PubMed Health⌕ Search

Biomedical subjects

Thomas M Best

Publications and source records attributed to Thomas M Best.

28 records · Page 2Linked to original sources

Simulation of biceps femoris musculotendon mechanics during the swing phase of sprinting.

INTRODUCTION/PURPOSE: Characterization of hamstring mechanics during sprinting is fundamental to understanding musculotendon injury mechanisms. The objective of this study was to use muscle-actuated forward dynamic simulations to investigate musculotendon mechanics of the biceps femoris long head during the swing phase of sprinting. METHODS: We used a three-dimensional linked segment model with 26 Hill-type musculotendon actuators to simulate swing phase dynamics. Muscle excitations were computed that drove the linked segment model to track measured hip and knee motion of an individual sprinting on a treadmill. The simulations were used to investigate the effect of tendon compliance on the excursions and power development of the muscle and tendinous components of the biceps femoris. RESULTS: The biceps femoris musculotendon complex underwent a stretch-shortening cycle over the latter half of swing phase, with the shortening portion occurring in the final 10% of the gait cycle. Biceps femoris excitation increased markedly between 70 and 80% of the gait cycle and continued through the end of swing. Following the onset of excitation, stretch of the muscle component slowed considerably while the tendon lengthened and stored elastic energy. Simulating the sprinting movement with a more compliant tendon increased tendon elastic energy storage, thereby reducing peak muscle stretch and negative muscle work. CONCLUSIONS: Muscle-actuated forward dynamic simulation provides a powerful approach for investigating biomechanical factors that may contribute to the occurrence of hamstring musculotendon injuries.

Adolescent↗

Pediatric residency education: is sports medicine getting its fair share?

INTRODUCTION: Sports are the leading injury-related cause for pediatric primary care visits. Pediatric residency education guidelines suggest incorporating sports medicine (SM) education into curricula; however, research is lacking regarding effective teaching methods. OBJECTIVE: To assess reported US pediatric residency SM curricula, teaching methods, and resident evaluation of SM education. DESIGN/METHODS: Chief residents (CRs) and third-year residents (PL3s) from 100 randomly selected US Accreditation Council for Graduate Medical Education-accredited residency programs, stratified by size and geographic location, received surveys regarding programs' SM curriculum and teaching methods and individuals' methods for learning SM. RESULTS: Response rates were 63% and 39% for CRs and PL3s, respectively. According to CRs, 34% of programs had no one in charge of their SM curriculum. Lecture (77%) was the primary method used for teaching SM. Hands-on teaching (37%) was used less frequently. CRs stated that 29% of programs did not include musculoskeletal examination teaching in their curriculums; 24% did not include formal teaching of concussion management, and 29% did not include reasons for medical disqualification. PL3s rated teaching of joint examinations and the preparticipation physical as the most poorly taught components of the physical examination. PL3s rated hands-on teaching and patient experience as the best methods for improving SM education. CRs reported that only 36% of programs have discussed incorporating more SM into their curriculum. CONCLUSIONS: SM education is deficient in US pediatric residency programs. Standardized curricula should be developed with a focus on hands-on training as a means for teaching SM to pediatric residents.

Athletic Injuries↗

Upper limb mechanical changes following short duration repetitive eccentric exertions.

BACKGROUND: Power hand tool use is considered a risk factor for upper extremity musculoskeletal disorders. It is unclear if submaximal eccentric activity inherent to power tool use adversely affects the mechanical properties of muscle. METHODS: This study investigated in vivo changes in human upper limb dynamic mechanical properties following exposure to short-term repetitive submaximal eccentric exertions that are similar to operating an industrial power hand tool. Eighteen subjects (12 males and 6 females) were assigned to one of three exercise groups (isometric, eccentric or control) and exercised 10 min for 60 repetitions at 50% of isometric forearm supination maximum voluntary contraction. Supination strength and dynamic mechanical properties (stiffness, effective mass, and damping) of forearm rotation, modeled as a single-degree-of-freedom system during maximal exertion, were ascertained prior to exercise, immediately following exercise and 24 h later. FINDINGS: Strength decreased for the isometric (17%) (P < 0.05) and eccentric (34%) (P < 0.01) groups following exercise. Only the eccentric exercise group had a reduction in mechanical stiffness (53%) (P < 0.01) and effective mass (58%) (P < 0.05). The other groups had no changes in mechanical properties. INTERPRETATION: The change in mechanical properties following repetitive submaximal eccentric activity could negatively impact the ability of the arm to react to rapid forceful loading during repetitive industrial work activities and may indicate mechanical strain on the upper limb.

Adaptation, Physiological↗

Muscle plasticity after weight and combined (weight + jump) training.

PURPOSE: The purpose of this study was to compare the effects of jump training as a complement to weight training on jump performance and muscle strategy during the squat and countermovement jump. METHOD: Twenty-two male handball players, between the ages of 17 and 24, and in good health, were randomly divided into three groups. Two were trained groups, weight training (WTG) and jump training combined with weight training (CTG), and one was a control group (CG). Maximal isometric force and maximal concentric power were assessed by a supine leg press, squat jump (SJ), counter movement jump (CMJ), and surface EMG was used to determine changes in muscle adaptation before and after the training period. RESULTS: After 6-wk training programs, the two training groups increased maximal isometric force, maximal concentric power, and squat jump performance. However, only combined training presented a significant increase in height jump performance during the countermovement jump (P < 0.05). EMG analysis (as interpreted through the root mean square values) showed that the SJ was performed similarly before and after the training period for the two training groups. However, during the CMJ, only the CTG group adopted a new technique manifested by a short transition phase together with an increase in knee joint stiffness and knee extensor muscle activation and rectus femoris ratio. CONCLUSION: It was suggested that the central activities in knee joint during the transition phase, in conjunction with intrinsic muscle contractile properties, play a major role in the regulation of performance during a CMJ. Furthermore, our study suggests that a change in maximal strength and/or explosive strength does not necessarily cause changes in combined movement such as the stretch shortening cycle.

Electromyography↗

A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains.

STUDY DESIGN: Prospective randomized comparison of 2 rehabilitation programs. OBJECTIVES: The objectives of this study were to compare the effectiveness of 2 rehabilitation programs for acute hamstring strain by evaluating time needed to return to sports and reinjury rate during the first 2 weeks and the first year after return to sport. A third objective was to investigate the relationship between functional testing performance and time to return to sports and reinjury rates after return to sport. BACKGROUND: Hamstring muscle strains are common in sports and often result in chronic pain, recurrent hamstring strains, and reduced sports performance. Current rehabilitation programs are primarily developed anecdotally and lack support from prospective, randomized research. METHODS AND MEASURES: Twenty-four athletes with an acute hamstring strain were randomly assigned to 1 of 2 rehabilitation groups. Eleven athletes were assigned to a protocol consisting of static stretching, isolated progressive hamstring resistance exercise, and icing (STST group). Thirteen athletes were assigned to a program consisting of progressive agility and trunk stabilization exercises and icing (PATS group). The number of days for full return to sports, injury recurrence within the first 2 weeks, injury recurrence within the first year of returning to sports, and lower-extremity functional evaluations were collected for all subjects and compared between groups. RESULTS: The average (+/- SD) time required to return to sports for athletes in the STST group was 37.4 +/- 27.6 days, while the average time for athletes in the PATS group was 22.2 +/- 8.3 days. This difference was not statistically significant (P = .2455). In the first 2 weeks after return to sports, reinjury rate was significantly greater (P = .00343, Fisher's exact test) in the STST group, where 6 of 11 athletes (54.5%) suffered a recurrent hamstring strain after completing the stretching and strengthening program, as compared to none of the 13 athletes (0%) in the PATS group. After 1 year of return to sports, reinjury rate was significantly greater (P = .0059, Fisher's exact test) in the STST group. Seven of 10 athletes (70%) who completed the hamstring stretching and strengthening program, as compared to only 1 of the 13 athletes (7.7%) who completed the progressive agility and trunk stabilization program, suffered a recurrent hamstring strain during that 1-year period. CONCLUSIONS: A rehabilitation program consisting of progressive agility and trunk stabilization exercises is more effective than a program emphasizing isolated hamstring stretching and strengthening in promoting return to sports and preventing injury recurrence in athletes suffering an acute hamstring strain. Future randomized clinical trials should investigate the potential for progressive agility and trunk stabilization programs in the prevention of hamstring strain injury during sports.

Acute Disease↗

A nonlinear rheological assessment of muscle recovery from eccentric stretch injury.

PURPOSE: To better understand the mechanical behavior of healing skeletal muscle; specifically the tissue's response after acute eccentric stretch injury. METHODS: Rabbit tibialis anterior (TA) muscle tendon units were subjected to an in vivo single stretch (eccentric) injury and mechanically evaluated (constant rate elongation to failure) at 1, 3, and 7 d postinjury. In addition to a traditional linear analysis (linear stiffness and failure load), an existing nonlinear rheological model was modified to interpret the experimental load-to-failure data. The models' performance were evaluated and discussed. RESULTS: No significant injury effect was observed, either within or between groups, across the 7-d healing interval, using the linear analysis. However, interpretation of the data using our nonlinear phenomenological model identified significant changes in mechanical behavior that went undetected by linear analyses. Percent differences, between injured and contralateral control limbs, of model parameter estimates were analyzed. Nonparametric statistical analysis illustrated significant changes in the first-order stiffness (k1) throughout the 7-d healing interval. Model simulations using mean values of each parameter revealed increased low-load tissue compliance after injury, with a decrease in linear slope that recovered steadily toward control values by day 7. At 7 d postinjury, virtually no differences were observed between injured and sham control tissues. CONCLUSIONS: Our findings suggest that acute eccentric injury increases the muscle's compliance 24 h after injury, with a steady recovery to uninjured values by the 7th day, yet these changes went undetected by linear analysis. Therefore, nonlinear analysis is necessary to recognize valuable information contained in the low-load region and to quantify important biomechanical phenomena of stretch-injured healing skeletal muscle.

Animals↗

Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball pitchers.

Sonography is a valuable method for imaging superficial tendons and ligaments. The ability to obtain comparison images easily with dynamic stress allows assessment of ligament and tendon integrity. We studied the medial elbow joints of two baseball pitchers using MR imaging and dynamic sonography. Both sonography and MR imaging identified the ulnar collateral ligament tears. Dynamic sonography uniquely demonstrated the medial joint instability.

Adolescent↗