Assessment of the knee joint position sense at a reference point of 70 degrees of knee flexion revealed a significant improvement of the proprioception of the operated knee at 6 months after surgery compared with the pre-operative condition. The results of this study suggest that although no significant improvement of pain and functionality of the operated knee occurred at this short-term follow-up period, a meniscal allograft transplantation seems to have a significant positive effect on the joint position sense of the previously meniscectomised knee.

Adolescent↗
PubMed2005

A functional foot type classification with cluster analysis based on plantar pressure distribution during jogging.

The purpose of this study was to establish a reference dataset for peak pressures and pressure-time integrals during jogging, to compare this reference dataset with existing walking data and to develop a foot type classification, all based on plantar pressure data obtained from 215 healthy young adults. The subjects ran at 3.3 m s(-1) over a 16.5 m long running track, with a built-in pressure platform mounted on top of a force platform. Peak pressures, regional impulses and relative regional impulses were measured. These variables were found to be reliable (all intra class correlation coefficients above 0.75) and, except for the heel areas, gender and asymmetry effects could be neglected. Highest peak pressures were found under the heel due to large impact forces during initial contact phase (ICP). In the forefoot, the highest peak pressure was found under the second metatarsal (64.2 +/- 21.1 N cm(-2)). Compared to walking data, overall higher peak pressures and impulses and difference in hallux loading were found during barefoot jogging. Four pressure loading patterns were identified using a K-means cluster analysis, based on the relative regional impulses underneath the forefoot: medial M1 pattern, medial M2 pattern, central pattern and central-lateral pattern. These four pressure loading patterns could help in the functional interpretation of the foot behaviour during the stance phase in slow running.

Adolescent↗
PubMed2005

A prospective study of gait related risk factors for exercise-related lower leg pain.

The purpose of this study was to determine prospectively gait related risk factors for exercise-related lower leg pain (ERLLP) in 400 physical education students. Static lower leg alignment was determined, and 3D gait kinematics combined with plantar pressure profiles were collected. After this evaluation, all sports injuries were registered by the same sports physician during the duration of the study. Forty six subjects developed ERLLP and 29 of them developed bilateral symptoms thus giving 75 symptomatic lower legs. Bilateral lower legs of 167 subjects who developed no injuries in the lower extremities served as controls. Cox regression analysis revealed that subjects who developed ERLLP had an altered running pattern before the injury compared to the controls and included (1) a significantly more central heel-strike, (2) a significantly increased pronation, accompanied with more pressure underneath the medial side of the foot, and (3) a significantly more lateral roll-off. These findings suggest that altered biomechanics play a role in the genesis of ERLLP and thus should be considered in prevention and rehabilitation.

Adolescent↗
PubMed2005

Relationship between gait biomechanics and inversion sprains: a prospective study of risk factors.

This prospective study determined gait related risk factors for inversion sprains in 223 physical education students. Static lower leg alignment was determined, and 3D-kinematics combined with plantar pressure profiles were collected. After evaluation, the same sports physician registered all sports injuries during the next 6-18 months. During this period, 21 subjects had an inversion sprain, one of whom had a bilateral sprain. Twenty-two ankles, 12 left and 10 right comprised the inversion sprain group and both feet of 36 non-injured subjects acted as controls. Comparison of the two groups revealed that the gait of subjects who are at risk of sustaining an inversion sprain had a laterally situated centre of pressure at initial contact. These subjects also showed a mobile foot type at first metatarsal contact, forefoot flat and heel off. In this type the foot is more pronated over a prolonged period and accompanied by more pressure underneath the medial side of the foot and a delayed maximal knee flexion. Resupination is delayed and roll off does not occur across the hallux, but more laterally, probably because of the diminished support at the first metatarsophalangeal joint. Total foot contact time was also longer in the inversion sprain group compared with controls. The findings of this study suggest that effective prevention and rehabilitation of inversion sprains should include attention to gait patterns and adjustments of foot biomechanics.

Adolescent↗
PubMed2005

Temporal characteristics of foot roll-over during barefoot jogging: reference data for young adults.

The purpose of this study was to establish a representative reference dataset for temporal characteristics of foot roll-over during barefoot jogging, based on plantar pressure data collected from 220 healthy young adults. The subjects ran at 3.3 ms-1 over a 16.5 m long running track, having a built-in pressure platform mounted on a force platform. The initial contact, final contact, time to peak pressure and the duration of contact at the lateral and medial heel, metatarsal heads I to V and the hallux were measured. Temporal plantar pressure variables were found to be reliable (93% of ICC coefficients above 0.75) and both gender and asymmetry influences could be neglected. Foot roll-over during jogging started with heel contact followed by a latero-medial contact of the metatarsals and finally the hallux. After heel off, the forefoot started to push off at the lateral metatarsals, followed by a more central push off over the second metatarsal and finally over the hallux. Based on the plantar pressure data, the stance phase during running was divided into four distinct phases: initial contact (8.2%), forefoot contact (11.3%), foot flat (25.3%) and forefoot push off (55.1%). These findings provide a reliable and representative reference dataset for temporal characteristics of foot roll-over during jogging of young adults that may also be relevant in the evaluation of running patterns.

Adolescent↗
PubMed2005

Intrinsic risk factors for inversion ankle sprains in females--a prospective study.

Ankle sprains are extremely common. However, very little is known about the variables that predispose individuals to these injuries. The purpose of this study was to examine prospectively intrinsic risk factors for inversion sprains in a young physically active female population. One hundred and fifty-nine female physical education students were evaluated for several possible intrinsic risk factors for inversion sprains at the beginning of their academic study. The evaluated intrinsic risk factors included anthropometrical and physical characteristics, ankle joint position sense, isokinetic ankle muscle strength, lower leg alignment characteristics, postural control and muscle reaction time during a sudden inversion perturbation. All sports injuries were registered during 1-3 years and exposure to sport was recorded (mean: 15.33+/-4.33 h a week). Thirty-two (20%) of the 159 females sprained their ankle. The number of ankle sprains per 1000 h of sports exposure was 0.75. The Cox regression analysis revealed that females with less accurate passive joint inversion position sense [hazard ratio (HR): 1.08, 95% confidence interval (CI): 1.02-1.14 for absolute error at 15 degrees inversion], a higher extension range of motion at the first metatarsophalangeal joint (HR: 1.03, 95% CI: 1.00-1.06) and less coordination of postural control (HR: 0.96, 95% CI: 0.93-1.00 for endpoint excursion; HR: 0.94, 95% CI: 0.89-0.99 for maximal endpoint excursion) are at greater risk of an ankle sprain. The findings of this study suggest that effective prevention and conservative rehabilitation of ankle inversion sprains should include attention to these variables.

Adolescent↗
PubMed2004

Effect of bracing on the prevention of anterior knee pain--a prospective randomized study.

There have been numerous reports about the use of knee braces to prevent traumatic knee injuries. Despite the frequent use of braces, very few prospective studies have been performed to study the effect of knee braces for preventing anterior knee pain syndrome (AKPS). The purpose of this study was to assess the effectiveness of a dynamic patellofemoral brace (On-Track System, dj Orthopedics) in the prevention of AKPS. 167 military recruits without history of knee pain were randomized into two groups prior to the start of their 6-week basic military training (BMT) program. The first group (brace group) consisted of 54 recruits who wore the braces for all physical activities during these 6 weeks. 113 recruits served as a control group, and followed the same 6-week strenuous training program. Chi square statistics (Fisher exact test) were used to compare the number of AKPS patients in the brace group and in the non-brace group. Our results indicated that recruits in the brace group appeared to develop significantly less anterior knee pain compared to the recruits in the control group (p=0.020). Out of the 54 recruits in the brace group, ten (18.5%) developed anterior knee pain during this study. In the control group (n=113), 42 recruits (37%) developed anterior knee pain. We conclude that the result of the present study suggests that the use of a dynamic patellofemoral brace is an effective way to prevent the development of anterior knee pain in persons undergoing a strenuous training program.

Adolescent↗
PubMed2003

The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: a prospective randomized intervention study.

The purpose of this prospective randomized intervention study was to evaluate the effect of two exercise protocols on reflex response time of vastus medialis obliquus (VMO), vastus lateralis (VL), in patients with anterior knee pain. Sixty patients were randomized into a 5-week treatment program, which consisted of only open kinetic chain tonification exercises (group I) (n = 30), or only closed kinetic chain tonification exercises (group II) (n = 30). Assessment of an aspect of neuromotor control was obtained by measuring the reflex response times of VMO and VL at the time of initial clinical examination, at the end of the exercise period (five weeks), and three months after the completion of the exercise period. At these evaluation occasions, the intensity and the number of times that the patients experienced anterior knee pain during daily life was recorded on a Visual Analog Scale (VAS). No alterations in reflex response times of VMO and VL were observed in either group. Changes of anterior knee pain over time were statistically significant in both groups. Only small and not statistically supported differences in anterior knee pain were found between the two groups. These results suggest that the reflex response times of the two vasti muscles can not be altered after a five week open or closed kinetic chain exercise program. In contrast, knee pain decreased significantly in both groups.

Exercise Therapy↗
PubMed2002

A correlation study of objective functionality and WOMAC in total knee arthroplasty.

Function studies after total knee arthroplasty (TKA) generally use either self-reported instruments or objective quantitative measurements of walking activities, but it is unclear how objective factors influence self-reports. This retrospective multicenter study assessed the impact of objective variables on subjective self-reported functional outcome after TKA in 128 patients at a mean of 41 months after TKA. Self-reported disability was measured by the Western Ontario and McMaster University (WOMAC) scale, and the quality of walking and representative daily activities were determined objectively by the DynaPort knee test. Objective assessment was found to be a poor predictor of WOMAC abnormality, with correlations of 0.343, 0.246, and 0.269 with WOMAC function, stiffness, and pain, respectively. The results of WOMAC are thus strongly influenced by factors other than quantitative parameters of the lower extremity. These findings provide support for including an objective assessment of activities of daily living together with a subjective self-report.

Activities of Daily Living↗
PubMed2001

Patellar tendon vs. doubled semitendinosus and gracilis tendon for anterior cruciate ligament reconstruction.

In a prospective study on ACL reconstruction we treated 17 patients with a "central third-bone-patellar tendon-bone" autograft (PT group) and 32 patients with a doubled semitendinosus/doubled gracilis autograft (HS group). Patients were reviewed at 6 weeks, and at 3, 6, and 12 months postoperatively and the groups compared. Up till 6 months, the KT-1000 side-to-side difference was significantly greater in the HS group (P<0.05) and at 6 and 12 months isokinetic hamstrings strength was lower (P<0.05). No significant differences were noted at any stage with respect to quadriceps strength, functional scores, range of motion, or swelling.

Adolescent↗
PubMed2001

Therapeutic ultrasound: temperature increase at different depths by different modes in a human cadaver.

A specific increase in temperature is necessary to achieve a temperature-mediated therapeutic impact by ultrasound in rehabilitation. In order to obtain a physical basis for a definite temperature rise at a certain depths in the human body a human cadaver study in situ was conducted. A set of 16 experiments was carried out with an ultrasound frequency of 1 and 3 MHz. For each frequency the pulsed and continuous mode of energy delivery were compared at a variable intensity of 0.5, 1.0, 1.5 and 2.0 W/cm2. The ultrasonic energy was delivered in direct contact to the cadaver at the posterior crural compartment of the leg in a static manner. Temperature was monitored with a 1-minute interval during an insonation of 10 minutes. Results revealed that theoretical physical predictions concerning tissue heating by therapeutic ultrasound could not always be consolidated and that thermal therapeutic effects for deeper conditions are not obvious to be achieved by ultrasonic therapy.

Blood Circulation↗
PubMed2000

Suprascapular neuropathy in volleyball players.

BACKGROUND: Suprascapular nerve entrapment with isolated paralysis of the infraspinatus muscle is uncommon. However, this pathology has been reported in volleyball players. Despite a lack of scientific evidence, excessive strain on the nerve is often cited as a possible cause of this syndrome. Previous research has shown a close association between shoulder range of motion and strain on the suprascapular nerve. No clinical studies have so far been designed to examine the association between excessive shoulder mobility and the presence of this pathology. AIM: To study the possible association between the range of motion of the shoulder joint and the presence of suprascapular neuropathy by clinically examining the Belgian male volleyball team with respect to several parameters. METHODS: An electromyographic investigation, a clinical shoulder examination, shoulder range of motion measurements, and an isokinetic concentric peak torque shoulder internal/external rotation strength test were performed in 16 professional players. RESULTS: The electrodiagnostic study showed a severe suprascapular neuropathy in four players which affected only the infraspinatus muscle. In each of these four players, suprascapular nerve entrapment was present on the dominant side. Except for the hypotrophy of the infraspinatus muscle, no significant differences between the affected and non-affected players were observed on clinical examination. Significant differences between the affected and non-affected players were found for range of motion measurements of external rotation, horizontal flexion and forward flexion, and for flexion of the shoulder girdle (protraction); all were found to be higher in the affected players than the non-affected players. CONCLUSIONS: This study suggests an association between increased range of motion of the shoulder joint and the presence of isolated paralysis of the infraspinatus muscle in volleyball players. However, the small number of patients in this study prevents definite conclusions from being drawn.

Adult↗
PubMed1997

Open versus arthroscopic subacromial decompression: analysis of one-year results.

The results of open subacromial decompression (OSD) were compared with arthroscopic subacromial decompression (ASD) after 1 year in 32 subjects (4 bilateral), and the correlation between the two shoulder rating scales for impingement was documented. Patients were evaluated clinically on the modified University of California at Los Angeles (UCLA) shoulder rating scale, and Constant scale. Scapular position and rotation were evaluated as well as a rotation and abduction shoulder strength test using the Cybex II dynamometer. No parameters revealed significant differences between the groups, except for the UCLA score which indicated an advantage for the ASD group (p = 0.046). The OSD group scored 24.5 (5.45) on the UCLA scale and 73.8 (18.9) on the Constant scale, whereas the ASD group scored 28.3 (5.6) and 80.8 (16.4). To study the correlation between both scales, the Pearson correlation product-moment coefficient was calculated and a high correlation (r = 0.81) obtained. Less mobility was found in the operated arm for all parameters, with the exception of glenohumeral abduction in both groups and passive elevation in the OSD group. Only in the OSD group did the scapula in the operated extremity show more abduction of the inferior angle of the scapula. Weaker abduction strength in the operated side was found in the ASD group, whereas in the OSD group there was significantly less adduction and external rotation strength at 180 degrees/s en 240 degrees/s. We conclude that after one year the open group tends to catch up with the arthroscopic patients and that the main benefits after arthroscopic surgery as described in literature are more evident in the shorter period.

Adult↗
PubMed1997

Graft selection in anterior cruciate ligament reconstruction--prospective analysis of patellar tendon autografts compared with allografts.

A prospective study of 73 arthroscopic anterior cruciate ligament reconstructions using either a patellar tendon autograft or an allograft was made to assess any difference in clinical outcome. Allocation was by availability of an allograft. There were 48 autografts and 25 allografts. Evaluation was by clinical examination and physical tests. At follow-up 2 years after operation, there were no statistically significant differences between the two groups in mobility or in physical tests, but KT-1000 evaluation showed a slightly greater anterior translation in the autografts at 6 months and one year, although at 2 years the allografts developed greater anterior laxity. Cybex testing showed greater quadriceps strength at 6 months and one year in the allografts, but at 2 years the strength was greater in the autografts. Re-rupture occurred in 3 allografts. ACL reconstruction with a patellar tendon allograft does not produce a significant functional deficit. Full quadriceps recovery takes 2 years. Allografts are not recommended as stability deteriorates with time.

Adolescent↗
PubMed1996

Reflex response times of vastus medialis oblique and vastus lateralis in normal subjects and in subjects with patellofemoral pain syndrome.

Various authors have indicated that imbalance of the vastus medialis/vastus lateralis muscles might lead to patellofemoral pain syndrome. However, few reports have been published to substantiate such a hypothesis. The purpose of this study was to attempt to set a scale for the normal reflex response times of the vastus medialis oblique and vastus lateralis muscles after a patellar tendon tap and to determine if patellofemoral pain syndrome patients have an alteration in this firing sequence. A control group of 80 healthy adults was compared with a group of 19 patellofemoral pain syndrome patients. Results indicated that the reflex response time of the vastus medialis oblique was significantly shorter than the reflex response time of the vastus lateralis in the normal subjects (p < or = .01). When comparing these data in the patellofemoral pain syndrome group, a significant earlier firing was obtained from the vastus lateralis in comparison with the vastus medialis oblique (p < or = .01). These findings suggest that a reversal has occurred in the firing pattern of the vastus medialis oblique and vastus lateralis muscles in patellofemoral pain syndrome patients. The results indicate an alteration in the neuromuscular answer of the vastus medialis oblique and vastus lateralis muscles during a patellar tendon tap.

Adolescent↗
PubMedDate not supplied

Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study.

Many variables have retrospectively been associated with the presence of anterior knee pain. Very few prospective data exist, however, to determine which of these variables will lead to the development of anterior knee pain. It was our purpose in this study to determine the intrinsic risk factors for the development of anterior knee pain in an athletic population over a 2-year period. Before the start of training, 282 male and female students enrolled in physical education classes were evaluated for anthropometric variables, motor performance, general joint laxity, lower leg alignment characteristics, muscle length and strength, static and dynamic patellofemoral characteristics, and psychological parameters. During this 2-year follow-up study, 24 of the 282 students developed patellofemoral pain. Statistical analyses revealed a significant difference between those subjects who developed patellofemoral pain and those who did not concerning quadriceps and gastrocnemius muscle flexibility, explosive strength, thumb-forearm mobility, reflex response time of the vastus medialis obliquus and vastus lateralis muscles, and the psychological parameter of seeking social support. However, only a shortened quadriceps muscle, an altered vastus medialis obliquus muscle reflex response time, a decreased explosive strength, and a hypermobile patella had a significant correlation with the incidence of patellofemoral pain. We concluded that the latter four parameters play a dominant role in the genesis of anterior knee pain and we therefore deem them to be risk factors for this syndrome.

Adolescent↗
PubMedDate not supplied

Open versus closed kinetic chain exercises for patellofemoral pain. A prospective, randomized study.

The goal of this prospective study was to evaluate the efficacy of open versus closed kinetic chain exercises in the nonoperative management of patellofemoral pain. Sixty patients were randomized into a 5-week program that consisted of only closed kinetic chain exercises or only open kinetic chain exercises. Muscle characteristics, subjective symptoms, and functional performance were evaluated in this study at the time of the initial physical examination, at the end of the treatment period, and 3 months later. Both groups experienced a statistically significant decrease in pain and an increase in functional performance. This study shows that both open and closed kinetic chain exercise programs lead to an improved subjective and clinical outcome in patients with anterior knee pain. The few significantly better functional results for some of the tested parameters in the closed kinetic chain group suggest that this type of treatment is a little more effective than the open kinetic chain program in the treatment of these patients.

Adolescent↗