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At least 937 records · Page 52Linked to original sources

PubMed2000

Comparison of conservative and operative treatments of massive rotator cuff tears.

The results of conservative and operative treatment of massive rotator cuff tears were compared. All 9 men and 5 women who were treated conservatively (group I) had a Hamada Gpoup 4 arthrographic tear. The mean follow-up period was 4 years. The operative group (group II) was composed of 23 men and 3 women who had cuff tears of more than 5.0 cm in longest dimension. The mean age range at surgery was 62 years. Following anterior acromioplasty (n = 26), additional procedures included tenorrhaphy (n = 12), fascial grafting (n = 8), laterl transfer of the long head of the biceps brachii tendon (n = 2), muscle transfer of the teres minor (n = 3), muscle transfer of the supraspinatus (n = 1). The mean follow-up period was 4 years. The results were assessed using the Japanese Orthopaedic Association score. The JOA score was increased from 53.2 to 71.1 in group I, and from 58.8 to 85.9 in group II. More improvement in painrelief, muscle strength, and range of motion was obtained in group II than in group I. There was a significantly better final result in the patients without rupture of the tendon of the long head of the biceps brachii muscle.

Aged↗

PubMed2004

Spermine reduces infarction and neurological deficit following a rat model of middle cerebral artery occlusion: a magnetic resonance imaging study.

The role of nitric oxide (NO) in post-ischemic cerebral infarction has been extensively examined, but few studies have investigated its role on the neurological deficit. In the present study, we investigated the effect of spermine on the temporal evolution of infarct volume, NO production and neurological deficit using magnetic resonance imaging in a model of permanent focal cerebral ischemia in rats. Spermine given at 10 mg/kg 2 h after ischemia reduced the infarct volume by 40% and abolished brain NO production and improved the neurological score 24 h, 48 h and 72 h after ischemia. Spermine also reduced the neurological deficit as evaluated by rotamex, grip strength and neurological severity score tests.

Analysis of Variance↗

PubMed2003

Decreased strength and mobility in patients after anterior cervical diskectomy compared with healthy subjects.

OBJECTIVE: To evaluate whether patients acquired normal physical function after cervical disk prolapse and surgery compared with healthy matched controls. DESIGN: Cross-sectional study. SETTING: Hospital in central Finland. PARTICIPANTS: Fifty-three patients with cervical diskectomy and 53 healthy matched controls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Postoperative physical function was studied by measuring muscle strength and range of motion (ROM) values of the neck and grip strength. Disability was assessed by the neck and shoulder pain index and by the Oswestry index, mood by the Short Depression Inventory; and pain on a visual analog scale (VAS). RESULTS: Most patients recovered well after the operation. Forty-three percent of the patients still experienced moderate or high pain (VAS score, >30mm). Subjective pain and disability were associated with decreased neck movement and strength. Both ROM and cervical muscle strength values were significantly lower (P<.001) in all the measured directions in cervical disk surgery patients compared with healthy controls. ROM was mostly confined in extension (25%). Muscle strength of the neck was mostly confined in both rotation directions (38%). No statistically significant difference in grip strength was found between the groups. CONCLUSION: The loss of muscle strength and ROM is clearly visible postoperatively and thus the effectiveness of the early identification and rehabilitation of these deficits merits further studies.

Activities of Daily Living↗

PubMed1998

A prospective randomized comparison of Sutter and Swanson silastic spacers.

This study compares two currently available prostheses for the reconstruction of rheumatoid joints. A single operator performed 72 resection arthroplasties with Swanson or Sutter prostheses being randomly allocated. Assessment of each patient was carried out preoperatively, and at 6 months and 12 months postoperatively by a single investigator. In the Swanson group an improvement of the flexion arc was seen, from 29 degrees to 44 degrees at 6 months but this reduced to 36 degrees at 12 months. In the Sutter group there was no significant difference between flexion arcs pre- and postoperatively. Grip strength improved in the Swanson group, but not in the Sutter group. Extensor lag was improved in both groups. Patient satisfaction measured by linear analogue scales for pain, function and deformity was high in both groups.

Aged↗

PubMed1996

[Articular fractures of the base of the first metacarpal. Comparative study of direct osteosynthesis and closed pinning].

The authors retrospectively studied 35 articular fractures of the base of the first metacarpal, with an average follow-up of 3 years. Treatment consisted of closed reduction and pinning in 19 cases, open reduction and rigid fixation in 16 cases. Results were estimated in terms of pain, range of movement (flexion-adduction arc and abduction-extension arc), strength and X-rays. There was no significant difference between the two groups, for age, sex, occupation, side and postoperative care. Only one significant difference between both procedures was found: flexion-adduction was better after osteosynthesis than after closed pinning (p = 0.03). The authors observed a better range of flexion-adduction and pinch strength after treatment of Bennett's fracture. Radiographic features were not different at follow-up between open and closed osteosynthesis.

Adolescent↗

PubMed2000

The role of multiple strands and locking sutures on gap formation of flexor tendon repairs during cyclical loading.

The purpose of this study was to delineate the contribution of increasing suture strands and locking repair design in the prevention of gap formation using a cadaveric model for linear cyclical loading. Forty flexor digitorum profundus tendons were lacerated and repaired using locked and nonlocked variations of a 4- and 8-strand flexor tendon repair. An incremental cyclical loading protocol from 25 N to 65 N was used. Comparison of the amount of Newton-cycles to reach 1, 2, 3, and 4 mm of gap and the Newton-cycles withstood before failure was performed using 2-way ANOVA. The 8-strand repairs demonstrated significantly increased fatigue strength compared with the 4-strand repairs, but the number of strands crossing the repair site did not significantly affect gap resistance. The locked repairs demonstrated a significant increase in gap resistance to 1 and 2 mm compared with the nonlocked repairs, but the difference was not sustained at higher load cycles. There was no association between gap resistance and fatigue strength. We conclude that an increase in the number of strands significantly increases the fatigue strength of a tendon repair but does not alter its gap resistance to cyclic loading. Locking of the repair does provide additional gap resistance at the relatively low cyclical loads anticipated during the early healing period using an active motion rehabilitation protocol.

Biomechanical Phenomena↗

PubMed2004

Does sarcopenia originate in early life? Findings from the Hertfordshire cohort study.

BACKGROUND: Sarcopenia is defined as the loss of skeletal muscle mass and strength with aging. Recent epidemiological studies have shown that men and women who grew less well in early life have lower muscle strength. Our objective was to investigate the relationship between birth weight, infant growth, and the development of sarcopenia. METHODS: We studied 730 men and 673 women, of known birth weight and weight at 1 year, who were born in Hertfordshire, U.K., between 1931 and 1939. Participants completed a health questionnaire, and we measured their height, weight, and grip strength. Standard deviation scores for birth weight, and for infant growth conditional on birth weight, were analyzed in relation to grip strength before and after adjustment for adult size. RESULTS: Grip strength was most strongly associated with birth weight in men (r = 0.19, p < .001) and women (r = 0.16, p < .001). These relationships remained significant after adjustment for adult height and weight. In contrast, the associations with infant growth were weakened after allowing for adult size. Adjustment for age, current social class, physical activity, smoking, and alcohol did not affect these results. CONCLUSIONS: Birth weight is associated with sarcopenia in men and women, independently of adult height and weight. The influence of infant growth on long-term muscle strength appears to be mediated through adult size. Sarcopenia may have its origins in early life, and identifying influences operating across the whole life course may yield considerable advances in developing effective interventions.

Adult↗

PubMed1997

Muscle mass and strength: relation to function in population studies.

The use of the term sarcopenia to describe the age-related loss in skeletal muscle and its functional consequences is relatively recent. However, interest in the relationship of muscle mass to strength and function predates the concept of sarcopenia as researchers have attempted to understand differences in mass and strength between men and women, young and old. Most of these studies are cross-sectional comparisons in which muscle mass and strength tend to be linearly related, so that those with more muscle tend to be stronger. This article focuses instead on some potential problems with the sarcopenia-function association in old age and presents what little data exist from longitudinal population studies addressing the effect of sarcopenia over time.

Aged↗

PubMed1997

Testosterone replacement in older hypogonadal men: a 12-month randomized controlled trial.

A decline in testicular function is recognized as a common occurrence in older men. However data are sparse regarding the effects of hypogonadism on age-associated physical and cognitive declines. This study was undertaken to examine the year-long effects of testosterone administration in this patient population. Fifteen hypogonadal men (mean age 68 +/- 6 yr) were randomly assigned to receive a placebo, and 17 hypogonadal men (mean age 65 +/- 7 yr) were randomly assigned to receive testosterone. Hypogonadism was defined as a bioavailable testosterone <60 ng/dL. The men received injections of placebo or 200 mg testosterone cypionate biweekly for 12 months. The main outcomes measured included grip strength, hemoglobin, prostate-specific antigen, leptin, and memory. Testosterone improved bilateral grip strength (P < 0.05 by ANOVA) and increased hemoglobin (P < 0.001 by ANOVA). The men assigned to testosterone had greater decreases in leptin than those assigned to the control group (mean +/- SEM: -2.0 +/- 0.9 ng/dL vs. 0.8 +/- 0.7 ng/dL; P < 0.02). There were no significant changes in prostate-specific antigen or memory. Three subjects receiving placebo and seven subjects receiving testosterone withdrew from the study. Three of those seven withdrew because of an abnormal elevation in hematocrit. Testosterone supplementation improved strength, increased hemoglobin, and lowered leptin levels in older hypogonadal men. Testosterone may have a role in the treatment of frailty in males with hypogonadism; however, older men receiving testosterone must be carefully monitored because of its potential risks.

Aged↗

PubMed1995

Balneotherapy for rheumatoid arthritis at the Dead Sea.

Thirty-six patients with active rheumatoid arthritis were treated for 12 days at the Ein Gedi Spa. The patients were allocated randomly to four study groups. Group 1 (n = 9) was treated with daily baths in the Dead Sea, group 2 (n = 9) was treated with daily sulphur baths, group 3 (n = 10) was treated with a combination of daily Dead Sea bathing and sulphur baths, and group 4 (n = 8) served as a control group. All patients were assessed by a rheumatologist who was blinded to the treatment modalities and group allocation. Clinical parameters assessed included: duration of morning stiffness, 15 m walk time, grip strength, activities of daily living, patient's assessment of disease severity, number of active joints, and the Ritchie articular index. Statistically significant improvement lasting up to 3 months was observed only in the three treatment groups.

Activities of Daily Living↗

PubMed2005

[Results after arthroplasty of the metacarpophalangeal joints with uncemented, unconstrained HM prosthesis in rheumatoid patients].

PURPOSE: In 80 % of patients with rheumatoid arthritis, the metacarpophalangeal (MP) joints are involved with increasing destruction and loss of function. Silicone arthroplasty of the MP joints leads to a limited range of motion, an increase in osteolysis and fractures of the implants. The cementless, unconstrained design of the HM prosthesis is a new concept for replacing the MP joints of rheumatoid patients. Short-term and midterm results are shown. METHOD AND MATERIAL: In a prospective study, 38 HM prostheses were implanted, 28 in patients with rheumatoid arthritis, four with osteoarthrosis, five with polyarthrosis and one after revision of a silicone implant. The patients were reexamined clinically and radiologically after an average follow-up of 16 months (6 - 37 months). RESULTS: The average active range of motion for extension, flexion increased from 0/15/65 degrees before surgery to 0/9/65 degrees after surgery. The remaining ulnar drift was 12 degrees (preoperative 18 degrees ). The average grip strength after surgery was 80 % of the opposite side. Pain in the verbal analog scale improved from 2.3 to 1.7 postoperatively. One palmar subluxation of an implant of the little finger was recognized. No infection occurred. The X-rays showed complete osteointegration in all metacarpal components. Radiolucent zones were found in progress only at the basis on the phalangeal components without radiological signs of loosening or sinking. CONCLUSION: The short- and midterm results after implantation of the cementless, unconstrained HM prosthesis show an improved hand function and pain relief. The design of the implant may solve the accepted postoperative problem of instability of the MP joints. Until now, no prosthesis had to be exchanged.

Adult↗

PubMed2005

Neuromuscular performance characteristics of open-wheel and rally drivers.

The purpose of the present study was to investigate neuromuscular performance characteristics in open-wheel and rally drivers using the cross-sectional study design. The subjects (N = 28) consisted of experienced international-level open-wheel drivers (n = 9), experienced international-level rally drivers (n = 9) and a physically active nondriving male control group (n = 10). In 3 separate test sessions, speed, muscle strength, and endurance tests were performed. The rally drivers had higher (p < 0.05) grip, shoulder flexion, and ankle plantar flexion strength, as compared to the control group. The open-wheel drivers showed higher strengths (p < 0.05) than the controls in neck forces, grip, shoulder flexion, and leg extension. The rally drivers were stronger (p < 0.05) than the open-wheel drivers in grip, plantar flexion, and trunk extension forces, whereas the open-wheel drivers were stronger (p < 0.01) than the rally drivers in neck lateral flexions and extension forces. Thus, competitive long-term open-wheel and rally drivers differ specifically in neuromuscular performance. For practice, these findings suggest that rally drivers should concentrate on training hand, ankle, and trunk muscles, whereas open-wheel drivers should train neck muscles, especially, and all other muscle groups rather equally.

Adult↗

PubMedDate not supplied

The recovery phase in Guillain-Barré syndrome: moving from dependency to independence.

In this study, we examined the perspectives of patients with Guillain-Barré syndrome during their recovery phase. We used a grounded theory approach. Five patients discharged from a major teaching hospital were interviewed; the format was semi-structured. Data were analyzed through a constant comparative method. We describe the central theme of moving from dependency to independence. There are five phases in the recovery process: experiencing dependency, encountering helplessness, wanting to know more about GBS, discovering inner strength, and regaining independence. Moving from dependency to independence was facilitated by the patients' discovery of their inner strengths. Regaining their independence was facilitated by their strong desire to walk out of the hospital. Patients realized that they had little knowledge about their illness and prognosis; further research in this area would be beneficial.

Activities of Daily Living↗

PubMed1999

Pyridinium crosslinks excretion in patients with rheumatoid arthritis. Correlation with disease activity and glucocorticoid treatment.

In patients with rheumatoid arthritis, significant positive correlations were found between urinary pyridinium crosslinks and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and articular index. Also an inverse correlation was observed between pyridinium crosslinks excretion and grip strength. Glucocorticoid therapy, equivalent to daily doses of 7.5 mg of prednisolone or less, did not appear to have deleterious effect on bone metabolism in these patients as measured by urinary pyridinium crosslinks.

Adult↗

PubMed1996

Lack of variation in muscle strength with menstrual status in healthy women aged 45-54 years: data from a national survey.

Isometric handgrip, quadriceps muscle strength and leg extensor power were assessed as part of a large representative survey of adult men and women in England. The gender ratios for these muscle strength measurements did not differ across age groups, which ranged from 25 to 65 years. Data from a subsample of women who were aged between 45 and 54 years and free of major health problems or current gynaecological problems (n = 299) and were analysed to see if there were differences in the muscle measurements according to reported menstrual status. Analysis of variance was used to compare four subgroups of women as follows: those who were still menstruating regularly (n = 89), those who had stopped altogether (n = 92), those who were irregular (n = 33) and those on hormone replacement therapy (n = 15). No significant differences were found between these subgroups in any of the three muscle measurements, body mass, fat-free mass (derived from four skinfolds), body mass index, or customary activity levels. There was a significant age difference of 2 years between two subgroups. After having controlled for this, using analysis of covariance, the outcome was not changed. These women were also compared with men in the same age range; the women had about 60% of the strength of the men and a highly significant difference remained after controlling for fat-free mass in all subgroups. No evidence was found for an ergogenic effect of the high oestrogen status conferred by natural menstruation or hormone replacement therapy.

Analysis of Variance↗

PubMed1995

Quantitative measurement of muscle strength in the mouse.

We have designed a special dynamometer for measuring mouse forelimb muscle strength and endurance. The device exploits a mouse's tendency to grasp a horizontal metal bar while suspended by its tail. A threshold value for the magnitude and duration of force that the mouse can exert is obtained by first allowing the animal to grasp the bar and then applying a steadily increasing downward force to the opposite end of a cable to which the mouse attaches. The bar is attached to a force transducer and pen recorder to produce a permanent record of the force produced by the mouse. Test results show that this dynamometer provides quantitative measurements of muscle strength and endurance in the mouse. Comparisons between experimental groups of normal and wobbler mice, a model for lower motor neuron disease, show that both the force exerted by the animals (muscle strength), and the duration of the pull (endurance), can be quantified and statistically analyzed. This technique can be used as an assay for quantitating the effects of in vivo drug treatments on murine neuromuscular disorders.

Animals↗

PubMed2006

Outcomes of dorsal capsulodesis and tenodesis for treatment of scapholunate instability.

PURPOSE: The ideal treatment for scapholunate (SL) instability has not yet been established. This study examined the results of 2 procedures for the primary treatment for chronic SL dissociation of dorsal capsulodesis and flexor carpi radialis tenodesis. METHODS: A retrospective analysis was conducted that examined dorsal capsulodesis and tenodesis procedures performed for chronic SL instability between January 1995 and February of 2003. Twenty-nine patients were identified with isolated chronic SL instability. Of the 29 patients, 14 had a dorsal capsulodesis procedure and 15 had a tenodesis procedure. The follow-up period averaged 38 months in the capsulodesis group and 36 months in the tenodesis group. Results were reviewed clinically and radiographically. Groups were compared with a Student t test. RESULTS: Postoperative wrist motion decreased in both groups after surgery. Final wrist range of motion was 64% of the unaffected side in the capsulodesis group and 63% of the unaffected side in the tenodesis group. Postoperative grip strength remained unchanged in both groups; grip strength measured 91% of the unaffected side in the capsulodesis group and 87% of the unaffected side in the tenodesis group. The average Mayo wrist scores were 77 in the capsulodesis group and 74 in the tenodesis group. One frank failure occurred in the tenodesis group resulting in a wrist fusion. There was no statistical difference in the overall wrist motion, grip strength, or wrist scores between the capsulodesis and tenodesis groups. CONCLUSIONS: Dorsal capsulodesis and tenodesis provided improvement in symptoms for patients with chronic SL instability. Both procedures appear to provide similar results in the treatment of this difficult problem.

Adult↗

PubMed2005

Long-term follow-up of surgical treatment for thumb duplication.

There are few long-term follow-up reports concerning the treatment of thumb duplication. We reviewed the treatment of 19 of 74 patients treated at our institution between 1956 and 2002. The average follow-up was 22 (range, 7 years to 35 years) years. Satisfactory function was achieved in 18 thumbs and cosmesis in 12 thumbs. Six thumbs were cold-intolerant at this late follow-up. Pinch strength was similar to the contralateral normal thumbs. Collateral ligament repair did not significantly contribute to joint stability. An objective method of postoperative evaluation showed good results in five, fair results in 12 and poor results in two thumbs.

Adolescent↗