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At least 505 records · Page 28Linked to original sources
PubMed1982

The anterior cruciate: a dilemma in sports medicine.

This study presents an extensive review of the literature concerning the natural history, diagnosis and treatment of anterior cruciate (AC) injury. This ligament is the most frequently disrupted ligament in the human knee, yet wide disagreement exists concerning the effects of its rupture and the appropriate means of treatment. Diagnosis of AC sprain is difficult, however the appropriate use of the Lachman and pivot shift tests can improve accuracy markedly. The Lachman test has several advantages over the standard drawer test: 1) the knee is examined in 10--20 degrees of flexion (a comfortable position for the injured knee); 2) it minimizes the blocking effect of the hamstring muscles on the anterior drawer motion; 3) minimized the blocking effect of the posterior horns of the menisci; 4) eliminates confusion with rotary instability. The pivot shift test demonstrates the clinical effects of loss of anterior cruciate function, but does not correspond to anterolateral rotary instability which, unfortunately, it has been named. The wide variety of treatment of acute total disruption suggested numerous authors reveals the lack of a single satisfactory way to successfully obtain excellent results. A survey of 56 North American knee surgeons concerning their treatment of "isolated" tears of the AC ligament in young vigorous athletes revealed that 30.3% would treat nonoperatively, 62.5% would repair the ligament with or without a graft and 7.2% would ignore the ligament but replace it with a graft or do a capsular reconstruction.

Athletic Injuries↗
PubMed2005

Stability of pedalling mechanics during a prolonged cycling exercise performed at different cadences.

The aim of this study was to analyse the effect of pedalling rate on the pattern of mechanical torque application and on neuromuscular fatigue during prolonged cycling exercise. Eleven well-trained individuals performed three 1-h pedalling sessions, at 50 rev.min-1, 110 rev.min-1 and a freely chosen cadence, at an intensity corresponding to 65% of their maximal aerobic power. The mechanical torque applied on the right pedal was recorded for 30 s every 5 min while pedalling. Contractile and neural properties of the quadriceps and hamstring muscles were analysed before and immediately after each of the three pedalling sessions. The post-exercise reduction in knee extensors maximal voluntary contraction was significant (P<0.01) irrespective of the cadence, but no difference was found between cadences. The use of a particular cadence did not lead to preferentially central or peripheral fatigue. An increase in cadence resulted in greater positive and negative work generated during pedalling. The mechanical pattern was not altered during the exercise, whatever the selected cadence. The present study demonstrates that despite the occurrence of neuromuscular fatigue, trained individuals maintained a stable pedalling pattern throughout an endurance cycling exercise for cadences ranging from 50 to 110 rev.min-1.

Adult↗
PubMed1987

Optimal duration of static stretching exercises for improvement of coxo-femoral flexibility.

The purpose of this study was to determine the effect of different durations of static stretching exercises on coxo-femoral (hip) flexibility. The experimental group, consisting of 20 sedentary women (20-30 years of age), participated in an exercise programme of static stretching exercises with emphasis on the hamstring muscles. The programme lasted for 10 weeks and consisted of two 50-min sessions per week. A control group of 15 sedentary women did not participate in the programme. Hip flexibility was determined before, during and at the end of the programme by means of a goniometric measuring technique developed by us and described elsewhere. Three sub-groups were formed, each following the same programme except that the duration of the static stretch differed (group 1, 10 s; group 2, 20 s; group 3, 30 s). The ANOVA tests showed that for all groups - the control group excepted - the hip flexibility had improved significantly after 10 weeks (P less than 0.05). No significant differences in hip flexibility were noted between the three subgroups at the end of the programme. This finding suggests that a duration of 10 s static stretching is sufficient for improving coxo-femoral flexibility.

Adult↗
PubMed2000

Isokinetic strength and endurance of the knee extensors and flexors in trans-tibial amputees.

Significant levels of muscular fatigue alter the co-ordination patterns and the ability to accomplish proper daily functions, especially in patients with initial low levels of strength. The purpose of this study was to evaluate the strength and endurance of the quadriceps and hamstring muscles in trans-tibial amputees. Concentric strength and endurance of the thigh muscles were measured bilaterally by an isokinetic dynamometer. The measured variables were torque and angle. For the endurance test, a fatigue index was calculated. Peak torque for extension and flexion was significantly higher in the sound limb (p<0.01). The fatigue index for extension was not significantly different in the sound limb from the amputated limb. The fatigue index for flexion is significantly higher in the sound limb (p<0.01). The finding may imply that from a metabolic point of view, the muscles of the amputated limb function properly. It is of great importance to reduce the bilateral deficit and the degree of atrophy as soon as possible in order to improve the level of performance. By choosing a correct strength and endurance training programme, one may expect to get a significant and good reaction from the muscles of the amputated limb as is expected from training the muscles of a sound limb.

Adaptation, Physiological↗
PubMed1985

Effects of ankle dorsiflexion on active and passive unilateral straight leg raising.

The purpose of this study was to analyze the straight-leg-raising (SLR) maneuver while the ankle was fixed in dorsiflexion or relaxed in plantar flexion. Twenty-two healthy subjects underwent active and passive SLR with the ankle in each position. We used cinematography to document movement of the right lower limb and pelvis and electromyography to document hamstring muscle activity. Analyses of variance of the angles of maximum SLR and change in the pelvic position showed a significant F ratio (p = .01) among the active and passive trials. Post hoc analyses demonstrated significant differences (p = .01) between SLR with dorsiflexion and SLR with plantar flexion. The EMG activity among trials was not significantly different. The possible causes of the effects of dorsiflexion on SLR are discussed. We encourage clinicians to document and compare SLR with dorsiflexion and SLR with plantar flexion, and we recommend additional research to examine the relative influence of tissue structures on SLR.

Adult↗
PubMed1987

Influence of prior knowledge on automatic and voluntary postural adjustments in healthy and hemiplegic subjects.

The purpose of this study was to analyze the effects of prior instruction on automatic postural responses and voluntary postural sways measured about the ankle joint. Ten subjects with right hemiplegia resulting from a cerebrovascular accident (mean age = 56 +/- 14 years) and 5 healthy subjects (mean age = 47 +/- 6 years) stood symmetrically on a movable force platform. During platform-induced sway, the support surface was translated horizontally to induce antero-posterior body sway about the ankle joints. Surface electromyographs were obtained from the tibialis anterior, quadriceps femoris, gastrocnemius, and hamstring muscles bilaterally. Prior knowledge appeared to have no significant influence on healthy subjects' ability to execute postural adjustments more rapidly during AP displacements. Hemiplegic subjects exhibited longer and more variable latencies in the paretic limb than in the nonparetic limb during voluntary AP weight shifts. When hemiplegic subjects had prior knowledge of the platform's movement (time and direction), latencies were significantly shorter in the paretic limb and could be as brief as those seen in the nonparetic limb. The results showed that prior knowledge may be an important treatment consideration for patients with muscle timing disorders.

Adult↗
PubMed1987

Toe-touch test. A measure of its validity.

The primary purpose of this study was to investigate the relationships between the vertical fingertip-floor distance (FFD) and the hip and vertebral components of trunk flexion during the toe-touch test. Measurements were taken from lateral photographs of each subject standing in the erect and maximally flexed positions. The subjects were healthy young men (n = 16) and women (n = 17). The mean FFD was 3 cm below floor level (-3 cm) with a standard deviation of 8 cm. Reliability of this measure was indicated by a test-retest correlation coefficient of .97. The FFD was a measure of both trunk (r = -.85) and hip flexion (r = -.79), but not of vertebral flexion (r = .10). At maximum trunk flexion, therefore, FFD is mainly a measure of the extensibility of the hamstring muscles that limit hip flexion when the knees remain extended. The toe-touch test was determined to be unsuitable for monitoring the effect of a treatment regimen to improve vertebral mobility because the partial correlation coefficient between vertebral flexion and FFD was -.64 (p less than .01), with the effect of hip flexion held constant. Although this correlation is significant, it means that less than half of the variation in FFD can be explained by changes in vertebral mobility. For this group of young adults, no significant correlations existed between the FFD and limb length and abdominal girth at maximum trunk flexion.

Adult↗
PubMed1987

High intensity electrical stimulation effect on thigh musculature during immobilization for knee sprain. A case report.

We conducted high intensity electrical stimulation of the quadriceps femoris and hamstring muscle groups daily during a three-week period of lower extremity cast immobilization for an athlete who sustained Grade II medial collateral and anterior cruciate ligament sprains. Thigh muscle hypertrophy of the injured (stimulated) leg was suggested by an increase in girth measurement on the day of cast removal. Three weeks after cast removal, single-leg, vertical-leap height was 92% of that accomplished by the dominant, uninjured leg, and the patient was able to return to athletic competition. This case report documents the usefulness of high intensity electrical stimulation for maintaining limb motor function during cast immobilization. Limb stabilization during stimulation and simultaneous excitation of agonist-antagonist muscle pairs also are discussed.

Adolescent↗
PubMed1993

Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome.

BACKGROUND AND PURPOSE: The effectiveness of soft foot orthotics in the treatment of patients who have patellofemoral pain syndrome was investigated. SUBJECTS: Subjects were 20 adolescent female patients, aged 13 to 17 years (mean = 14.8, SD = 1.2), who were diagnosed with patellofemoral pain syndrome and who exhibited excessive forefoot varus or calcaneal valgus. METHODS: Subjects were randomly assigned to one of two groups: a control group (n = 10), which took part in an exercise program, or a treatment group (n = 10), which used soft foot orthotics in addition to participating in the exercise program. The exercise program consisted of quadriceps femoris and hamstring muscle strengthening and stretching exercises. A visual analogue scale was used to assess the level of pain of the subjects over an 8-week period. RESULTS: Both the treatment and control groups demonstrated a significant decrease in the level of pain, but the improvement of the treatment group was significantly greater than that of the control group. CONCLUSION AND DISCUSSION: The results suggest that in addition to an exercise program, the use of soft foot orthotics is an effective means of treatment for the patient with patellofemoral pain syndrome.

Activities of Daily Living↗
PubMed1994

Effect of including a clinical example on the ability of physical therapists to apply information in a technical research report.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether an example in a technical research report would affect application of content to hypothetical patient problems and to future patients. SUBJECTS: Subjects were 69 physical therapists who routinely used isokinetic equipment in the treatment of patients with knee joint pathologies. METHODS: Thirty-five subjects (group 1) read a research report that described mathematical models for predicting preinjury quadriceps femoris and hamstring muscle performance. The report included an example of applying the information. The remaining 34 subjects (group 2) read the same research report with the example omitted. Subjects were asked to select appropriate prediction models and determine preinjury knee torques for two hypothetical patients. Subjects were also contacted 6 to 12 weeks after initial data collection to determine whether they had applied research report results in their treatments of patients. RESULTS: Chi-square analyses indicated manuscript type was not related to the selection of correct models, but group 1 subjects computed correct torque values more frequently than did group 2 subjects. Insufficient data were available regarding application of research report content to patients. CONCLUSION AND DISCUSSION: The results indicate application of technically oriented research reports may be enhanced by including examples of applications. (Gross MT, Sekerak DK, Allen DD. Effect of including a clinical example on the ability of physical therapists to apply information in a technical research report.

Adult↗
PubMed1997

Reliability of impairment and physical performance measures for persons with Parkinson's disease.

BACKGROUND AND PURPOSE: Parkinson's disease (PD) is characterized by rigidity, postural instability, bradykinesia, and tremor, as well as other musculoskeletal impairments and functional limitations. The purpose of this investigation was to determine the reliability and stability of measures of impairments and physical performance for people in the early and middle stages of PD, Subjects. Thirteen men and 2 women in Hoehn and Yahr stages 2 and 3 of PD participated. Their mean age was 74.5 years (SD = 5.7, range = 64-84). METHODS: Thirteen impairment-level variables and 8 physical performance variables were measured. Measurements were taken on two consecutive days and again a week later on the corresponding two consecutive days. Reliability and stability were assessed using analysis of variance and intraclass correlation coefficients (ICCs). RESULTS: Test-retest reliability (ICCs) of variables ranged from .69 (hamstring muscle length) to .97 (lumbar flexion). Intraclass correlation coefficients were .85 or greater for 10 of the variables. CONCLUSIONS AND DISCUSSION: The results suggest that in the early and middle stages of PD, many of the measures of impairment and physical performance are relatively stable.

Activities of Daily Living↗
PubMed2002

A comparison of intertendinous and classical approaches to popliteal nerve block using magnetic resonance imaging simulation.

UNLABELLED: The classical approach to sciatic nerve block in the popliteal fossa (popliteal block) often requires multiple attempts to localize the sciatic nerve. Recently, it has been suggested that an intertendinous approach to popliteal block may result in a more consistent localization of the sciatic nerve. In the current study, we compared anatomical landmarks for the intertendinous and classical approaches to popliteal block with respect to the accuracy in localizing the sciatic nerve using magnetic resonance imaging simulation. Two anesthesiologists experienced in popliteal block drew landmarks for the intertendinous and classical approaches on 10 volunteers; a 1.5 Tesla superconducting magnet was used to obtain simultaneous, 10-mm thick, fast-spin echo proton density transverse axial sequences of the lower extremities. Using these acquired images, the two approaches were simulated off-line using previously identified landmarks. The spatial relationships of the simulated needle paths to the nerves and vessels in the popliteal fossa, as well as other relevant structures, were measured and compared. Simulation of the intertendinous approach to popliteal block resulted in needle-to-sciatic nerve contact in 14 legs (70%) versus 5 legs (25%) when the classical approach was used (P < 0.05). We conclude that the intertendinous approach might result in a more consistent localization of the sciatic nerve and may decrease the risk of sciatic vessel puncture. IMPLICATIONS: A simulation of popliteal block using magnetic resonance imaging in volunteers suggests that using tendons of the hamstring muscles as the anatomical landmarks yields a more consistent localization of the sciatic nerve.

Adult↗
PubMed1992

The management of decubitus ulcers by musculocutaneous flaps: a five-year experience.

Large decubitus ulcers can be treated by using many methods, including musculocutaneous flaps. Musculocutaneous flaps provide reliable, well-vascularized cover and often can be revised in patients with secondary recurrence. We have treated 30 patients with large decubitus ulcers during a 5-year period by using musculocutaneous advancement flaps of the gluteus maximus, the hamstring muscle, and the tensor fasciae latae. There were two complications treated by debridement with flap advancement in 1 patient and the use of another flap in the second patient. Four patients developed a recurrent ulcer, which was treated by reelevation and advancement of the original flap in all patients. The general management and overall results are presented.

Buttocks↗
PubMed1976

Fresh and cultured thyroid gland: survival and function after implantation.

Isogeneic or allogeneic thyroid glands were implanted into thyroidectomized recipeint rats. These grafts, either fresh or cultured, were placed in hamstring muscle pocket or under the renal capsule. Survival and function of the grafts were evaluated by: restoration of normal levels of serum thyroxine, weight gain, kidney transamidinase (a thyroxine-induced enzyme), and histological appearance of re-excised implants. A isografts, fresh and cultured, functioned well as ectopic thyroid glands, though restoration of normal serum thyroxine levels was more rapid for the fresh implants. Fresh allografts functioned transiently but then failed due to rejection. No function was detected for cultured allografts, and rejection was seen histologically. The rat thyroid allograft therefore differs from the rat parathyroid allograft, which often can function for several months despite histological evidence of rejection. Maintenance in tissue culture prior to implantation does not appear to alter the longterm immunogenicity of either organ.

Amidinotransferases↗
PubMed1997

Near-infrared spectroscopy: continuous measurement of cytochrome oxidation during hemorrhagic shock.

OBJECTIVE: Mitochondrial cytochrome a,a3 redox shifts can be determined by near-infrared wavelength reflection. Since near-infrared wavelengths penetrate skin and bone, a potential exists to noninvasively measure mitochondrial oxidation using this phenomenon. The purpose of this study was to compare conventional parameters of resuscitation with regional measurements of spectroscopically derived cytochrome redox state in a hemorrhagic shock model. DESIGN: Prospective, controlled laboratory investigation. SETTING: Animal research laboratory of a university medical center. SUBJECTS: New Zealand white rabbits (n = 23), weighing 2 to 3 kg. INTERVENTIONS: After anesthesia and instrumentation, the subjects underwent laparotomy with placement of near-infrared spectroscopy probes on the stomach, liver, kidney, and hamstring muscle. Baseline measurements were obtained, and phlebotomy was used to reduce cardiac output by 60% for 30 mins. Animals were resuscitated with shed autologous blood and crystalloid to reach baseline cardiac output (0.9%), and were monitored for an additional 60 mins. MEASUREMENTS AND MAIN RESULTS: Significant correlations between mitochondrial cytochrome a,a3 redox state, cardiac output, and oxygen delivery were observed throughout shock and resuscitation. However, gastric cytochrome oxidation did not recover after shock, despite systemic evidence of adequate resuscitation (p < .05). CONCLUSIONS: Resuscitation from severe hemorrhagic shock may not uniformly restore cellular oxygenation, despite normalization of traditional parameters of resuscitation. Direct monitoring of cytochrome oxidation may be useful in identifying regional areas of dysoxia.

Animals↗
PubMed1976

The treatment of intoed gait in spina bifida patients by lateral transfer of the medial hamstrings.

The operation of lateral transfer of the medial hamstring muscles is described. Its applicating in the management of intoed gait in spina bifida is discussed, and the results of eight such operations, performed on four children, are recorded. The operation was effective in correcting the intoed gait in all; however, there was no activity in the transferred muscles in one child.

Child, Preschool↗
PubMed1981

Treatment of extension contracture of the hip in cerebral palsy.

Twenty patients with cerebral palsy had a total of 35 extension contractures of the hip, resulting from tightness of the gluteus maximus or hamstring muscles, with associated quadricepts muscle spasticity. Associated deformities included anteriorly dislocated hips, patella alta, lumbar lordosis, thoracic kyphosis and calcaneus feet. Active and passive exercises, surgical release of contractures and reduction of anteriorly dislocated hips improved function. Hip flexor or adductor tenotomies must be considered cautiously for patients with spastic hip extensor muscles, because severe extension constricture may develop after either procedure.

Adolescent↗