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Biomedical subjects

R R Wroble

Publications and source records attributed to R R Wroble.

At least 19 recordsLinked to original sources
PubMed2001

The effect of winter sports participation on high school football players: strength, power, agility, and body composition.

In this study, football players (N = 57) in grades 9-11 from 3 high schools chose to participate in 1 of 2 groups. Group WC (N = 39) participated in off-season strength training only. Group SP (N = 18) participated in both a winter sport (either wrestling or basketball) and an identical strength training program. All participants were tested at the close of football season (Pre) and at the end of the winter sports season (Post), a period of 4 months. Body composition (weight [W] and body fat percentage [BF]), strength (calculated 1RM [1 repetition maximum] max for barbell bench press [BP] and squat [SQ]), power (vertical jump [VJ] and seated shot put [UP]), and agility (18.3-m agility run [AG]) were measured. Both groups WC and SP increased significantly in W and BF and improved significantly in BP and VJ (p < 0.05). Only the WC group improved significantly in SQ and AG (p < 0.05). Only the SP group increased significantly in UP (p < 0.05). Only the difference in SQ was statistically greater in the WC than in the SP group (p < 0.05). Regardless of winter activity, football players gain significant amounts of BF resulting in overall W increases. Football players participating in winter sports improved significantly in measurements of strength and power. There appears to be no clear advantage to devoting time solely to strength training.

Adolescent↗
PubMed1999

Prevention of tinea corporis in collegiate wrestlers.

OBJECTIVE: To examine the role of a comprehensive skin disease prevention protocol in conjunction with the use of a barrier cream to prevent tinea corporis (ringworm) in collegiate wrestlers. DESIGN AND SETTING: We studied a college wrestling team for 16 weeks during 1 season. During the first 8 weeks, no preventive measures were taken. For the remaining 8 weeks, wrestlers were randomized into 2 groups and used either a barrier or a placebo. SUBJECTS: Twenty-two male college wrestlers with a mean age of 20.4 years (range, 18.1 to 23.2), a mean weight of 68.4 kg (range, 55.8 to 130.2), and a mean height of 177.8 cm (range, 168.7 to 186.9). MEASUREMENTS: We performed skin checks daily. All new or exacerbated lesions were clinically diagnosed by the same team physician and recorded. RESULTS: Cases of tinea corporis declined from 10 diagnosed before initiation of the protocol to 1 after the protocol was initiated. One athlete in the placebo group was found to have tinea corporis versus none in the barrier cream group. CONCLUSIONS: Strict adherence to the prevention protocol for skin infections significantly decreased the number of cases of tinea corporis. The use of the barrier cream in conjunction with the prevention protocol did not result in any further statistical reduction in the number of wrestlers who contracted tinea corporis.

Journal Article↗
PubMed1998

Weight loss patterns and success rates in high school wrestlers.

PURPOSE: The purposes were to: 1) examine the weight loss patterns in a group of high school varsity wrestlers whose teams participated in a body composition measurement@nutrition education program, and 2) test the hypothesis that wrestling at a weight below recommended Minimum Wrestling Weight (MWW) results in decreased wrestling success. METHODS: We measured skinfold thickness in 465 wrestlers at 16 schools and, using the Lohman method, determined their percent body fat. An educational program presented at each school explained the results, provided nutritional information regarding proper diet and methods of weight loss, and suggested a voluntary MWW corresponding to 5% body fat. After excluding the heavyweight wrestlers, there were 159 varsity wrestlers. At the end of the season, we noted their weight class and whether they placed in post-season state championship qualifying tournaments. RESULTS: We found that 53 wrestlers (33%) wrestled below MWW. When analyzed by school, wrestlers' non-adherence to MWW ranged from 0% to 56% of all wrestlers. In the lightest four weight classes, 62% wrestled below MWW; in the middle four classes, 29%; and in the heaviest four classes, 6%. Of the 53 wrestlers below MWW, 57% placed and of the 106 above MWW, 33% placed (P < 0.01). CONCLUSIONS: These results show that a substantial number of wrestlers who participate in a voluntary body fat measurement and diet education program wrestle below recommended MWW. This is particularly true at lower weight classes. Further, wrestling below MWW was associated with greater wrestling success. The current concept of MWW should not be based on wrestling performance effects.

Adolescent↗
PubMed1998

Acute weight gain and its relationship to success in high school wrestlers.

OBJECTIVE: The purpose of this study was to investigate 1. the extent of weight gain by high school wrestlers between an evening weigh-in and the first round of wrestling the next morning and 2. the relationship between weight gain and wrestling success. METHODS: Body weights of competitors (N = 260) in a high school wrestling tournament were recorded at official weigh-in and again, about 12 h later, immediately before the first round of wrestling. Data for the heavyweight class was excluded. Weight gain (WG in kg), relative weight gain (RWG in %), and weight discrepancy between opponents (WD in kg) were calculated from data obtained at the weighings. The mean WG for all wrestlers was 1.3 kg +/- 1.1 with a range of -2.0 kg to +4.4 kg. This corresponds to RWG of 2.2 +/- 1.7% body weight. RESULTS: WG in the lower weight classes was statistically larger than that seen in the highest weight classes (P < 0.05). The smallest RWG was seen in the 189-lb. class (1.1 +/- 1.9%), and the largest RWG was seen in the 112-lb. class (3.0 +/- 2.1%). Average WD between competitors was 1.7 +/- 1.5 kg (range 0-7.5 kg.). Average WD was largest in the two heaviest classes. Average WG was 1.5 +/- 1.1 kg for winners and 1.2 +/- 1.0 kg for losers. RWG was 2.4 +/- 1.8% for winners and 1.9 +/- 1.6% for losers. CONCLUSIONS: The difference in WG and RWG between winners and losers was significant (P < 0.05). In 74 of the 130 bouts (57%), the heavier wrestler was successful (NS).

Adolescent↗
PubMed1997

Changes in knee kinematics after application of an articulated external fixator in normal and posterior cruciate ligament-deficient knees.

We studied how the location of an articulated external fixator, the EBI-Orthofix (EBI Corp, Persippany, NJ), affects the kinematics of the posterior cruciate ligament (PCL)-deficient knee. Ten unembalmed cadaver whole lower limbs were randomly divided into two groups of five limbs each: (1) fixator hinge located near the average knee flexion axis (the anatomic position group); and (2) fixator hinge located distal to the joint line and posterior to the flexion axis (the fibular styloid position group). Three loading conditions, passive flexion/extension, flexion/extension with anterior force of 100 N, and flexion/extension with posterior force of 100 N were used for each knee with the PCL intact and with the PCL cut. With the fixator located in the anatomic position, and after cutting of the PCL, posterior translation was reduced to normal limits only at flexion angles < or = 15 degrees. In this configuration, the fixator was ineffective at minimizing posterior translation at flexion angles > or = 30 degrees. With the fixator located at the fibular styloid position, however, posterior translation of the tibia in the PCL deficient knees was reduced to near normal limits at all flexion angles. These results were statistically different than the anatomic position group at all flexion angles > or = 30 degrees (P < .01). The external fixator appears to allow normal range of motion while effectively shielding the PCL graft from stress caused by posterior translational forces. Issues related to the potential complications and patient acceptance must be addressed thoroughly before this technique is applied in clinical practice.

Cadaver↗
PubMed1992

Meniscectomy in children and adolescents. A long-term follow-up study.

Thirty-nine patients treated with total meniscectomy younger than 16 years of age were studied. The average follow-up period was 21 years; 71% of the patients reported pain; 68%, stiffness; 54%, swelling; and 41%, giving way. Approximately half the patients described progression of symptoms, but only 27% were asymptomatic. Only 10% noted limitations at work, but 62% had limitations in sports. Twelve percent have had further knee surgery. Forty-nine percent received unsatisfactory subjective/functional ratings. On physical examination, 25% of patients had range of motion loss of greater than 5 degrees, 22% had thigh atrophy of greater than 1 cm, and 20% developed substantial instability. Overall, 27% received unsatisfactory objective ratings. Ninety percent of patients had abnormal roentgenograms. Changes occurred predominantly in the meniscectomized compartment. Forty-four percent of patients had unsatisfactory roentgenographic ratings. Overall ratings indicated that 63% of patients' results rated unsatisfactory. More unsatisfactory results occurred in patients with a follow-up period of longer than 26 years, in those with substantial instability, and in males. Few differences existed between medial and lateral meniscectomies or with increasing durations of symptoms preoperatively.

Adolescent↗
PubMed1990

Paradoxes in the history of the anterior cruciate ligament.

A historic review of anterior cruciate ligament (ACL) investigation reveals two important paradoxes. (1) Ideas and concepts recently proposed were first put forth much earlier. (2) Controversy regarding this ligament continues despite the increased amount of information available. Much of the recent ACL literature, although regarded as newly discovered, has its roots in far older, and apparently forgotten or overlooked, work. Examples include: (1) ACL intactness is best tested at full extension; (2) hemarthrosis and ACL rupture are closely associated; and (3) ACL rupture sometimes masquerades as a minor injury. Additionally, early investigators achieved notable advances in surgical techniques. These contributions disappeared from the literature for two major reasons. First, early investigators observed few patients, with typical practitioners rarely seeing ACL injuries, and consequently, little data existed to support their observations. Second, observations could not be confirmed until the advent of widespread, successful surgery. Undoubtedly, orthopedists now know much more about the ACL, yet many issues remain controversial. Does the ACL perform a vital function? What is the efficacy of operative versus nonoperative treatment? What are the relative merits of direct repair, intraarticular substitutes, and extraarticular nonanatomic procedures? The origins and continued existence of controversy stem from several sources, including the less than rigorous study design and the scarcity of natural history, long-term follow-up studies, and basic science studies. The perception of the ACL as a simple structural unit has also perpetuated this controversy.(ABSTRACT TRUNCATED AT 250 WORDS)

Anterior Cruciate Ligament↗
PubMed1988

Ankle dislocation without fracture.

Dislocation of the ankle without accompanying malleolar fracture has been regarded as a rare lesion, with few cases reported in the literature. To date, there has been no precedent for accurate descriptions of the mechanisms, optimum treatment, and long-term prognosis of this injury. Our goal was to evaluate these variables by a retrospective review of cases from our institution. We identified eight patients who had sustained ankle dislocation without fracture and were treated at the University of Iowa during the period 1958 to 1986. We interviewed and examined each patient and obtained ankle radiographs at an average of 11.5 years postinjury (range 2 to 24 years). After analyzing our cases and other reported in the literature, we have found that this injury is most common in young people (average age 31 years, range 10 to 73 years) and males (72%), and occurs most frequently in falls, motor vehicle accidents, and sports (86%). Medial displacement occurs most frequently (27%). Disruption of the mortise occurs variably. The most likely mechanism appears to be anterior or posterior extrusion of the talus from the mortise secondary to a force applied to the plantarflexed foot. Final displacement is then determined by the position of the foot and the direction of the force applied. Physical findings are commensurate with the deformity. Neurovascular compromise is uncommon (10%). Closed reduction is almost invariably accomplished easily unless the deformity is accompanied by posterior tibiofibular dislocation. Optimum treatment appears to be immobilization in a short leg cast for 6 weeks with no weightbearing for the first 3 weeks. Long-term follow-up revealed the following. Results were all good to excellent considering the following variables: return to work and sports activities, pain, instability, swelling, and ankle and subtalar joint motion. No patient reported instability and all returned to work and sports participation. We noted mild pain and swelling that was not severe enough to require medication in 25% of patients. Range of motion was normal in all but four patients; none of these lacked more than 10 degrees of motion in any plane. Radiographic abnormalities consisted of minor ligamentous or capsular calcification in all patients, small osteophytes in four patients, and minimal joint space narrowing in one patient. No patient had normal radiographs.

Adult↗
PubMed1988

The stabilized Lachman test.

While the Lachman test is the clinical standard for assessing increased anterior tibial translation, it has some drawbacks. Problems remain with quantitation, reproducibility, and execution. The authors report on modifications designed to solve these problems. The modifications are comfortable for patients, reliable, and can be performed on limbs of all sizes.

Humans↗
PubMed1987

The malignant potential of enchondromatosis.

In a tri-institutional, retrospective study with long-term follow-up, forty-four patients who had multiple enchondromas were identified. Thirty-seven patients did not have hemangiomas (Ollier disease) and seven did (Maffucci syndrome). Of the thirty-seven patients who had Ollier disease, a low-grade chondrosarcoma developed in four; an astrocytoma, in one; and a granulosa-cell ovarian tumor, in one. In four of the seven patients who had Maffucci syndrome, there were six low-grade chondrosarcomas, one high-grade osteosarcoma, one pancreatic adenocarcinoma, one biliary adenocarcinoma, and one astrocytoma. None of the patients in either group died of the skeletal sarcoma, but four of five patients who had a non-skeletal malignant lesion died. From life-table analyses of these patients, we estimated that the incidence of secondary chondrosarcoma in patients who have Ollier disease is about 25 per cent at the age of forty years, and that malignant degeneration is almost a certainty in patients who have Maffucci syndrome. We concluded that periodic surveillance of the brain and abdomen for occult malignant lesions is indicated in patients who have enchondromatosis.

Adolescent↗
PubMed1986

Neck and low back injuries in wrestling.

Drs. Wroble and Albright review the neck and low back injuries of the University of Iowa wrestling teams over the last 8 years with respect to diagnosis, mechanism of injury, time lost from wrestling, and recurrence. They describe examination of the low back and treatment of low back injuries. Examination of the neck is reviewed in detail and common neck injuries are discussed. Emergency management of acute neck injuries is outlined. Various aspects of prevention of neck injuries are presented.

Adult↗
PubMed1985

Fixed atlantoaxial rotary deformity with bilateral facet dislocation.

A 21-year-old patient with Down syndrome who developed rotary atlantoaxial dislocation of C1 and C2 following an upper respiratory infection is presented. Techniques for detection and quantification of this potentially serious dislocation using multidirectional tomography and computerized tomography are described.

Adult↗
PubMedDate not supplied

Prepatellar bursitis in wrestlers.

As part of a larger retrospective study examining all knee injuries sustained by the University of Iowa wrestling team over 6 years, prepatellar bursitis was found to be the most frequent injury and, therefore, was examined in depth. Of the 136 wrestlers studied, 13 developed an initial case of prepatellar bursitis. This represented 21% of all initial episodes of knee injuries. Five of these wrestlers had no recurrences, but the other eight together had 20 recurrences. Median time lost for the initial injury was only 4 days, but recurrences and surgeries added significantly to the total time lost. There were only two cases of septic prepatellar bursitis, but there have been six cases (in four wrestlers) in the three seasons since the end of the larger study period. The infecting organism in all but one case was Staphylococcus aureus and was penicillin-resistant in all but one. There was no clinical evidence of infection in 50% of the cases, emphasizing the need to do a Gram's stain and culture (and, therefore, an aspiration) on all cases of prepatellar bursitis. The prognosis appeared better if the wrestler had no previous history of bursitis, suggesting that pathologic changes in the bursal wall may impair its defense mechanisms. In sharp contrast to all other knee injuries, most prepatellar bursitis cases occurred in the off-season. Most developed insidiously, but direct impact during a takedown maneuver is suspected as being the most frequent cause.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

Patterns of knee injuries in wrestling: a six year study.

Data on knee injuries sustained by the University of Iowa wrestling team over a 6 year period were compiled. There were a total of 136 wrestlers during this time. Fifty-one different wrestlers sustained 136 injuries (64 knees). Multiple parameters were examined for each injury, including date of injury; days lost; diagnosis; side injured; mechanism; occurrence during competition or practice; whether the wrestler was in control, "on the bottom," or both wrestlers standing; type of move being made at the time of injury; how far into a match or practice the injury happened; initial versus recurrent injury; principal form of management; weight-bearing status; and presence of knee pads. Each wrestler's weight class, years of experience, rank on the team, lead leg, and compliance were noted. We found an incidence of 30 knee injuries per 100 wrestlers per year. There were 11.5 knee injuries per 100 wrestlers per year requiring a week or greater time loss. This comprises over one third of all serious wrestling injuries. Exposure data revealed injury rates in matches to be almost 40 times those of practice. Wrestlers with previous knee injuries were at high risk for reinjury. Early season competition is an extremely high risk period. The most frequent injuries were prepatellar bursitis, lateral and medial sprains, and lateral and medial meniscal tears. We noted a relatively higher rate of lateral versus medial meniscal tears compared to other sports and a somewhat common presentation of a meniscal tear resulting from minimal trauma. The lead leg was injured most often. The takedown was the most frequent situation where any injury occurred. Defensive wrestlers appeared to be at higher risk during takedowns. The wrestler "underneath" was also injured more often. Compliance correlated with decreased recurrence of injury. Approximately 50% of wrestlers were found to be noncompliant with medical recommendations. Junior varsity wrestlers lost significantly more time than varsity wrestlers with equivalent injuries. There was no correlation of injury rate with weight class, period of match, timing in practice, or years of experience.

Athletic Injuries↗
PubMedDate not supplied

Reproducibility of Genucom knee analysis system testing.

The Genucom knee analysis system was studied to determine the reproducibility of test results. In the first phase of the study we investigated the reproducibility of anterior/posterior stress tests at 30 degrees and 90 degrees of flexion and varus/valgus stress tests at 20 degrees of flexion in 10 control subjects during three seatings on 3 separate days. In the second phase we studied the effect of errors in the digitization procedure (a part of the patient installation process) on anterior/posterior translation measurements. In the third phase we studied the reproducibility of a battery of tests in patients with chronic unilateral ACL deficient knees. The test battery was repeated 8 times on each knee on 6 separate days. In Phase I, analysis of variance revealed no significant differences between tests within a single seating. The day-to-day variance of all subjects was not significant, but we found a significant interaction between day and subject which was due to significant day-to-day differences in individual subjects. We found in Phase II that changing the location of the tibial joint line digitization points in the anterior/posterior or proximal/distal direction affected anterior/posterior translation measurements. Effects were larger at 30 degrees of flexion than at 90 degrees and when both the medial and lateral points were moved. Movement of the femoral condylar points resulted in a similar pattern of effects. In Phase III, although we found significant differences between our two examiners, there were no significant intraexaminer test-to-test (within seating) effects. Additionally, while there was no significant day-to-day variance overall, we found a significant interaction between day and subject.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Repeatability of the KT-1000 arthrometer in a normal population.

Despite its popularity, the MEDmetric KT-1000 arthrometer's reliability remains inadequately documented. We conducted this study to determine the magnitude of trial-to-trial (within installation), installation-to-installation (within day), and day-to-day (between day) variability of anterior/posterior translation measurements in normal knees. We selected six normal subjects, three males and three females, and tested each on 6 consecutive days with three separate installations per day. We recorded the total anterior/posterior translation at +/- 89 and +/- 134 N force at 25 degrees of flexion during three consecutive trials in a single installation. Analysis of variance showed that no significant difference existed between trials (within installation) or between installations (within day) for all parameters. However, we did find a significant difference between days for individual right and left knee translation measurements at 89 and 134 N force. More importantly, no significant difference existed between days for right to left differences at both force levels. The magnitude of the expected measurement variability was expressed by computing 90% confidence limits for total anterior/posterior translation at +/- 89 N force. These were +/- 1.5 mm for the right knees, +/- 1.4 mm for the left knees, and +/- 1.6 mm for the right-left differences. Fischer's protected least significant difference post hoc test revealed that for all parameters, the 1st day measurements were significantly less than those on following days, suggesting that patient and examiner adjust to the testing procedure. We conclude that the standard KT-1000 evaluation should report paired differences rather than individual knee measurements. Additionally, initial evaluation should be supplemented by follow-up examinations for verifying translation values.

Adult↗