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Lang AE, Chorneyko A, Heinrichs V. Comparing and characterizing scapular muscle activation ratios in males and females during execution of common functional movements. PeerJ 2024; 12:e17728. [PMID: 39035170 PMCID: PMC11260415 DOI: 10.7717/peerj.17728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Background The shoulder complex relies on scapular movement controlled by periscapular muscles for optimal arm function. However, minimal research has explored scapular muscle activation ratios during functional tasks, nor how they might be influenced by biological sex. This investigation aims to characterize how sex impacts scapular muscle activation ratios during functional tasks. Methods Twenty participants (ten females, ten males) were assessed with surface electromyography (EMG) and motion tracking during seven functional tasks. Activation ratios were calculated from normalized EMG for the three trapezius muscles and serratus anterior. Scapular angles were calculated using a YXZ Euler sequence. Two-way mixed methods ANOVAs (p < .05) were used to assess the effects of sex and humeral elevation level on ratios and angles. Results Sex-based differences were present in the Tie Apron task, with males exhibiting higher upper trapezius/lower trapezius and upper trapezius/middle trapezius ratios than females. Males also demonstrated decreased internal rotation in this task. Other tasks showcased significant sex-based differences in scapular upward rotation but not in activation ratios. Humeral elevation generally demonstrated an inverse relationship with scapular muscle activation ratios. Conclusions This study highlights sex-based differences in scapular muscle activation ratios during specific functional tasks, emphasizing the need to consider sex in analyses of shoulder movements. Normative activation ratios for functional tasks were provided, offering a foundation for future comparisons with non-normative groups. Further research is warranted to confirm and explore additional influencing factors, advancing our understanding of shoulder activation and movement in diverse populations.
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Affiliation(s)
- Angelica E. Lang
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Annaka Chorneyko
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Vivian Heinrichs
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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2
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Schlager A, Nilsson-Wikmar L, Ahlqvist K, Olsson CB, Kristiansson P. "Could a subset of joint mobility tests define generalized joint hypermobility?": A descriptive observational inception study. PLoS One 2024; 19:e0298649. [PMID: 38635598 PMCID: PMC11025819 DOI: 10.1371/journal.pone.0298649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 01/30/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Generalized joint hypermobility is an inherited collagen phenotype based on clinical assessments of joint mobility. However, there is no international consensus to define generalized joint hypermobility, both considering which joint mobility tests should be included and limits for joint hypermobility. OBJECTIVES The primary aim of the study was to identify a subset of joint mobility tests to define generalized joint hypermobility. A further aim was to evaluate standardized limits for the classification of hypermobility in different joint types throughout the body. METHODS A total of 255 early pregnant women were included in the study. Joint mobility was measured according to a structured protocol. Correlation and principal component analysis were used to find a subset of joint mobility tests. To classify hypermobility in each joint mobility test, five different standard deviation levels plus 0.84, plus 1.04, plus 1.28, plus 1.64 and plus 2 were used, corresponding to 20%, 15%, 10%, 5% and 2.5% of the normal distribution. RESULTS No subset of joint mobility test could define generalized joint hypermobility. The higher the standard deviation levels, the higher the limit to classify joint hypermobility and the lower the prevalence. As a result of no subset of joint mobility tests were found to define generalized joint hypermobility, different combinations of major and minor joints in upper and lower limbs and the axial skeleton, were systematically developed. These combinations were evaluated for each standard deviation level, resulting in a prevalence of generalized joint hypermobility between 0% and 12.9% and a clear variation in how the hypermobile joint mobility tests were distributed. CONCLUSION It is probably not possible to choose a subset of joint mobility tests to define GJH. In order not to overlook generalized joint hypermobility, a broader assessment of different joint types and sizes of joints appears to be needed. The prevalence of generalized joint hypermobility is dependent on joint hypermobility limit and the chosen combination of joint mobility tests.
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Affiliation(s)
- Angela Schlager
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lena Nilsson-Wikmar
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Kerstin Ahlqvist
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Christina B. Olsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Karagiannopoulos C, Griech SF. Impact of chronic wrist hypermobility on proprioception, strength, and functional performance in young adults. J Hand Ther 2024; 37:209-217. [PMID: 38342640 DOI: 10.1016/j.jht.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/30/2023] [Accepted: 10/05/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Chronic joint hypermobility has been attributed to repetitive ligamentous microtrauma, benign joint hypermobility syndrome (BJHS), or genetic connective tissue disorders that lead to pain and functional impairment, especially among females. Chronic wrist hypermobility (CWH) prevalence, etiology, and effects on proprioception, strength, and function have yet to be established. PURPOSE This pilot study aimed to determine the CWH prevalence among adults; its effects on proprioception, strength, and function; and whether these effects are gender based. STUDY DESIGN This was a quasi-experimental cross-sectional study. METHODS Ninety wrists (55 participants, mean age 27.46 years) with no wrist range of motion (ROM) restrictions or previous trauma for ≥6 months were screened for CWH based on an exploratory set of diagnostic criteria. Fifty-eight wrists (34 adults) were allocated to a CWH group, and 32 wrists (21 adults) were allocated to a healthy control group. Twenty-five CWH and 25 healthy control matched (gender, age, and handedness) participants were compared. Assessment included the active wrist joint position sense test, hand-held dynamometry for wrist extension and grip strength, and the patient-rated wrist evaluation for function. Testers were blinded to group allocation. RESULTS A 64.4% CWH prevalence existed among CWH participants, who were mostly asymptomatic females (74%). Frequent etiologic factors were midcarpal (96.5%) and scapholunate (39%) instabilities and BJHS (37%), which was higher among females (30%) than males (8%). Independent t-tests showed statistically significant (p < 0.05) group differences in wrist proprioception, wrist isometric extension, grip strength, and function with moderate-high (0.41-0.75) effect size. No significant gender differences existed in proprioception and function. CONCLUSIONS CWH is very prevalent among functional independent young adults with atraumatic midcarpal and intercarpal ligamentous laxities and BJHS. CWH prevails among women and adversely affects wrist proprioception, strength, and function. The study's specific CWH diagnostic criteria may be useful for clinicians to identify and timely manage impacted individuals by CWH.
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Affiliation(s)
- Christos Karagiannopoulos
- DeSales University Division of Healthcare, Doctor of Physical Therapy Program, Center Valley, PA, USA.
| | - Sean F Griech
- DeSales University Division of Healthcare, Doctor of Physical Therapy Program, Center Valley, PA, USA.
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Jansen van Vuuren L, Jansen van Vuuren WA, Broadbent JM, Duncan WJ, Waddell JN. Measurement of tooth displacement. J Mech Behav Biomed Mater 2023; 146:106059. [PMID: 37604099 DOI: 10.1016/j.jmbbm.2023.106059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023]
Abstract
The periodontium is a biological structure that supports the tooth in the jaw and behave as a developmental, biological, and functional unit. Teeth may be considered to be 'suspended' in their tooth sockets which provides teeth the ability to move in response to an applied load. In terms of the protection the suspension effect of the periodontal ligament may offer dental restorations, movement in an axial direction is of interest. No device or system to measure this movement is readily available, thus a novel approach had to be developed to address the questions of this research. The device developed allowed images to be taken of the participants teeth before, during and after a participant bit down on the tooth and used to measure the displacement of the tooth in image processing software. Average maximum tooth displacement from all participants of 73.8 μm (sd = 22.5 μm) were recorded. Longer application time of bite force was associated with greater cumulative tooth displacement, for a given level of force, and female participants experienced approximately 2 μm more displacement per Newton than males. The device and methods utilised in this study has shown good potential as a measurement protocol for measurement of vertical tooth movements in vivo. The response to load the teeth in this study has shown, highlighted the visco-elastic properties of the periodontal ligament and the amount of movement recorded supports the protection that controlled tooth movement offers teeth.
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Affiliation(s)
- L Jansen van Vuuren
- Department of Oral Rehabilitation, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.
| | - W A Jansen van Vuuren
- Department of Oral Rehabilitation, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - J M Broadbent
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - W J Duncan
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Lindskog J, Piussi R, Simonson R, Högberg J, Samuelsson K, Thomeé R, Sundemo D, Hamrin Senorski E. Lower rates of return to sport in patients with generalised joint hypermobility two years after ACL reconstruction: a prospective cohort study. BMC Sports Sci Med Rehabil 2023; 15:100. [PMID: 37573382 PMCID: PMC10422717 DOI: 10.1186/s13102-023-00707-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/24/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Generalised joint hypermobility (GJH) has been associated with an increased risk of suffering an anterior cruciate ligament (ACL) injury. Patients with GJH exhibit lower muscle strength and poorer scores for patient-reported outcomes after ACL reconstruction, compared with patients without GJH. The aim of this study was to examine differences in the percentages of patients who return to sport (RTS) or pre-injury level of activity (RTP), muscle function and patient-reported outcomes at the time of RTS or RTP, as well as the time of RTS or RTP in patients with GJH compared with patients without GJH in the first two years after ACL reconstruction. METHODS This prospective study used data from an ACL- and rehabilitation-specific register located in Gothenburg, Sweden. Patients aged between 16 and 50, who had a primary ACL injury treated with reconstruction, were included. Data up to two years after ACL reconstruction were used and consisted of achieving RTS and RTP, results from isokinetic muscle function tests for knee extension and flexion and patient-reported outcomes (Knee Self-Efficacy Scale, Knee injury and Osteoarthritis Outcome Score and ACL-Return to Sport after Injury scale) at the time of RTS, as well as the time of RTP. A Beighton Score of ≥ 5/9 was used to define GJH. A Tegner Activity Scale of ≥ 6 was used to define RTS, while a Tegner equal to or above pre-injury level was used to define RTP. RESULTS A total of 1,198 patients (54.7% women) with a mean age of 28.5 ± 8.6 years were included. A smaller proportion of patients with GJH achieved RTS compared with patients without GJH (49.2% vs. 57.3%, Odds ratio: 0.720, p = 0.041). Furthermore, patients with GJH were marginally less symmetrical on the knee extension strength test, expressed as a Limb Symmetry Index, at the time of RTP compared with patients without GJH (87.3 ± 13.5 vs. 91.7 ± 14.3, Cohen's d = 0.142, p = 0.022). No further differences were found between groups regarding any muscle function tests or patient-reported outcomes. CONCLUSION A smaller proportion of patients with GJH achieved RTS compared with patients without GJH. Patients with GJH displayed less symmetrical knee extension strength at the time of RTP compared with patients without GJH.
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Affiliation(s)
- Jakob Lindskog
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden
| | - Ramana Piussi
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg, SE-405 30, Sweden
- Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, Sweden
| | - Rebecca Simonson
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg, SE-405 30, Sweden
- Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, Sweden
| | - Johan Högberg
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg, SE-405 30, Sweden
- Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, Sweden
| | - Kristian Samuelsson
- Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Roland Thomeé
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg, SE-405 30, Sweden
| | - David Sundemo
- Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, Sweden
- Närhälsan Lerum Primary Health Care Center, Lerum, Sweden
| | - Eric Hamrin Senorski
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg, SE-411 01, Sweden.
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg, SE-405 30, Sweden.
- Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, Sweden.
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Miyamori T, Saito T, Aoyagi M, Nozu S, Masui Y, Ishihara Y, Shimasaki Y, Yoshimura M. Differences in the elastic modulus of the lumbar muscles between female athletes with and without low back pain. Clin Biomech (Bristol, Avon) 2023; 105:105968. [PMID: 37116229 DOI: 10.1016/j.clinbiomech.2023.105968] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Low back pain is the most prevalent musculoskeletal disorder affecting performance and sports participation among athletes and is more prevalent among female athletes. Evaluating the stiffness of the lumbar muscles is important for understanding the pathophysiology of low back pain. Therefore, this study examined the differences in stiffness of the lumbar multifidus and erector spinae muscles between female university athletes with and without low back pain. METHODS This was a cross-sectional study. The study was conducted at a single centre, the university research laboratory. Twenty female university athletes with low back pain or a history of low back pain and 20 without low back pain participated in this study. The shear elastic moduli of the multifidus and erector spinae muscles were evaluated in the prone (to relax the muscles) and sitting with 35° of trunk flexion (to stretch the muscles) positions using shear wave ultrasound imaging equipment. FINDINGS The low back pain group showed significantly greater shear elastic modulus in the multifidus in both prone and sitting positions than the non-low back pain group. There were no differences in the erector spinae muscle between the two groups at either position. INTERPRETATION These results provide new insights into the microscopic characteristics of low back pain pathophysiology in young female athletes. Stiffness assessment using shear wave elastography will help provide a specific treatment strategy for female athletes with low back pain or a history of low back pain.
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Affiliation(s)
- Takayuki Miyamori
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 2-1-1, Hongo Bunkyo-ku, Tokyo 113-8421, Japan; Graduate school of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan; Graduate school of Health Science, Juntendo University, 2-1-1, Hongo Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Taiki Saito
- Rehabilitation Center, Oyumino Central Hospital, 6-49-9, Oyuminominami Midori-ku, Chiba 266-0033, Japan
| | - Masashi Aoyagi
- Juntendo Administration for Sports, Health and Medical Sciences, Juntendo University, 2-1-1, Hongo Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shojiro Nozu
- Graduate school of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan; Department of Health and Sports Science, Faculty of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan
| | - Yuki Masui
- Graduate school of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan
| | - Yoshihiko Ishihara
- School of Science and Technology for Future Life, Tokyo Denki University, 5 Asahicho Senju Adachi-ku, Tokyo 120-8551, Japan
| | - Yu Shimasaki
- Department of Health and Sports Science, Faculty of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan
| | - Masafumi Yoshimura
- Graduate school of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan; Department of Health and Sports Science, Faculty of Health and Sports Science, Juntendo University, 1-1, Hirakagakuendai Inzai-shi, Chiba 270-1695, Japan
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Sports-Related Shoulder Injuries Among Female Athletes. Curr Rev Musculoskelet Med 2022; 15:637-644. [PMID: 36469281 PMCID: PMC9789246 DOI: 10.1007/s12178-022-09802-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW The objectives of this review are to explore the recent literature evaluating sports-related shoulder injuries among female athletes. RECENT FINDINGS Recent literature has highlighted sex-related differences in injury trends and patterns among athletes. Increased participation of women in both recreational and professional sports has resulted in increased exposure to injury. While men experience greater rates of shoulder injury overall, women tend to experience more overuse-related injuries. Evidence also suggests women are more susceptible to shoulder laxity and rotator cuff tears. In comparison to their male counterparts, women note poorer function, increased pain, and decreased activity level following shoulder injuries. Women may also be more likely to experience worse outcomes following surgical intervention. Sex-related differences in injury patterns and outcomes results from a combination of molecular and environmental influences, including hormone pathways, shoulder morphology, and differing rates of participation in, and athletic regulations among, certain sports. Sex-related differences occur in how athletes sustain, experience, and recover from sports-related injuries. A comprehensive understanding of sex-related injuries enhances clinical decision making, treatment, and recovery. Further research is needed to clarify sex as an independent variable when evaluating sports-related shoulder injuries.
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Hershkovich O, Gordon B, Derazne E, Tzur D, Afek A, Lotan R. Symptomatic Joint Hypermobility Is Associated with Low Back Pain: A National Adolescents Cohort Study. J Clin Med 2022; 11:jcm11175105. [PMID: 36079031 PMCID: PMC9456634 DOI: 10.3390/jcm11175105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Low back pain (LBP) is a widespread medical complaint affecting many people worldwide and costing billions. Studies suggest a link between LBP and joint hypermobility. This study aimed to examine the association between symptomatic joint hypermobility (SJH), LBP, and gender. Methods: Data were obtained from a medical database containing 17-year-old candidates’ records before recruitment into mandatory military service. According to the Regulations of Medical Fitness Determination, information on disability codes associated with LBP and SJH was retrieved. Results: According to this national survey, the prevalence of SJH is 0.11% (1355 cases out of 1,220,073 subjects). LBP was identified in 3.7% of the cohort (44,755 subjects). Subjects were further subdivided into LBP without objective findings (LBPWF) (3.5%) and LBP with objective findings (LBPOF) (0.2%). The association between SJH and LBP was examined: the Odds Ratio (OR) was 2.912 (p < 0.0001). The odds rations for LBPWF and LBPOF were further calculated to be 2.914 (p < 0.000) and 2.876 (p < 0.000), respectively. Subjects with SJH were almost three times more prone to LBPWF and LBPOF. Conclusion: SJH is strongly associated with LBP in young adults. Further pathophysiological research is needed.
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Affiliation(s)
- Oded Hershkovich
- Department of Orthopedic Surgery, Wolfson Medical Center, Ha-Lokhamim St 62, Holon 5822012, Israel
- Medical Corps, Israeli Defense Forces, Jerusalem 9112102, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-3-5028383; Fax: +972-3-5028774
| | - Barak Gordon
- Medical Corps, Israeli Defense Forces, Jerusalem 9112102, Israel
- Department of Military Medicine, Faculty of Medicine, Institute for Research in Military Medicine (IRMM), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Estela Derazne
- Medical Corps, Israeli Defense Forces, Jerusalem 9112102, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Dorit Tzur
- Medical Corps, Israeli Defense Forces, Jerusalem 9112102, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Raphael Lotan
- Department of Orthopedic Surgery, Wolfson Medical Center, Ha-Lokhamim St 62, Holon 5822012, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Barrio ED, Ramirez-Campillo R, Garcia de Alcaraz Serrano A, RaquelHernandez-García R. Effects of core training on dynamic balance stability: A systematic review and meta-analysis. J Sports Sci 2022; 40:1815-1823. [PMID: 35976032 DOI: 10.1080/02640414.2022.2110203] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Core stability has a strong relationship with dynamic balance stability (DBS). The purpose of this review with meta-analysis was to analyse the effects of core training programmes from different studies on DBS. A literature search was performed using different databases. Subgroups analyses on duration, training frequency, total sessions, chronological age, training status, equipment and movements were performed. A random-effects model for meta-analyses was used. Thirteen studies were selected for the systematic review and 10 for the meta-analysis, comprising 226 participants. A moderate effect was noted for core training on DBS (p < 0.001; ES = 0.634). Greater DBS improvements were found in core training interventions with ≤6 weeks (ES = 0.714), after high volume (ES = 0.787) and more frequent interventions (ES = 0.787), as well as in younger participants (ES = 0.832). In addition, body weight exercises may be better than med ball, swiss ball or band resisted exercises. Core training improves DBS among athletes and a non-trained population, creating a more solid stable base that allows better lower extremity movements. This could be more effective considering different modulators ≤6 weeks intervention, >2 sessions per week, >17 total sessions, body weight core programmes and applied to ≤18.0 years old.
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Affiliation(s)
| | - Rodrigo Ramirez-Campillo
- exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Antonio Garcia de Alcaraz Serrano
- Faculty of Educational Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Raquel RaquelHernandez-García
- Faculty of Sports Sciences, University of Murcia, Murcia, Spain.,Faculty of Educational Sciences, University of Castilla la Mancha, Cuenca, Spain
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Inoue J, Takenaga T, Tsuchiya A, Okubo N, Takeuchi S, Takaba K, Nozaki M, Kobayashi M, Fukushima H, Kato J, Murakami H, Yoshida M. Ultrasound Assessment of Anterior Humeral Head Translation in Patients With Anterior Shoulder Instability: Correlation With Demographic, Radiographic, and Clinical Data. Orthop J Sports Med 2022; 10:23259671221101924. [PMID: 35837445 PMCID: PMC9274420 DOI: 10.1177/23259671221101924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Ultrasonography can be used to quantitatively assess anterior humeral head
translation (AHHT) at different degrees of shoulder abduction. Risk factors
for recurrent shoulder instability have been identified. Hypothesis: It was hypothesized that the number of dislocations or glenoid or humeral
bone loss would be associated with more AHHT as measured using
ultrasound. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 39 patients who underwent surgery for anterior shoulder
instability were prospectively studied. Ultrasound assessment of AHHT was
performed immediately after general anesthesia was induced. The upper arm
was placed at 0°, 45°, and 90° of abduction, and a 40-N anterior force was
applied to the proximal third of the arm. The distance from the posterior
edge of the glenoid to that of the humeral head was measured at each
abduction angle using ultrasound with and without a 40-N anterior force, and
the AHHT was calculated. The differences in translation at each shoulder
angle were compared. Additionally, the authors investigated the association
between AHHT and demographic, radiographic, and clinical data. Results: Compared with the AHHT at 0° of abduction (5.29 mm), translation was
significantly larger at 45° of abduction (8.90 mm; P <
.01) and 90° of abduction (9.46 mm; P < .01). The mean
translation was significantly larger in female patients than in male
patients at all degrees of abduction (P ≤ .036 for all).
There was no correlation between AHHT at any abduction angle and number of
dislocations, clinical data, or radiographic data (including bone loss). Conclusion: Ultrasound assessment of AHHT showed larger amounts of laxity at 45° and 90°
than at 0° of abduction. Anterior glenohumeral laxity was greater in female
than male patients. Glenoid or humeral bone loss did not correlate with
AHHT, thereby clarifying that bone loss has no direct effect on measurements
of capsular laxity in neutral rotation.
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Affiliation(s)
- Jumpei Inoue
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Tetsuya Takenaga
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Atsushi Tsuchiya
- Arthroscopy and Sports Medicine Center, Meitetsu Hospital, Nagoya, Japan
| | - Norio Okubo
- Department of Orthopedic Surgery, Meitetsu Hospital, Nagoya, Japan
| | - Satoshi Takeuchi
- Department of Orthopedic Surgery, Toyohashi Medical Center, Toyohashi, Japan
| | - Keishi Takaba
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Masahiro Nozaki
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Makoto Kobayashi
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Hiroaki Fukushima
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Jiro Kato
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Hideki Murakami
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Masahito Yoshida
- Department of Musculoskeletal Sports Medicine, Research and Innovation, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
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11
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Wessel LE, Eliasberg CD, Bowen E, Sutton KM. Shoulder and elbow pathology in the female athlete: sex-specific considerations. J Shoulder Elbow Surg 2021; 30:977-985. [PMID: 33220412 DOI: 10.1016/j.jse.2020.10.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 02/01/2023]
Abstract
Unique biologic and biomechanical aspects of the female body make women more prone to certain orthopedic injuries. Sex differences are well understood with regard to certain orthopedic pathologies such as anterior cruciate ligament injury, hallux valgus, carpal tunnel, and carpometacarpal joint arthritis; however, sex differences are less commonly discussed with regard to shoulder and elbow pathology. The purpose of this review is to elucidate sex differences specific to sports-related shoulder and elbow injuries in the female athlete population.
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Affiliation(s)
- Lauren E Wessel
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Claire D Eliasberg
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Edward Bowen
- Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Karen M Sutton
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
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12
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Torgutalp ŞŞ, Babayeva N, Özkan Ö, Yilmaz S, Dönmez G, Korkusuz F. Do Plantar Pressure and Loading Patterns Vary with Joint Hypermobility in Young Females? J Am Podiatr Med Assoc 2021; 111:441321. [PMID: 32701151 DOI: 10.7547/18-146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Joint hypermobility is a connective tissue disorder that increases joint range of motion. Plantar pressure and foot loading patterns may change with joint hypermobility. We aimed to analyze static plantar pressure in young females with and without joint hypermobility. METHODS Joint laxity in 27 young females was assessed cross sectionally using the Beighton and Horan Joint Mobility Index. Participants were divided into the hypermobility (score, 4-9) and no hypermobility (score, 0-3) groups according to their scores. Static plantar pressure and forces were recorded using a pedobarographic mat system. RESULTS Higher peak pressures (P = .01) and peak pressure gradients (P = .025) were observed in the nondominant foot in the hypermobility group. According to the comparison of dominant and nondominant feet in each group, the hypermobility group showed significantly higher peak pressures (P = .046), peak pressure gradients (P = .041), and total force values (P = .028) in the nondominant foot. CONCLUSIONS The plantar pressure and loading patterns vary in young females with joint hypermobility. Evaluation of plantar loading as an injury prevention tool in individuals with joint hypermobility syndrome can be suggested.
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ALAY H, YILMAZ S, KESMEZ CAN F, PARLAK M. An evaluation of risk factors affecting amputation in patients with diabetic foot Infection. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.809986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Madaleno FO, Verhagen E, Ferreira TV, Ribeiro T, Ocarino JM, Resende RA. Normative reference values for handgrip strength, shoulder and ankle range of motion and upper-limb and lower limb stability for 137 youth judokas of both sexes. J Sci Med Sport 2021; 24:41-45. [DOI: 10.1016/j.jsams.2020.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/27/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
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15
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Ali A, Andrzejowski P, Kanakaris NK, Giannoudis PV. Pelvic Girdle Pain, Hypermobility Spectrum Disorder and Hypermobility-Type Ehlers-Danlos Syndrome: A Narrative Literature Review. J Clin Med 2020; 9:jcm9123992. [PMID: 33317183 PMCID: PMC7764306 DOI: 10.3390/jcm9123992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 01/04/2023] Open
Abstract
Pelvic girdle pain (PGP) refers specifically to musculoskeletal pain localised to the pelvic ring and can be present at its anterior and/or posterior aspects. Causes such as trauma, infection and pregnancy have been well-established, while patients with hypermobile joints are at greater risk of developing PGP. Research exploring this association is limited and of varying quality. In the present study we report on the incidence, pathophysiology, diagnostic and treatment modalities for PGP in patients suffering from Hypermobility Spectrum Disorder (HSD) and Hypermobility-Type Ehlers-Danlos Syndrome (hEDS). Recommendations are made for clinical practice by elaborating on screening, diagnosis and management of such patients to provide a holistic approach to their care. It appears that this cohort of patients are at greater risk particularly of mental health issues. Moreover over, they may require a multidisciplinary approach for their management. Ongoing research is still required to expand our understanding of the relationship between PGP, HSD and hEDS by appropriately diagnosing patients using the latest updated terminologies and by conducting randomised control trials to compare outcomes of interventions using standardised patient reported outcome measures.
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Affiliation(s)
- Ahmed Ali
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Floor D, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK
| | - Paul Andrzejowski
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Floor D, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK
| | - Nikolaos K Kanakaris
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Floor D, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Floor D, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK
- NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, Leeds LS7 4SA, UK
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Sobhani-Eraghi A, Motalebi M, Sarreshtehdari S, Molazem-Sanandaji B, Hasanlu Z. Prevalence of joint hypermobility in children and adolescents: A systematic review and meta-analysis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:104. [PMID: 33824669 PMCID: PMC8019126 DOI: 10.4103/jrms.jrms_983_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 12/31/2019] [Accepted: 06/21/2020] [Indexed: 11/06/2022]
Abstract
Background: The inconsistent results of different studies regarding the prevalence of joint hypermobility (JH) or joint laxity in children and adolescents made us conduct a meta-analysis on the prevalence of JH in this age group. Materials and Methods: We searched electronic databases including Trip, Scopus, Medline, Embase, PubMed, and Google Scholar; some Iranian databases including Iran Medex and Magiran; and Scientific Information Database to find studies in which the prevalence of JH in children and adolescents had been reported since January 1990 to April 2017. In this process, two researchers evaluated the articles separately while they were not aware of each other's method, and they extracted and matched the information. Results: Necessary data of twenty studies (15,097 boys and 6048 girls) were entered into this meta-analysis. The age range in these studies was 3–19 years. According to the meta-analysis conducted on the twenty studies, it was determined that the total prevalence of JH among children and adolescents was 34.1% (95% confidence interval [CI]: 33.3%–34.8%). Based on the results obtained from the studies, a significant heterogeneity (I2 index equals to 99,415 and P ≤ 0.001) was shown, so we used random-effects model; moreover, the overall assessment of studies showed a statistically significant publication bias (P = 0.02). In total, the prevalence in girls was equal to 32.5% (95% CI: 31.4%–33.7%), and in boys, it was equal to 18.1% (95% CI: 17.2%–19.1%). Conclusion: According to this meta-analysis, studies showed high heterogeneity, and the prevalence of JH in children and adolescents around the world was equal to 34.1% (95% CI: 33.3%–34.8%) in total, whereas it was higher in girls and lower in older ages.
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Affiliation(s)
- Amir Sobhani-Eraghi
- Department of Orthopaedics Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Motalebi
- Department of Medicine, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Siavash Sarreshtehdari
- Department of Orthopaedics Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Borzooyeh Molazem-Sanandaji
- Department of Orthopaedics Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hasanlu
- Department of Orthopaedics Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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17
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Dworak TC, Balazs GC, Tropf J, Nanos GP, Tintle SM. Epidemiology of Symptomatic Dorsal Wrist Ganglia in Active Duty Military and Civilian Populations. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2020; 2:349-353. [PMID: 35415521 PMCID: PMC8991698 DOI: 10.1016/j.jhsg.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 08/04/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose The epidemiology of dorsal wrist ganglia (DWG) has been poorly studied. The purpose of this study was to determine the epidemiology of DWG in the US military and civilian populations. We hypothesized that military service would be associated with an increased risk for developing a DWG. Methods The US Department of Defense Management Analysis and Reporting Tool, a database of health care encounters by military personnel and dependents, was queried for encounters with an International Classification of Diseases, Ninth Revision diagnosis of 727.41 (ganglion of a joint) or 727.43 (ganglion, unspecified location) between 2009 and 2014. There is no specific code for DWG, so a random sample of 1,000 patients was selected from both the military and civilian cohorts. These 2,000 electronic medical records were examined to identify patients with a DWG. This estimate was used to determine the unadjusted incidence of DWG with a 95% confidence interval and a 5% margin of error in the entire military and civilian dependent population. Adjusted incidence rates and incidence rate ratios (IRR) were determined using Poisson regression, controlling for demographic covariates. Results The incidence of DWG in the military population is 14.25/10,000 person-years compared with 7.01/10,000 person-years in the civilian population. Female sex was a significant risk factor in both the military (IRR, 2.59) and civilian populations (IRR, 2.26). Younger age group (age 25–34 years) was a significant risk factor for DWG compared with an older age group (age 45–64 years) in both the military (IRR, 1.74) and civilian populations (IRR, 2.56). Senior rank (both officer and enlisted) was a significant risk factor for DWG compared with junior rank (IRR, 1.95). Conclusions The incidence of DWG was higher in the military compared with the civilian population. There is a higher incidence of a DWG in females and in the senior ranks (both officer and enlisted). Type of study/level of evidence Prognostic III.
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Affiliation(s)
- Theodora C. Dworak
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - George C. Balazs
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jordan Tropf
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD
| | - George P. Nanos
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Scott M. Tintle
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
- Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA
- Corresponding author: Scott Tintle, MD, Department of Orthopaedics, Walter Reed National Military Medical Center, America Building, 2nd Floor, 8901 Wisconsin Avenue, Bethesda, MD.
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Xiong XF, Wei L, Xiao Y, Han YC, Yang J, Zhao H, Yang M, Sun L. Family history of diabetes is associated with diabetic foot complications in type 2 diabetes. Sci Rep 2020; 10:17056. [PMID: 33051498 PMCID: PMC7555504 DOI: 10.1038/s41598-020-74071-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/18/2020] [Indexed: 12/20/2022] Open
Abstract
To investigate the relationship between diabetic foot complications (DFCs) and clinical characteristics, especially the number and types of first-degree family members with diabetes. A total of 8909 type 2 diabetes patients were enrolled. The clinical characteristics of these patients, including DFCs and family history of diabetes (FHD), were collected from medical records. Multiple regression was used to investigate the association between FHD and DFCs after adjusting for confounding factors. The patients with one and more than one first-degree family member with diabetes accounted for 18.7% and 12.8%, respectively. The proportions of the participants with a father with diabetes, a mother with diabetes, both parents with diabetes, siblings with diabetes, father and siblings with diabetes, mother and siblings with diabetes, and both parents and siblings with diabetes were 3.5%, 6.2%, 1.1%, 14.4%, 1.5%, 4%, and 0.7%, respectively. The multiple regression analysis showed that the number of family members with diabetes was positively associated with DFCs. However, among the different types of FHD, only the patients with a mother with diabetes showed a statistical association with DFCs. In addition to FHD, other factors, including gender, body mass index, platelet count, hemoglobin levels, albumin levels, high-density cholesterol levels, diabetic peripheral neuropathy, and the use of lipid-lowering agents, oral hypoglycemic agents, and insulin, were also associated with DFCs. DFCs were associated with different numbers of family members with diabetes and types of FHD. This association reveals the importance of genetic and environmental factors in DFCs and highlights the importance of adding FHD to public health strategies targeting detecting and preventing the disease.
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Affiliation(s)
- Xiao-Fen Xiong
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ling Wei
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ying Xiao
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ya-Chun Han
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Jinfei Yang
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Hao Zhao
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ming Yang
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Lin Sun
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China.
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Sirajudeen MS, Waly M, Alqahtani M, Alzhrani M, Aldhafiri F, Muthusamy H, Unnikrishnan R, Saibannavar R, Alrubaia W, Nambi G. Generalized joint hypermobility among school-aged children in Majmaah region, Saudi Arabia. PeerJ 2020; 8:e9682. [PMID: 32864212 PMCID: PMC7427539 DOI: 10.7717/peerj.9682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022] Open
Abstract
Generalized joint hypermobility (GJH) is common among schoolchildren and usually benign. However, it may progressively lead to joint pain and developmental delay. Identifying GJH in school-aged children would facilitate the monitoring of early changes and planning for early rehabilitative intervention. Epidemiological studies addressing the prevalence of GJH among children in the Gulf region and Arab ethnicity are lacking. Hence, we aimed to determine the prevalence, pattern, and factors associated with GJH among school-aged children in the Majmaah region, Saudi Arabia. Male and female school-aged children 8–14 years of age from the Majmaah region of Saudi Arabia participated in this cross-sectional study. Beighton score was used to assess GJH. Personal characteristics such as age, height, weight, body mass index, and handedness were also collected. Descriptive statistics were obtained for personal characteristics, the point prevalence of hypermobility, frequency of Beighton score distribution, and prevalence of GJH. The associations between specific factors and the presence of GJH were analyzed using chi-square and Mann-whitney tests. Using the Beighton score cutoff ≥ 4 and ≥ 6, 15.2% and 7.6% of the school children in our study were diagnosed with GJH respectively. The prevalence of GJH was higher among females (16.8%) than among males (13.4%), but the difference was not statistically significant. The elbow joints (17.2%) were the most common hypermobile joints and the trunk (0.7%) was the least involved. The children with GJH were younger and had lesser BMI compared to children without GJH (P < 0.05). The prevalence reported in this study among school-aged children was comparable with those reported worldwide.
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Affiliation(s)
- Mohamed Sherif Sirajudeen
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Waly
- Department of Medical Equipment Technology, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mazen Alqahtani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Msaad Alzhrani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Fahad Aldhafiri
- Department of Public Health, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Hariraja Muthusamy
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Radhakrishnan Unnikrishnan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Rashmi Saibannavar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Wafa Alrubaia
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudi Arabia
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Moon KC, Kim SB, Han SK, Jeong SH, Dhong ES. Risk factors for major amputation in hospitalized diabetic patients with forefoot ulcers. Diabetes Res Clin Pract 2019; 158:107905. [PMID: 31676331 DOI: 10.1016/j.diabres.2019.107905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/04/2019] [Accepted: 10/25/2019] [Indexed: 01/13/2023]
Abstract
AIMS The purpose of this study was to investigate the risk factors for major amputation in patients hospitalized with diabetic forefoot ulcers. METHODS Between January 2003 and December 2018, a total of 1792 diabetic patients were admitted to the diabetic wound center for the management of diabetic foot ulcers. Among the patients, 1032 diabetic patients with forefoot ulcers were included in this study. Nine hundred and eighty-three patients (95%) healed without major amputations while 49 patients (5%) healed after major amputations. Data related to 88 potential risk factors including demographics, ulcer condition, vascularity, bioburden, neurology, and serology were collected from the patients in these two groups for comparison. RESULTS Among the 88 potential risk factors, 34 showed statistically significant differences between the two groups. In the univariate analysis of 88 risk factors, 33 showed statistically significant differences. In stepwise multiple logistic regression analysis, four of the 33 risk factors remained statistically significant. The multivariate-adjusted odds ratios for gender, magnesium levels, platelet levels, and glycated hemoglobin (HbA1c) levels were 8.216, 2.480, 1.009, and 0.570, respectively. CONCLUSION Risk factors for major amputation in patients hospitalized with diabetic forefoot ulcers include male gender, increased magnesium, increased platelet levels, and low levels of HbA1c.
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Affiliation(s)
- Kyung-Chul Moon
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea
| | - Soo-Byn Kim
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea
| | - Seung-Kyu Han
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea.
| | - Seong-Ho Jeong
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea
| | - Eun-Sang Dhong
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea
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Reuter PR, Fichthorn KR. Prevalence of generalized joint hypermobility, musculoskeletal injuries, and chronic musculoskeletal pain among American university students. PeerJ 2019; 7:e7625. [PMID: 31565567 PMCID: PMC6744937 DOI: 10.7717/peerj.7625] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 08/06/2019] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to investigate the prevalence of generalized joint hypermobility (GJH) in a university-aged population, whether young adults (aged 18–25 years) with GJH are prone to sustain more musculoskeletal injuries, and are more likely to suffer from chronic musculoskeletal pain. The study used an interactive survey to gather data; GJH was assessed using a cut-off Beighton score of ≥5 in accordance with the 2017 International Classification of EDS criteria. The analyzed sample consisted of 482 female and 172 male participants from Florida Gulf Coast University (USA). The prevalence of GJH in a university-aged population can be estimated at 12.5%. Women did not have higher rates of GJH than men. However, female participants showed significantly higher rates of hypermobility of the spine as well as the right knee and elbow joints. The Beighton scores did not differ by ethnicity/race. Female participants had a lower rate of self-reported injuries than male participants, although this difference was not significant. There was no difference in the proportion of all participants classified within different categories (0; 1–4; 5–9) of Beighton scores and whether or not they reported having been injured. Male and female participants reported chronic pain of joints and neck or back at the same rates across the Beighton score categories. Female participants, however, reported higher pain intensity for chronic neck and back pain. This study increases knowledge about a correlation between GJH, musculoskeletal injuries, and chronic pain of joints, neck, and back in a university-aged population.
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Affiliation(s)
- Peter R Reuter
- Department of Rehabilitation Sciences, Marieb College of Health & Human Services, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Kaylee R Fichthorn
- Department of Rehabilitation Sciences, Marieb College of Health & Human Services, Florida Gulf Coast University, Fort Myers, FL, USA
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Sex-related differences in patients undergoing surgery for shoulder instability: a Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study. J Shoulder Elbow Surg 2019; 28:1013-1021. [PMID: 31003889 DOI: 10.1016/j.jse.2019.02.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 02/01/2023]
Abstract
HYPOTHESIS AND BACKGROUND Male sex has been identified as a risk factor for both primary shoulder dislocation and recurrent instability, and male patients more often undergo surgery for instability. Despite published discrepancies between sexes regarding the incidence and surgical rates of shoulder instability, there is little detail on the differences in presentation, mechanism of injury, and intraoperative findings. The purpose of this study was to explore these differences. METHODS Prospective baseline data from 1010 patients in the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort were analyzed for sex-related differences using demographic characteristics, patient-reported outcomes, radiographic findings, intraoperative findings, and surgical procedures performed. Two-tailed t tests and χ2 tests were used to compare the continuous and categorical data, respectively. Patients were categorized using the Frequency, Etiology, Direction, Severity (FEDS) classification system. RESULTS Male patients comprised 81.3% of the cohort. Male patients had a significantly higher rate of traumatic instability and rate of initial instability while playing sports, as well as significantly higher activity scores. Female patients had significantly lower preoperative American Shoulder and Elbow Surgeons, Western Ontario Shoulder Instability Index, 36-Item Health Survey, and Single Assessment Numeric Evaluation scores. No difference in the number of dislocations was found between male and female patients. Intraoperatively, male patients had higher rates of labral pathology and bone loss whereas female patients had higher rates of capsular laxity. These differences resulted in more Latarjet procedures for male patients and more soft-tissue procedures for female patients. CONCLUSION There are differences between male and female patients in the etiology of their instability, baseline patient-reported outcomes, and associated shoulder pathology, likely reflecting intrinsic and activity-related variation. These differences may influence clinical decision making and patient outcomes.
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Frey A, Lambert C, Vesselle B, Rousseau R, Dor F, Marquet LA, Toussaint JF, Crema MD. Epidemiology of Judo-Related Injuries in 21 Seasons of Competitions in France: A Prospective Study of Relevant Traumatic Injuries. Orthop J Sports Med 2019; 7:2325967119847470. [PMID: 31211149 PMCID: PMC6545656 DOI: 10.1177/2325967119847470] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Judo is a full-contact fighting sport that may lead to severe injuries. There are limited data available on the incidence of judo-related injuries. The French Judo Federation has established a surveillance system to document the frequency and type of injuries during judo competitions. PURPOSE To describe the incidence rates and types of judo-related traumatic injuries during 21 seasons of competitions in France with respect to athlete (judoka) age, sex, and level of performance. STUDY DESIGN Descriptive epidemiology study. METHODS Between 1993 and 2014, each physician in charge of each judo competition filled out a form in which he/she documented the number of competing judokas, the number of fights, the number of medical interventions, the specific type of traumatic injuries for each intervention, the number of fight interruptions, and the number of athletes removed from the competition venue because of an injury. The age, sex, and level of performance of each judoka were also documented. Variance analysis was applied to assess whether differences in incidence rates of injuries between groups were significant (Student t test and chi-square test). RESULTS Surveillance of 421,670 fights demonstrated 3511 injuries in 316,203 judokas (incidence proportion, 1.1%). Among the injuries recorded, the most common were sprains (54.3%), fractures (15.6%), and dislocations (12.5%). Female athletes exhibited significantly higher incidence rates for knee sprains and elbow dislocations, whereas male athletes exhibited a higher incidence rate for shoulder dislocations (P < .001 for all). Regarding age, higher incidence rates were observed in young adults (aged 18-20 years) for acromioclavicular sprains and in children (aged 10-14 years) for clavicle fractures compared with adults (aged 21-35 years) (P < .001 for both). Both young adult and adult athletes had a higher incidence rate of shoulder dislocations (P < .001). Regarding the level of performance, athletes competing at higher levels had a higher incidence rate of sprains to the knee (P < .001). CONCLUSION During 21 years of surveillance of injuries in judo competitions in France, the incidence proportion of injuries was 1.1%. Significant differences in incidence rates demonstrated when considering age, sex, and level of performance may help in developing strategies to prevent traumatic injuries in the future.
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Affiliation(s)
- Alain Frey
- Sport Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Christophe Lambert
- Department of Trauma and Orthopedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany
| | - Benoit Vesselle
- Rehabilitation and Sport Medicine Department, CHU Robert Debré, Reims, France
| | | | - Frédéric Dor
- Institute of Biomedical Research and Epidemiology of Sport, National Institute of Sport, Expertise, and Performance, Paris, France
| | | | - Jean François Toussaint
- Institute of Biomedical Research and Epidemiology of Sport, National Institute of Sport, Expertise, and Performance, Paris, France
- Paris Descartes University, Paris, France
| | - Michel Daoud Crema
- Institute of Sports Imaging, National Institute of Sport, Expertise, and Performance, Paris, France
- §Saint-Antoine Hospital, Sorbonne University, Paris, France
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
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Bisciotti GN, Chamari K, Cena E, Bisciotti A, Bisciotti A, Corsini A, Volpi P. Anterior cruciate ligament injury risk factors in football. J Sports Med Phys Fitness 2019; 59:1724-1738. [PMID: 31062538 DOI: 10.23736/s0022-4707.19.09563-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) lesion represents one of the most dramatic injuries in a football (soccer) player's career. There are many injury risk factors related to intrinsic (non-modifiable) and/or extrinsic (modifiable) factors of ACL injury. EVIDENCE ACQUISITION Research of the studies was conducted until September 2018 without publication data limitation or language restriction on the following databases: PubMed/MEDLINE, Scopus, ISI, EXCERPTA. EVIDENCE SYNTHESIS To date, evidence from the literature suggests that the risk of ACL injury is multifactorial and involves biomechanical, anatomical, hormonal, and neuromuscular factors. Despite this relative complexity, the mechanisms of injury are well known and rationally classified into two categories: mechanisms of injury based on contact or on non-contact with another player, with the non-contact injury mechanisms clearly prevailing over the mechanisms of contact injury. One of the most frequent biomechanical risk factors, associated with ACL non-contact injury, is represented by the valgus knee in the pivoting and cutting movements and in the landing phase after jumping. Gender-related risk factors show female populations to have a higher predisposition to ACL injury than males However, there are still some theoretical and practical aspects that need further investigation such as; genetic risks together with the role of estrogen and progesterone receptors in female populations, and the in-vivo interaction shoe-playing surface. In particular, the genetic risk factors of ACL lesion seem to be an interesting and promising field of investigation, where considerable progress has still to be made. CONCLUSIONS This narrative review provides an insight into the risk factors of ACL injury that could be used by practitioners for preventing injury in football (soccer).
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Affiliation(s)
- Gian Nicola Bisciotti
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar -
| | - Karim Chamari
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Emanuele Cena
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | | | | | | | - Piero Volpi
- FC Internazionale Milano, Milan, Italy.,Unit of Traumatology, Department of Knee Orthopedic and Sports, Humanitas Research Hospital, Rozzano, Milan, Italy
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Antonio DH, Magalhaes CS. Survey on joint hypermobility in university students aged 18-25 years old. Adv Rheumatol 2018; 58:3. [PMID: 30657079 DOI: 10.1186/s42358-018-0008-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Joint hypermobility is defined as a wide range of movements beyond the physiological limits, it has been recognized in healthy people, gymnasts, acrobats, and carriers of genetic affections of connective tissue. A survey among young adults was conducted to describe the frequency of joint hypermobility, estimating its impact on function and quality of life. METHODS Volunteer university students aged 18 to 25 years old who answered a valid 5-item questionnaire about hypermobility, a physical activity questionnaire, and the Brazilian version of the Medical Outcome Survey Short Form 36 (SF-36) were included. Hypermobility was also assessed by a guided self-examination, with Beighton's criteria being scored and scores greater than or equal to 4 or less than 4 being discriminated. RESULTS A total of 388 subjects were included, of which 299 were women (77.06%) and 89 were men (22.94%); the median age was 23 years old. Generalized joint hypermobility (Beighton score ≥ 4) was observed in 104 individuals (26.8%). Localized hypermobility (Beighton score 1-3) was observed in 135 (34.79%) individuals, where the hypermobility of the 5th finger was the most frequent in 165 (57.47%) individuals, followed by hypermobility of the thumb in 126 (32.56%) individuals, hypermobility of the elbows and knees each in 72 (18.6%) individuals, and hypermobility of the spine in 69 (17.79%) individuals. The descriptive observation of physical activity indicated regular practice. The correlation coefficients between the SF-36 domains and hypermobility scores were very low and statistical comparison not significant. CONCLUSION In this population of youngsters, predominantly women, localized hypermobility was more frequent than generalized hypermobility; however, with low impact on health domains and quality of life scores, estimated in each domain of the SF-36, the physical and mental component scores, and the time dedicated to physical activity.
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Affiliation(s)
- Darcisio Hortelan Antonio
- Pediatrics Department, Botucatu Medical School, Graduate Program in Public Health of UNESP, Sao Paulo State University UNESP, Avenida Prof. Mario Rubens Guimarães Montenegro SN, Campus da Unesp, Rubião Junior, CEP, Botucatu, SP, 18618-687, Brazil
| | - Claudia Saad Magalhaes
- Pediatrics Department, Botucatu Medical School, Graduate Program in Public Health of UNESP, Sao Paulo State University UNESP, Avenida Prof. Mario Rubens Guimarães Montenegro SN, Campus da Unesp, Rubião Junior, CEP, Botucatu, SP, 18618-687, Brazil.
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Bronner S, Bauer NG. Risk factors for musculoskeletal injury in elite pre-professional modern dancers: A prospective cohort prognostic study. Phys Ther Sport 2018; 31:42-51. [PMID: 29597115 DOI: 10.1016/j.ptsp.2018.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/22/2017] [Accepted: 01/23/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine risk factors for injury in pre-professional modern dancers. DESIGN With prospectively designed screening and injury surveillance, we evaluated four risk factors as categorical predictors of injury: i) hypermobility; ii) dance technique motor-control; iii) muscle tightness; iv) previous injury. Screening and injury data of 180 students enrolled in a university modern dance program were reviewed over 4-yrs of training. Dancers were divided into 3-groups based on predictor scores. Dance exposure was based on hours of technique classes/wk. Negative binomial log-linear analyses were conducted with the four predictors, p < 0.05. RESULTS Dancers with low and high Beighton scores were 1.43 and 1.22 times more likely to sustain injury than dancers with mid-range scores (p ≤ 0.03). Dancers with better technique (low or medium scores) were 0.86 and 0.63 times less likely to sustain injury (p = 0.013 and p < 0.001) compared to those with poor technique. Dancers with one or 2-4 tight muscles were 2.7 and 4.0 times more likely to sustain injury (p ≤ 0.046). Dancers who sustained 2-4 injuries in the previous year were 1.38 times more likely to sustain subsequent injury (p < 0.001). CONCLUSIONS This contributes new information on the value of preseason screening. Dancers with these risk factors may benefit from prevention programs.
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Affiliation(s)
- Shaw Bronner
- ADAM Center, New York, NY, USA; Alvin Ailey American Dance Theater, New York, NY, USA.
| | - Naomi G Bauer
- ADAM Center, New York, NY, USA; Department of Physical and Occupational Therapy, Duke University Health System, Durham, NC, USA
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Ota S, Ohko H. Sex differences in passive lateral and medial patellar mobility in healthy young adults. J Back Musculoskelet Rehabil 2018; 31:127-132. [PMID: 28946527 DOI: 10.3233/bmr-169704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sex differences in passive patellar mobility have not been quantitatively evaluated. OBJECTIVE The present study aimed to: 1) investigate sex differences in absolute and normalized patellar mobility, and 2) verify the relationship between patellar mobility and knee joint laxity. METHODS Two hundred and five pain-free individuals (205 knees, 103 men, 102 women) participated. Passive lateral and medial patellar displacement was measured using a modified patellofemoral arthrometer and manual pushing method at 0∘ and 30∘ knee flexion angles. The absolute values of lateral and medial patellar displacement (LPD and MPD, respectively), and values normalized to patellar width (PW) and body height (HT) were used in the final analysis. RESULTS At a 30∘ knee flexion angle, LPD/PW and LPD/HT were greater in women than in men (LPD/PW: 27.0 ± 6.7% vs. 22.6 ± 6.7%, LPD/HT: 0.81 ± 0.19% vs. 0.70 ± 0.15%, respectively, P< 0.001, effect size > 0.50). Absolute and normalized lateral and medial patellar mobility correlated positively with the range of the knee extension angle. CONCLUSIONS Sex differences in LPD/PW and LPD/HT at a 30∘ knee flexion were detected in healthy subjects. Although the knee extension angle related to both the lateral and medial direction of the patellar mobility, the relations were only fairly correlated in asymptomatic young subjects.
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ASTUR DIEGOCOSTA, LARA PAULOHENRIQUESCHMIDT, SANTOS MARCELOABDULKLECH, OLIVEIRA GABRIELTANIGUTIDE, ARLIANI GUSTAVOGONÇALVES, COHEN MOISÉS. INFLUENCE OF JOINT HIPERMOBILITY ON POSTOPERATIVE RESULTS OF KNEE SURGERY. ACTA ORTOPEDICA BRASILEIRA 2018; 26:19-21. [PMID: 29977138 PMCID: PMC6025503 DOI: 10.1590/1413-785220182601174568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate the prevalence of joint hypermobility in patients undergoing knee surgery to treat traumatic injury to the meniscus and anterior cruciate ligament, and the influence of this hypermobility on postoperative results. Methods: This prospective study assessed joint hypermobility in patients who underwent surgical reconstruction of the anterior cruciate ligament (ACL), partial meniscectomy, or a procedure combining ACL reconstruction and partial meniscectomy during the period 2011-2015. The Beighton score was used to evaluate joint hypermobility and Tegner activity scale for postoperative assessment. Results: A total of 242 patients underwent surgery during the study period: 107 to treat ACL injuries, 75 to treat ACL injuries associated with meniscus injuries, and 60 to treat meniscus injuries. Of the total, 45 patients had joint hypermobility. We found no association between joint hypermobility and sex or type of injury. Postoperative Tegner scale results were not influenced by the presence of joint hypermobility. Conclusion: No association was found between joint hypermobility and the evaluated variables (gender and type of specific injury), and hypermobility did not have a negative impact on postoperative outcomes. Level of Evidence IV; Case series.
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Al-Rubeaan K, Almashouq MK, Youssef AM, Al-Qumaidi H, Al Derwish M, Ouizi S, Al-Shehri K, Masoodi SN. All-cause mortality among diabetic foot patients and related risk factors in Saudi Arabia. PLoS One 2017; 12:e0188097. [PMID: 29176889 PMCID: PMC5703519 DOI: 10.1371/journal.pone.0188097] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/31/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Although Diabetes mellitus is a major public health problem in the Middle East and North Africa (MENA) region with high rates of diabetic foot complications, there are only limited data concerning mortality among such a high risk group. Therefore, the main aim of the current study was to assess all-cause mortality and its related predictors among diabetic patients with and without diabetic foot complications. METHODS Using data from the Saudi National Diabetes Registry (SNDR), a total of 840 patients with type 1 or type 2 diabetes aged ≥25 years with current or past history of diabetic foot ulcer (DFU) or diabetes related lower extremity amputation (LEA) were recruited in 2007 from active patients' files and followed up to 2013. These patients were compared with an equal number of age and gender matched diabetic patients without foot complication recruited at the same period. All patients were subjected to living status verification at 31st December 2013. RESULTS The all-cause mortality rate among patients with DFU was 42.54 per 1000 person-years and among LEA patients was 86.80 per 1000 person-years among LEA patients for a total of 2280 and 1129 person-years of follow up respectively. The standardized mortality ratio (SMR) (95% CI) was 4.39 (3.55-5.23) and 7.21 (5.70-8.72) for cases with foot ulcer and LEA respectively. The percentage of deceased patients increased by almost twofold (18.5%) among patients with diabetic foot ulcer and more than threefold (32.2%) among patients with LEA compared with patients without diabetic foot complications (10.7%). The worst survival was among patients with LEA at 0.679 and the presence of diabetic nephropathy was the only significant independent risk factor for all-cause mortality among patients with diabetic foot complications. On the other hand, obese patients have demonstrated significantly reduced all-cause mortality rate. CONCLUSIONS Diabetic patients with diabetic foot complications have an excess mortality rate when compared with diabetic counterparts without foot complications and the general population. Early interventions to prevent foot ulceration and consequent LEA as well as all the measurements for reducing the prevalence of microvascular and macrovascular complications should be considered.
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Affiliation(s)
- Khalid Al-Rubeaan
- University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- * E-mail:
| | | | - Amira M. Youssef
- Registry Department, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Hamid Al-Qumaidi
- University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Al Derwish
- Diabetic Foot Unit, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Samir Ouizi
- Diabetic Foot Unit, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al-Shehri
- University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saba N. Masoodi
- University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Frequency of Benign Joint Hypermobility Syndrome in Patients Undergoing Inguinal Hernia Repair: A Prospective Study. Int Surg 2017. [DOI: 10.9738/intsurg-d-16-00100.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this prospective study is to investigate the frequency and associated clinical findings of benign joint hypermobility syndrome (BJHS) in adult patients who were diagnosed with inguinal hernia. Benign joint hypermobility syndrome (BJHS) is defined as a clinical condition consisting of musculoskeletal symptoms such as arthralgia, pain, recurrent soft tissue disorders, joint dislocation, as well as increased normal range of motion. We hypothesized that the frequency of BHJS may increase in the patients who underwent surgery for groin hernias due to the hypermobility in connective tissue. We evaluated 66 patients in terms of BHJS prospectively in a 6-month period. The patients were divided into 2 groups. The first group consisted of 33 patients who underwent inguinal hernia repair surgery. The second group also included 33 healthy volunteers who did not have inguinal hernia operation. General joint hypermobility (GJH) was assessed using Beighton hypermobility scoring criteria, and BJHS was scored by Brighton scoring criteria. The data were assessed statistically. BJHS was diagnosed in 22 (66%) patients with inguinal hernia and in 4 (12%) healthy volunteers, respectively. Prevalence of BJHS and Beighton scores in patients with inguinal hernia were significantly higher (P < 0.05). GJH was found in 20 (60%) of the inguinal hernia patients (Beighton score ≥ 4; P < 0.05). BJHS should be considered when evaluating patients with inguinal hernia. We believe that further studies are needed in big cohorts to verify the relationship between inguinal hernia in adults and BJHS.
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Aydın E, Metin Tellioğlu A, Kurt Ömürlü I, Turan Y. Impact of Generalized Joint Laxity on Plantar Loading Patterns in Young Females. Foot Ankle Int 2017; 38:909-915. [PMID: 28656782 DOI: 10.1177/1071100717709567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Generalized joint laxity is often associated with gait deviations. The aim of this study was to investigate the static and dynamic loading pattern of the foot with increasing joint mobility and to discuss the potential impact of this condition on the plantar loading patterns. METHODS Seventy female participants between ages of 18 and 30 were included in this cross-sectional survey. The Beighton-Horan Joint Mobility Index scores were assessed and participants divided into 3 categories: no hypermobility (NH) group, scores 0 to 2; moderate hypermobility (MH) group, scores 3 to 4; distinct hypermobility (DH) group, scores 5 to 9. Pedobarographic analysis was performed both in static and walking conditions. Dynamic foot loading examined in 10 anatomic zones. Contact areas of forefoot, midfoot, and rearfoot were recorded. RESULTS In the dynamic pedobarographic analysis, individuals with distinct joint hypermobility displayed higher peak pressure and maximum force values under the hallux, compared with other groups ( P < .05). The maximum force value of the second metatarsal was higher in the DH group than in the MH group ( P < .05). CONCLUSION Our study results suggest that plantar loading pattern differs with increasing degrees of the hypermobility score. CLINICAL RELEVANCE Differences in plantar loading parameters in people with severe joint mobility scores may be useful in interpreting the foot pathologies of these individuals.
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Affiliation(s)
- Elif Aydın
- 1 Department of Physical Therapy and Rehabilitation, Adnan Menderes University, School of Medicine, Aydin, Turkey
| | - Ayfer Metin Tellioğlu
- 2 Department of Anatomy, Adnan Menderes University, School of Medicine, Aydin, Turkey
| | - Imran Kurt Ömürlü
- 3 Department of Biostatistics, Adnan Menderes University, School of Medicine, Aydin, Turkey
| | - Yasemin Turan
- 4 Department of Physical Therapy and Rehabilitation, Adnan Menderes University, School of Medicine, Aydin, Turkey
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Abstract
STUDY DESIGN Cross-sectional. OBJECTIVE To examine the relationships between spine morphology, spine flexibility, and idiopathic scoliosis. BACKGROUND Girls have a higher incidence of clinically significant scoliosis than boys, along with smaller vertebrae and greater flexibility. Based on biomechanical modeling, we hypothesized that smaller vertebral width relative to intervertebral disc (IVD) height would be associated with both greater lateral flexibility of the spine and with idiopathic scoliosis. METHODS Magnetic resonance imaging was used to measure IVD height, vertebral width, and paraspinous musculature in 22 girls with mild and moderate idiopathic scoliosis and 29 girls without scoliosis ages 9-13 years. Clinical measurement of maximum lateral bending was also performed in the girls without scoliosis. A simple biomechanical model was used to estimate bending angle from the ratio of IVD height to vertebral half-width for L1-L4. The average ratio (Ravg) and calculated total bending angle (αtot) for L1-L4 were compared to the clinical measurements of lateral bending flexibility in the control group. These measures were also compared between the scoliosis and control groups. RESULTS There was a significant positive relationship between clinical flexibility and both Ravg (p = .041) and αtot (p = .042) adjusting for skeletal age, height, body mass index, and paraspinous muscle area as covariates. The ratio was significantly higher (Ravg = 0.45 vs. 0.38, p < .0001) and the bending angle was significantly greater (αtot = 107° vs. 89°, p < .0001) for girls with scoliosis compared with controls. CONCLUSION These results suggest that differences in spine morphology and corresponding changes in spine flexibility may be related to idiopathic scoliosis. If these relationships can be corroborated in larger prospective studies, these easily measured morphologic traits may contribute to a better understanding of the etiology of idiopathic scoliosis and an improved ability to predict scoliosis progression. LEVEL OF EVIDENCE Level III.
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Abstract
The purpose of this study was to systematically review and synthesize the literature measuring varus-valgus laxity in individuals with tibiofemoral osteoarthritis (OA). Specifically, we aimed to identify varus-valgus laxity differences between persons with OA and controls, by radiographic disease severity, by frontal plane knee alignment, and by sex. We also aimed to identify if there was a relationship between varus-valgus laxity and clinical performance and self-reported function. We systematically searched for peer-reviewed original research articles in PubMed, Scopus, and CINAHL to identify all existing literature regarding knee OA and objective measurement of varus-valgus laxity in vivo. Forty articles were identified that met the inclusion criteria and data were extracted. Varus-valgus laxity was significantly greater in individuals with OA compared with controls in a majority of studies, while no study found laxity to be significantly greater in controls. Varus-valgus laxity of the knee was reported in persons with OA and varying degrees of frontal plane alignment, disease severity, clinical performance, and self-reported function but no consensus finding could be identified. Females with knee OA appear to have more varus-valgus laxity than males. Meta-analysis was not possible due to the heterogeneity of the subject populations and differences in laxity measurement devices, applied loading, and laxity definitions. Increased varus-valgus laxity is a characteristic of knee joints with OA. Large variances exist in reported varus-valgus laxity and may be due to differences in measurement devices. Prospective studies on joint laxity are needed to identify if increased varus-valgus laxity is a causative factor in OA incidence and progression.
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Affiliation(s)
- Gregory M. Freisinger
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio
| | - Laura C. Schmitt
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
| | - Andrea B. Wanamaker
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
| | - Robert A. Siston
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
| | - Ajit M. W. Chaudhari
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
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Wren TAL, Ponrartana S, Gilsanz V. Vertebral cross-sectional area: an orphan phenotype with potential implications for female spinal health. Osteoporos Int 2017; 28:1179-1189. [PMID: 27975301 DOI: 10.1007/s00198-016-3832-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/02/2016] [Indexed: 12/23/2022]
Abstract
A high priority in imaging-based research is the identification of the structural basis that confers greater risk for spinal disorders. New evidence indicates that factors related to sex influence the fetal development of the axial skeleton. Girls are born with smaller vertebral cross-sectional area compared to boys-a sexual dimorphism that is present throughout life and independent of body size. The smaller female vertebra is associated with greater flexibility of the spine that could represent the human adaptation to fetal load. It also likely contributes to the higher prevalence of spinal deformities, such as exaggerated lordosis and progressive scoliosis in adolescent girls when compared to boys, and to the greater susceptibility for spinal osteoporosis and vertebral fractures in elderly women than men.
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Affiliation(s)
- T A L Wren
- Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - S Ponrartana
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - V Gilsanz
- Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Department of Radiology, Children's Hospital Los Angeles, MS no. 81, 4650 Sunset Boulevard, Los Angeles, CA, 90027, USA.
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Dijkstra P, Kropmans T, Stegenga B. The Association between Generalized Joint Hypermobility and Temporomandibular Joint Disorders: A Systematic Review. J Dent Res 2017. [DOI: 10.1177/0810158] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To analyze conflicting evidence in the literature for the association between temporomandibular joint disorders (TMD) and generalized joint hypermobility (GJH), we performed a bibliographic search. The methodological quality of the 14 papers found was assessed according to 14 criteria. Papers were included in the analysis if the study population was clinically relevant, if range of motion of 2 or more joints was assessed on the left and right sides, and if cases had a TMD. Four studies fulfilled these selection criteria. Data from 3 studies, 113 cases and 95 controls, were available for analysis. Twenty-six cases and five controls were hypermobile (odds ratio, 5.4). In a sensitivity analysis, the odds ratio changed from significant to non-significant in 2 of 5 scenarios. As a result, it is not clear whether GJH is associated with TMD, and more rigorous studies are needed.
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Affiliation(s)
- P.U. Dijkstra
- Dept. of Oral and Maxillofacial Surgery,
- Dept. of Rehabilitation,
- Pain Center,
- Northern Center for Health Care Research, and
- Institute for Medical Education, Dept. for Education Development and
Quality Assurance, Faculty of Medical Sciences, University of Groningen
| | - T.J.B. Kropmans
- Dept. of Oral and Maxillofacial Surgery,
- Dept. of Rehabilitation,
- Pain Center,
- Northern Center for Health Care Research, and
- Institute for Medical Education, Dept. for Education Development and
Quality Assurance, Faculty of Medical Sciences, University of Groningen
| | - B. Stegenga
- Dept. of Oral and Maxillofacial Surgery,
- Dept. of Rehabilitation,
- Pain Center,
- Northern Center for Health Care Research, and
- Institute for Medical Education, Dept. for Education Development and
Quality Assurance, Faculty of Medical Sciences, University of Groningen
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Postural balance control in women with generalized joint laxity. Turk J Phys Med Rehabil 2017; 63:259-265. [PMID: 31453463 DOI: 10.5606/tftrd.2017.160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/07/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the potential relationship between joint laxity and postural balance by using tetra-ataxiometric posturography (Tetrax®). Patients and methods A total of 69 healthy volunteers were included in the study and classified into three groups based on their hypermobility severity determined with Beighton-Horan hypermobility index scores. Of those, 29 participants were non-hypermobile, 13 participants were mildly hypermobile and remaining 27 patients had severe hypermobility. Postural control of the participants was evaluated by using the Tetrax® device in eight different positions. The stability index, Fourier index, weight distribution index, and synchronization index scores of each participant were recorded. Results We found that the participants with severe hypermobility exhibited significantly higher stability index scores while the position of the head is extended and rotated right. The weight distribution index on elastic surfaces was impaired in non-hypermobile and severely hypermobile participants. We observed that the Fourier Index scores were higher at a higher-medium frequency (0.5-1 Hz) in participants with severe hypermobility. There was no difference between the groups in terms of synchronization index scores. Conclusion These findings suggest that severely hypermobile individuals have a decreased postural stability in head-extended and head- rotated positions when compared to individuals who are non-hypermobile. This increased instability may lead to an increased risk of musculoskeletal injuries, especially in sports that require extension and rotation movements of the head.
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Abstract
The complex interaction of the carpal bones, their intrinsic and extrinsic ligaments, and the forces in the normal wrist continue to be studied. Factors that influence kinematics, such as carpal bone morphology and clinical laxity, continue to be identified. As imaging technology improves, so does our ability to better understand and identify these factors. In this review, we describe advances in our understanding of carpal kinematics and kinetics. We use scapholunate ligament tears as an example of the disconnect that exists between our knowledge of carpal instability and limitations in current reconstruction techniques.
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Affiliation(s)
- Robin N Kamal
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
| | - Adam Starr
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI
| | - Edward Akelman
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI
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Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis. Pediatr Radiol 2016; 46:1424-9. [PMID: 27183842 DOI: 10.1007/s00247-016-3633-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 03/24/2016] [Accepted: 04/27/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND When compared to boys, girls have smaller vertebral cross-sectional area, which conveys a greater spinal flexibility, and a higher prevalence of adolescent idiopathic scoliosis. OBJECTIVE To test the hypothesis that small vertebral cross-sectional area and tall intervertebral disc height are structural characteristics of patients with adolescent idiopathic scoliosis. MATERIALS AND METHODS Using multiplanar imaging techniques, measures of vertebral cross-sectional area, vertebral height and intervertebral disc height in the lumbar spine were obtained in 35 pairs of girls and 11 pairs of boys with and without adolescent idiopathic scoliosis of the thoracic spine matched for age, height and weight. RESULTS Compared to adolescents without spinal deformity, girls and boys with adolescent idiopathic scoliosis had, on average, 9.8% (6.68 ± 0.81 vs. 7.40 ± 0.99 cm(2); P = 0.0007) and 13.9% (8.22 ± 0.84 vs. 9.55 ± 1.61 cm(2); P = 0.009) smaller vertebral cross-sectional dimensions, respectively. Additionally, patients with adolescent idiopathic scoliosis had significantly greater values for intervertebral disc heights (9.06 ± 0.85 vs. 7.31 ± 0.62 mm and 9.09 ± 0.87 vs. 7.61 ± 1.00 mm for girls and boys respectively; both P ≤ 0.011). Multiple regression analysis indicated that the presence of scoliosis was negatively associated with vertebral cross-sectional area and positively with intervertebral disc height, independent of sex, age and body mass index. CONCLUSION We provide new evidence that girls and boys with adolescent idiopathic scoliosis have significantly smaller vertebral cross-sectional area and taller intervertebral disc heights - two major structural determinants that influence trunk flexibility. With appropriate validation, these findings may have implications for the identification of children at the highest risk for developing scoliosis.
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Jindal P, Narayan A, Ganesan S, MacDermid JC. Muscle strength differences in healthy young adults with and without generalized joint hypermobility: a cross-sectional study. BMC Sports Sci Med Rehabil 2016; 8:12. [PMID: 27119015 PMCID: PMC4845357 DOI: 10.1186/s13102-016-0037-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 04/13/2016] [Indexed: 01/23/2023]
Abstract
Background Generalized joint hypermobility (GJH), in the absence of symptoms, is a common clinical finding. The joint instability present due to excessive musculoskeletal flexibility in hypermobile joints impairs the external force production during muscle contraction. However, whether GJH is associated with muscle weakness is unclear. This study evaluated differences in upper and lower limb muscle strengths among asymptomatic young adults with and without GJH. Methods One hundred six young adults (53 hypermobile, i.e. 25 male (mean age 22 ± 1.8); 28 female (mean age 21 ± 1.8), and 53 non-hypermobile, i.e. 25 male (mean age 19 ± 1.06); 28 female (mean age 20 ± 1.4) were selected using a cut-off ≥ 4 on Beighton and Horan Joint Mobility Index. Isometric strength of elbow and knee extensors was measured using an isokinetic dynamometer. Independent sample t- tests were done to compare the muscle strengths of hypermobile and non-hypermobile participants. One-way ANCOVA was applied to control the effect of height and body mass on muscle strength. Results Male hypermobile participants had significantly less strength than non-hypermobile males in the right (71.7 Nm, SD = 23.1, vs 97.6 Nm, SD = 47.4, p = 0.006*) and left (74.8 Nm, SD = 24.3, vs 97.7 Nm, SD = 45.5, p = 0.007*) elbow extensors and right knee extensors (188.7 Nm, SD = 83.3, vs 228.3 Nm, SD = 106.7, p = 0.03*). In females, both elbow extensors (right: 51.9 Nm, SD = 16.2 vs 48.8 Nm, SD = 17.8, p = 0.4; left: 48.9 Nm, SD = 17.2, vs 44.7 Nm, SD = 15.1, p = 0.2) and knee extensors (right: 161.3 Nm, SD = 74.9 vs 145.5 Nm, SD = 75.8, p = 0.3; left: 155.2 Nm, SD = 73 vs 124.3 Nm, SD = 69.6, p = 0.07) strength were not statistically different between hypermobile and non-hypermobile participants. Conclusion The findings indicate that male participants with GJH have less isometric muscle strength in both elbow extensors and right knee extensors compared to non-hypermobile male participants. Female hypermobile participants did not show any significant differences in muscle strength compared to non-hypermobile female participants. Electronic supplementary material The online version of this article (doi:10.1186/s13102-016-0037-x) contains supplementary material, which is available to authorized users.
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Halilaj E, Moore DC, Patel TK, Ladd AL, Weiss APC, Crisco JJ. Early osteoarthritis of the trapeziometacarpal joint is not associated with joint instability during typical isometric loading. J Orthop Res 2015; 33:1639-45. [PMID: 25941135 PMCID: PMC4591106 DOI: 10.1002/jor.22936] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/27/2015] [Indexed: 02/04/2023]
Abstract
The saddle-shaped trapeziometacarpal (TMC) joint contributes importantly to the function of the human thumb. A balance between mobility and stability is essential in this joint, which experiences high loads and is prone to osteoarthritis (OA). Since instability is considered a risk factor for TMC OA, we assessed TMC joint instability during the execution of three isometric functional tasks (key pinch, jar grasp, and jar twist) in 76 patients with early TMC OA and 44 asymptomatic controls. Computed tomography images were acquired while subjects held their hands relaxed and while they applied 80% of their maximum effort for each task. Six degree-of-freedom rigid body kinematics of the metacarpal with respect to the trapezium from the unloaded to the loaded task positions were computed in terms of a TMC joint coordinate system. Joint instability was expressed as a function of the metacarpal translation and the applied force. We found that the TMC joint was more unstable during a key pinch task than during a jar grasp or a jar twist task. Sex, age, and early OA did not have an effect on TMC joint instability, suggesting that instability during these three tasks is not a predisposing factor in TMC OA.
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Affiliation(s)
- Eni Halilaj
- Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI 02912
| | - Douglas C. Moore
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903
| | - Tarpit K. Patel
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903
| | - Amy L. Ladd
- Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford School of Medicine, Stanford, CA 94304
| | - Arnold-Peter C. Weiss
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903
| | - Joseph J. Crisco
- Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI 02912,Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903
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Nagamatsu T, Kai Y, Gotoh M, Madokoro K, Shiba N. Effects of sex differences on scapular motion during arm elevation. SICOT J 2015; 1:9. [PMID: 27163065 PMCID: PMC4849248 DOI: 10.1051/sicotj/2015004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/10/2015] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Scapular motion during arm elevation is frequently evaluated in patients with shoulder disorders because it provides clinically useful information. With the development of measurement devices and improvement in accuracy, comparisons under various conditions have recently been reported. However, in most of these reports, the subjects examined were limited to males, or a mixed population of males and females. Only a few reports have described sex differences. In the current study, we performed three-dimensional dynamic analysis of arm elevation and investigated whether there is a sex difference in scapular motion. METHODS Subjects included 18 healthy adult males (18 shoulders) and 19 healthy adult females (19 shoulders). Thirty-seven shoulders were on the dominant side. The age range was 20.5 ± 0.03 years. Subjects performed scapular plane arm elevation, and kinematic data were recorded using an electromagnetic tracking device. Scapular upward rotation and internal rotation angles and the posterior tilt angle accompanying arm elevation were calculated from recorded data. Changes in each angle during scapular motion were recorded according to sex. RESULTS There were sex differences in scapular upward rotation and internal rotation angles. The upward rotation angle was significantly greater in males, whereas the internal rotation angle was significantly greater in females. No sex differences were noted in the scapular posterior tilt angle. DISCUSSION Findings of this study may serve as basic data for scapular motion during scapular plane elevation in healthy males and females. In addition, it is necessary to evaluate and treat the shoulder while taking sex differences in scapular movement into consideration.
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Affiliation(s)
- Takashi Nagamatsu
- Department of Physical Therapy, Fukuoka Rehabilitation College 3-29-17 Hakataekimae Hakata-ku, Fukuoka-si, Fukuoka Japan
| | - Yoshihiro Kai
- Faculty of Health Science, Kyoto Tachibana University 34 Yamada-cho Oyake Yamashina-ku Kyoto-si, Kyoto Japan
| | - Masafumi Gotoh
- Department of Orthopedic Surgery, Kurume University Medical Center 155-1 Kokubu-machi Kurume-si, Fukuoka Japan
| | - Kazuya Madokoro
- Kurume University School of Medicine Graduate School 67 Asahi-machi Kurume-si, Fukuoka Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University 67 Asahi-machi Kurume-si, Fukuoka Japan
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Al-Rubeaan K, Al Derwish M, Ouizi S, Youssef AM, Subhani SN, Ibrahim HM, Alamri BN. Diabetic foot complications and their risk factors from a large retrospective cohort study. PLoS One 2015; 10:e0124446. [PMID: 25946144 PMCID: PMC4422657 DOI: 10.1371/journal.pone.0124446] [Citation(s) in RCA: 204] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 03/14/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem. METHODS This is a cross-sectional study of a cohort of 62,681 patients aged ≥ 25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors. RESULTS The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%-3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%-2.16%), 0.19% (0.16%-0.22%), and 1.06% (0.98%-1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥ 10 years, insulin use, retinopathy, nephropathy, age ≥ 45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16-99.62), 14.47 (8.99-23.31), 12.06 (10.54-13.80), 7.22 (6.10-8.55), 4.69 (4.28-5.14), 4.45 (4.05-4.89), 2.88 (2.43-3.40), 2.81 (2.31-3.43), 2.24 (1.98-2.45), 2.02 (1.84-2.22), 1.54 (1.29-1.83), and 1.51 (1.38-1.65), respectively. CONCLUSIONS Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.
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Affiliation(s)
- Khalid Al-Rubeaan
- University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Al Derwish
- Diabetic Foot Unit, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Samir Ouizi
- Diabetic Foot Unit, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Amira M. Youssef
- Registry Department, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Shazia N. Subhani
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Heba M. Ibrahim
- Registry Department, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Bader N. Alamri
- Internal Medicine Department, Dalhousie University, Halifax, Nova Scotia, Canada
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Kircher J, Kuerner K, Morhard M, Krauspe R, Habermeyer P. Age-related joint space narrowing independent of the development of osteoarthritis of the shoulder. INTERNATIONAL JOURNAL OF SHOULDER SURGERY 2014; 8:95-100. [PMID: 25538427 PMCID: PMC4262869 DOI: 10.4103/0973-6042.145213] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Purpose: It is commonly accepted that the glenohumeral joint space remains unchanged until the onset of osteoarthritis, at which point progressive degenerative changes, and joint space narrowing occur. The aim of this study was to evaluate the radiographic width of the glenohumeral joint space in patients of different ages: Those with otherwise normal radiographs, those with a history of instability, those with calcific tendonitis, and those with a radiologic diagnosis of osteoarthritis. Materials and Methods: In this retrospective study, two independent investigators measured the glenohumeral joint width on true anteroposterior and axillary views of standardized shoulder radiographs taken from 2002 to 2009. The digital image resolution was 0.01 mm. Group I comprised 60 patients with normal shoulder radiographs, Group II comprised 53 patients with instability but normal radiographs, Group III comprised 109 patients with radiologically proven calcific tendonitis, and Group IV comprised 120 patients with manifest osteoarthritis. Results: The interobserver reliability (r) was 0.621-0.862. The mean joint space width was significantly different among Groups I-IV (central anteroposterior: 4.28 ± 0.75 mm, 3.12 ± 0.73 mm, 2.87 ± 0.80 mm, and 1.47 ± 1.07 mm, respectively; P = 0.001; central axillary: 6.12 ± 1.09 mm, 3.92 ± 0.77 mm, 3.34 ± 0.84 mm, and 1.08 ± 1.12 mm, respectively; P = 0.001). There was a significant negative correlation between the joint space width and age at all measured levels in both projections (P < 0.001). Conclusions: The glenohumeral joint space width decreases with increasing age beginning in early adulthood, and this effect is enhanced by osteoarthritis. Level of Evidence: Level II, retrospective study.
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Affiliation(s)
- Jörn Kircher
- Department of Orthopaedics, Shoulder and Elbow Surgery, Klinik Fleetinsel, Admiralitätstrasse 3-4, 20489 Hamburg, German, Germany ; Department of Orthopaedics, Medical Faculty, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, German, Germany ; Department of Shoulder and Elbow Surgery, ATOS Clinic, Bismarckstrasse 9-15, 69115 Heidelberg, German, Germany
| | - Konstanze Kuerner
- Department of Orthopaedics, Medical Faculty, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, German, Germany
| | - Markus Morhard
- Department of Shoulder and Elbow Surgery, ATOS Clinic, Bismarckstrasse 9-15, 69115 Heidelberg, German, Germany
| | - Rüdiger Krauspe
- Department of Orthopaedics, Medical Faculty, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, German, Germany
| | - Peter Habermeyer
- Department of Shoulder and Elbow Surgery, ATOS Clinic, Bismarckstrasse 9-15, 69115 Heidelberg, German, Germany
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Sanches SB, Osório FL, Louzada-Junior P, Moraes D, Crippa JAS, Martín-Santos R. Association between joint hypermobility and anxiety in Brazilian university students: gender-related differences. J Psychosom Res 2014; 77:558-61. [PMID: 25219975 DOI: 10.1016/j.jpsychores.2014.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/23/2014] [Accepted: 08/26/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Anxiety disorders may be associated with several non-psychiatric disorders. Current literature has been investigating the association between anxiety and joint hypermobility (JHM), with special interest in non-articular symptoms that may be related to autonomic dysfunction. This study investigated the association between anxiety and JHM in a sample of Brazilian university students. METHODS Data were cross-sectionally collected in two Brazilian universities (N=2600). Participants completed three validated self-rating anxiety scales: Beck Anxiety Inventory (BAI), Social Phobia Inventory (SPIN) and the brief-version of SPIN (Mini-SPIN). They also answered the self-rating screening questionnaire for JHM: the Five-part Questionnaire for Identifying Hypermobility. RESULTS Hypermobile women showed significantly higher scores in all the anxiety scales, when compared with men: BAI total score (t=3.77; p<0.001), its four subscales, SPIN score (t=2.71; p<0.007) and Mini-SPIN (t=2.58; p<0.01). Among BAI subscales, the autonomic subscale was shown to be more significantly (t=3.89; p<0.001) associated with joint hypermobility in women. CONCLUSIONS The results of the present study support earlier evidence on the relationship between anxiety and JHM in women, showing specific gender-related features in this field. It also directs attention to non-articular symptoms that may be enrolled in this association.
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Affiliation(s)
- S B Sanches
- Neuroscience and Behavior Department, Faculty of Medicine of Ribeirão Preto - University of São Paulo, Brazil; Departments of Psychiatry and Psychology, Hospital Clínic, University of Barcelona, Institut d'Investigació Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain.
| | - F L Osório
- Neuroscience and Behavior Department, Faculty of Medicine of Ribeirão Preto - University of São Paulo, Brazil
| | - P Louzada-Junior
- Division of Clinical Immunology, Center for Research in Inflammatory Disease, Faculty of Medicine of Ribeirão Preto - University of São Paulo, Brazil
| | - D Moraes
- Division of Clinical Immunology, Center for Research in Inflammatory Disease, Faculty of Medicine of Ribeirão Preto - University of São Paulo, Brazil
| | - J A S Crippa
- Neuroscience and Behavior Department, Faculty of Medicine of Ribeirão Preto - University of São Paulo, Brazil
| | - R Martín-Santos
- Departments of Psychiatry and Psychology, Hospital Clínic, University of Barcelona, Institut d'Investigació Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain
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Cheng X, Zhang T, Shan X, Wang J. Effect of posterior cruciate ligament creep on muscular co-activation around knee: A pilot study. J Electromyogr Kinesiol 2014; 24:271-6. [DOI: 10.1016/j.jelekin.2014.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 12/15/2013] [Accepted: 01/15/2014] [Indexed: 10/25/2022] Open
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Kajbafzadeh AM, Sharifi-Rad L, Seyedian SSL, Mozafarpour S, Paydary K. Generalized joint hypermobility and voiding dysfunction in children: is there any relationship? Eur J Pediatr 2014; 173:197-201. [PMID: 23959325 DOI: 10.1007/s00431-013-2120-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 07/23/2013] [Indexed: 11/27/2022]
Abstract
UNLABELLED Voiding dysfunction is a common entity in pediatric urology. It is believed to have a multifactorial etiology. The aim of this study was to investigate whether there is an increased prevalence of generalized joint hypermobility (GJH) in children with voiding dysfunction compared to normal children. Moreover, the prevalence of voiding complaints in patients with and without GJH was assessed. A total of 226 children--aged 5 to 14 years--including 113 patients diagnosed with voiding dysfunction and 113 sex/age/body mass index-matched normal children were recruited. GJH was evaluated in both groups using the Beighton score (4 or more= hypermobile). In the patient’s group, GJH was significantly more frequent than in controls: 51/113 (45 %) versus 19/113 (17 %) (P=0.001). In addition, in both groups, GJH was more prominent in girls than boys (P<0.05). Urinary tract infection was the most frequent features in children with voiding dysfunction (64 %). In the subgroup of positive GJH, urinary tract infection remained the most common manifestation among the girls (P=0.003), while constipation was the most prevalent manifestation among the boys (P=0.001). CONCLUSION Our findings suggest that children with voiding dysfunction have significantly higher prevalence of GJH compared to normal children. Further studies are needed to determine the cause and effect of these two common presentations and will help to develop a multidisciplinary approach in understanding and management of voiding dysfunction in children.
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Deodato F, Trusendi R, Giorgetti R, Scalese MU. Predisposition for Temporomandibular Joint Disorders: Loose Ligaments. Cranio 2014; 24:179-83. [PMID: 16933458 DOI: 10.1179/crn.2006.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Loose ligaments are often a predisposing factor of temporomandibular joint (TMJ) disorders. This causal factor was analyzed in 701 subjects presenting at the TMJ and Posture Center of Siena University with TMJ pain or dysfunction. Along with the conventional jaw examination, a Carter and Wilkinson test as modified by Beighton was also done. We found a correlation among the parameters of age, gender, TMJ disorder, joint pain, muscle pain, and loose ligaments.
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Beaulieu LD, Massé-Alarie H, Brouwer B, Schneider C. Brain control of volitional ankle tasks in people with chronic stroke and in healthy individuals. J Neurol Sci 2013; 338:148-55. [PMID: 24433928 DOI: 10.1016/j.jns.2013.12.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/04/2013] [Accepted: 12/23/2013] [Indexed: 11/28/2022]
Abstract
This study explored the relationships between motor cortical control of ankle dorsiflexors and clinical impairments of volitional ankle dorsiflexion in people with chronic stroke. Eighteen persons with stroke and 14 controls were evaluated. Clinical tools were used to assess ankle dorsiflexion amplitude and isometric strength. Transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) tested the functional integrity of cortical circuits controlling the tibialis anterior (TA). All clinical scores and most TMS outcomes were impaired in people with chronic stroke. The lower clinical scores were related to the reduction of the strength of corticospinal projections onto spinal motoneurons. Concurrent TMS and clinical testing in chronic stroke provided original data demonstrating relationships between the integrity of cortical and corticospinal components of TA motor control and volitional ankle tasks. Our study proposes that volitional ankle mobilization in chronic stroke may be explained by the residual abnormal M1 circuits which may be responsive for rehabilitation intervention. This should be confirmed in longitudinal studies with larger samples to determine whether TMS outcomes associated with lower limb muscles are predictive of clinical changes or vice versa.
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Affiliation(s)
- L D Beaulieu
- Axe neurosciences du Centre de recherche du CHU de Québec, Québec, QC, Canada
| | - H Massé-Alarie
- Axe neurosciences du Centre de recherche du CHU de Québec, Québec, QC, Canada
| | - B Brouwer
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, ONT, Canada
| | - C Schneider
- Axe neurosciences du Centre de recherche du CHU de Québec, Québec, QC, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, QC, Canada.
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Abstract
PURPOSE. To compare the rates of joint hypermobility in patients with and without anterior cruciate ligament (ACL) injury. METHODS. Records of 135 men and 75 women (mean age, 24.6 years) who underwent ACL reconstructions were reviewed and compared with 55 male and 35 female controls with no knee injury. Joint hypermobility was evaluated by 2 examiners using the Beighton score. The maximum score was 9, and a score of 4 or greater was defined as hypermobility. RESULTS. The mean time from injury to presentation was 18 days. A non-contact mechanism of injury was more common. The inter-observer reliability was 0.7. 127 (60.5%) of the patients with ACL injury and 23 (25.5%) of the controls had hypermobility (p<0.01). Among them, 58% and 24% were men and 65% and 29% were women, respectively. Female gender was associated with hypermobility. Patients with ACL injury were more likely to have joint hypermobility with an odds ratio of 4.46. CONCLUSION. Joint hypermobility was more common in patients with ACL injury.
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Affiliation(s)
- Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
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