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Hashimoto S, Murohashi T, Yamada S, Iesato N, Ogon I, Chiba M, Tsukamoto A, Hitrota R, Yoshimoto M. Broad and Asymmetric Lower Extremity Myotomes: Results From Intraoperative Direct Electrical Stimulation of the Lumbosacral Spinal Roots. Spine (Phila Pa 1976) 2024; 49:805-810. [PMID: 37249375 DOI: 10.1097/brs.0000000000004737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/13/2023] [Indexed: 05/31/2023]
Abstract
STUDY DESIGN Retrospective review of prospectively collected data. OBJECTIVE This study aimed to accurately map the lower extremity muscles innervated by the lumbar spinal roots by directly stimulating the spinal roots during surgery. SUMMARY OF BACKGROUND DATA Innervation of the spinal roots in the lower extremities has been estimated by clinical studies, anatomic studies, and animal experiments. However, there have been discrepancies between studies. Moreover, there are no studies that have studied the laterality of lower limb innervation. MATERIALS AND METHODS In 73 patients with lumbar degenerative disease, a total of 147 spinal roots were electrically stimulated and the electromyographic response was recorded at the vastus medialis (VM), gluteus medius (GM), tibialis anterior (TA), biceps femoris (BF), and gastrocnemius (GC). The asymmetry index (AI) was obtained using the following equation to represent the left-right asymmetry in the compound muscle action potential (CMAP) amplitude. Paired t tests were used to compare CMAP amplitudes on the right and left sides. Differences in the AI among the same spinal root groups were determined using one-way analysis of variance. RESULTS The frequency of CMAP elicitation in VM, GM, TA, BF, and GC were 100%, 75.0%, 50.0%, 83.3%, and 33.3% in L3 spinal root stimulation, 90.4%, 78.8%, 59.6%, 73.1%, and 59.6% in L4 spinal root stimulation, 32.2%, 78.0%, 93.2%, 69.5%, and 83.1% in L5 spinal root stimulation, and 40.0%, 100%, 80.0%, 70.0%, and 80.0% in S1 spinal root stimulation, respectively. The most frequent muscle with maximum amplitude of the CMAP in L3, L4, L5, and S1 spinal root stimulation was the VM, GM, TA, and GM, respectively. Unilateral innervation occurred at high rates in the TA in L4 root stimulation and the VM in L5 root stimulation in 37.5% and 42.3% of patients, respectively. Even in patients with bilateral innervation, a 20% to 38% AI of CMAP amplitude was observed. CONCLUSIONS The spinal roots innervated a much larger range of muscles than what is indicated in general textbooks. Furthermore, a non-negligible number of patients showed asymmetric innervation of lower limb by the lumbar spinal roots.
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Affiliation(s)
- Shuichi Hashimoto
- Department of Clinical Engineering, Sapporo Medical University Hospital, Sapporo, Hokkaido Prefecture, Japan
| | - Takao Murohashi
- Department of Clinical Engineering, Sapporo Medical University Hospital, Sapporo, Hokkaido Prefecture, Japan
| | - Shouto Yamada
- Department of Clinical Engineering, Sapporo Medical University Hospital, Sapporo, Hokkaido Prefecture, Japan
| | - Noriyuki Iesato
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido Prefecture, Japan
| | - Izaya Ogon
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido Prefecture, Japan
| | - Mitsumasa Chiba
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido Prefecture, Japan
| | - Arihiko Tsukamoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido Prefecture, Japan
| | - Ryosuke Hitrota
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido Prefecture, Japan
| | - Mitsunori Yoshimoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido Prefecture, Japan
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Taketomi S, Kawaguchi K, Mizutani Y, Takei S, Yamagami R, Kono K, Murakami R, Kage T, Arakawa T, Fujiwara S, Tanaka S, Ogata T. Lower hamstring to quadriceps muscle strength ratio and lower body weight as factors associated with noncontact anterior cruciate ligament injury in male American football players: A prospective cohort study. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:43-47. [PMID: 38187929 PMCID: PMC10770439 DOI: 10.1016/j.asmart.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/05/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Background Previous studies have aimed to determine the use of certain risk factors in predicting the occurrence of noncontact anterior cruciate ligament (ACL) injuries. Unfortunately, evidence regarding noncontact ACL injuries in male American football players is limited. This prospective cohort study aimed to identify intrinsic risk factors for noncontact ACL injury among male American football players. Methods This study evaluated 152 male American football players in Japan for potential noncontact ACL injury risk factors during a preseason medical assessment, including anthropometric, joint laxity, and flexibility, muscle flexibility, muscle strength, and balance measurements. A total of 25 variables were examined. Participants were monitored during each season for noncontact ACL injury, as diagnosed by physicians. Results Noncontact ACL injuries occurred in 11 knees of 11 players (prevalence; 7.1 %). Injured players were significantly more likely to have lightweight (P = 0.049). No statistically significant between-group differences were found for any other variables. Participants with a lower hamstring to quadriceps (H/Q) ratio (P = 0.04) were more likely to sustain noncontact ACL injuries. Conclusion Lower H/Q ratio and lower body weight were significantly associated with new-onset noncontact ACL injury in male American football players. These findings will help develop strategies to prevent noncontact ACL injuries in male American football players.
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Affiliation(s)
- Shuji Taketomi
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
- UTokyo Sports Science Initiative (UTSSI), Japan
| | - Kohei Kawaguchi
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
- UTokyo Sports Science Initiative (UTSSI), Japan
| | | | - Seira Takei
- UTokyo Sports Science Initiative (UTSSI), Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Ryo Murakami
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Tomofumi Kage
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Takahiro Arakawa
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Sayaka Fujiwara
- UTokyo Sports Science Initiative (UTSSI), Japan
- Department of Rehabilitation Medicine, The University of Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Toru Ogata
- UTokyo Sports Science Initiative (UTSSI), Japan
- Department of Rehabilitation Medicine, The University of Tokyo, Japan
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Torres-Banduc M, Chirosa-Ríos I, Chirosa-Ríos L, Jerez-Mayorga D. Impact of Starting Knee Flexion Angle on Muscle Activity and Performance during Plyometrics without Jumping. SENSORS (BASEL, SWITZERLAND) 2023; 24:44. [PMID: 38202906 PMCID: PMC10780924 DOI: 10.3390/s24010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/22/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
Most of the existing research has focused on jump plyometrics, where landing reaction forces must be dissipated among lower limb articulations. In contrast, the investigation of resisted plyometrics without jumping, devoid of such landing forces, remains relatively limited. This study aimed to (i) investigate the impact of resisted plyometrics without jumping at two knee flexion angles (60 and 90 degrees) on vastus muscle activity relative to limb dominance and (ii) assess strength, power, and work during the concentric-eccentric phases of these exercises. Thirty-one healthy participants underwent quantification of lower limb muscle amplitude, strength, power, and work during resisted plyometrics without jumping from both 60° and 90° knee flexion positions. After anthropometric evaluations, participants used a dynamometer with a load equal to 80% of body weight while wireless surface electromyography electrodes recorded data. Statistical analyses utilized paired t-tests or nonparametric equivalents and set significance at p ≤ 0.05. Results showed significantly higher muscle activity in the vastus medialis (VM) (dominant: 47.4%, p = 0.0008, rs = 0.90; nondominant: 54.8%, p = 0.047, rs = 0.88) and vastus lateralis (VL) (dominant: 46.9%, p = 0.0004, rs = 0.86; nondominant: 48.1%, p = 0.021, rs = 0.67) muscles when exercises started at 90° knee flexion, regardless of limb dominance. Substantial intermuscle differences occurred at both 60° (50.4%, p = 0.003, rs = 0.56) and 90° (54.8%, p = 0.005, rs = 0.62) knee flexion, favoring VM in the nondominant leg. Concentric and eccentric strength, power, and work metrics significantly increased when initiating exercises from a 90° position. In conclusion, commencing resisted plyometrics without jumping at a 90° knee flexion position increases VM and VL muscle activity, regardless of limb dominance. Furthermore, it enhances strength, power, and work, emphasizing the importance of knee flexion position customization for optimizing muscle engagement and functional performance.
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Affiliation(s)
- Maximiliano Torres-Banduc
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad de Las Américas, Viña Del Mar 2520000, Chile;
- Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain;
| | - Ignacio Chirosa-Ríos
- Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain;
| | - Luis Chirosa-Ríos
- Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain;
| | - Daniel Jerez-Mayorga
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7570172, Chile;
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Zlojutro N, Eler S, Joksimovic M, Eler N, Marković S, Kukrić A, Goranovic K. Kinematic parameters and metabolic power in elite soccer players: A small sided a large sided games comparison. Front Physiol 2023; 14:1150713. [PMID: 37089420 PMCID: PMC10119402 DOI: 10.3389/fphys.2023.1150713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction: The goal of this paper is to determine what happens in one minute (on average) in kinematic parameters and metabolic power in small sided games (SSG) (3v3; 5v5) and large sided games (LSG) (10v10) and in which games kinematic parameters and metabolic power are best developed. Methods: The participants of this study were 22 professional football players, height 182.95±6.52 cm, mass 77.17±8.21 kg, body mass index (BMI) 22.97±1.47 kg/m2, body fat 9.85±2.55 %, aged 27.1±5.4 yrs, who played in the Premier League of Bosnia and Herzegovina. Data total distance (TD), maximum speed (MS), number of accelerations (nAcc), number of decelerations (nDec), number of sprints (nS), high intensity distance (Z4≥19.8 km/h), sprint distance (Z5≥25.2 km/h) and movements requiring a certain metabolic power (Pmet), were collected using a 20 Hz Global positioning system (GPS) system Pro2 (GPEXE, Exelio srl, Udine, Italy), on a total of 307 individual observations. Results: The results showed that the average total distance was significantly higher in the 5v5 (135.16±18.78 m) and 10v10 (133.43±20.06 m) games (F=64.26, p<0.001) compared to the 3v3 (108.24±11.26 m). Furthermore, the values of the variables Z4 (8.32±3.38 m, F=97.59), Z5 (1.84±1.53 m, F=123.64), nS (0.13±0.10 n, F=96.14) as well as Maxspeed (27.06±1.90 km/h, F=139.33), are statistically significantly higher (p<0.001) in the 10v10 game compared to the other two game formats. The average number of nAcc (0.40±0.32 n, F=9.86, p<0.001) and nDec (0.62±0.36 n, F=6.42, p<0.001) is statistically significantly higher in the 5v5 game. The results showed that the 5v5 game is significantly more metabolically demanding Pmet (2.76±0.67 W•kg-1, F=66.08, p<0.001) compared to the other two game formats. Discussion: The data presented in this paper can be used as a basis for the construction of specific exercises based on kinematic and physiological requirements, and for planning and programming microcycles in football.
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Affiliation(s)
- Nemanja Zlojutro
- Faculty of Physical Education and Sport, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Serdar Eler
- Faculty of Sport Science, Gazi University, Ankara, Ankara, Türkiye
| | - Marko Joksimovic
- Faculty of Sports and Physical Education, University of Montenegro, Niksic, Montenegro
- *Correspondence: Marko Joksimovic,
| | - Nebahat Eler
- Vocational School of Physical Education and Sports, Bülent Ecevit University, Zonguldak, Zonguldak, Türkiye
| | - Saša Marković
- Faculty of Physical Education and Sport, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Aleksandar Kukrić
- Faculty of Physical Education and Sport, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Kosta Goranovic
- Faculty of Sports and Physical Education, University of Montenegro, Niksic, Montenegro
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Manchado I, Motta LM, Blanco G, González J, Garcés GL. Isometric Knee Muscle Strength and Patient-Reported Measures Five Years after Anterior Cruciate Ligament Reconstruction: Comparison of Single versus Dual Autograft Hamstring Tendon Harvesting. J Clin Med 2022; 11:jcm11195682. [PMID: 36233550 PMCID: PMC9572358 DOI: 10.3390/jcm11195682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
There is some controversy regarding the use of one or two hamstring tendons for anterior cruciate ligament reconstruction (ACLR). In this study, two cohorts of 22 male patients underwent an ACLR with hamstring tendon autografts. One cohort was reconstructed through an all-inside technique with the semitendinosus tendon (ST group) and the other with the semitendinosus and gracilis tendons (ST-G group). Anterior tibial translation (ATT), Lysholm, and IKDC scores were assessed preoperatively and five years postoperation. Additionally, isometric knee muscle strength was manually measured in both groups and in another cohort of 22 uninjured control male subjects five years after the operation. There were no significant differences in ATT and Lysholm scores between the operated groups. The IKDC score was lower in the ST-G group than in the ST group—9.57 (CI 14.89−4.25) (p < 0.001). No significant differences between injured and uninjured knees were detected in hamstring to quadriceps ratio strength and quadriceps limb symmetry index of the two operated groups, but the hamstring limb symmetry index was significantly lower in the ST-G group than in the ST and control groups. This study shows that using an ST-G autograft for ACLR yielded less flexor strength and worse results in some patient-reported outcome measures (PROM) than using an ST autograft five years after the operation. The observed results let us suggest that the use of one autograft hamstring tendon for ACLR is clinically preferable to the use of two hamstring tendons.
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Affiliation(s)
- Ignacio Manchado
- Hospital Perpetuo Socorro, 35007 Las Palmas, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Luci M. Motta
- Hospital Perpetuo Socorro, 35007 Las Palmas, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | | | - Jesús González
- Unidad de Investigación, Hospital Dr Negrin, 35007 Las Palmas, Spain
| | - Gerardo L. Garcés
- Hospital Perpetuo Socorro, 35007 Las Palmas, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
- Correspondence: ; Tel.: +34-696-471-915
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Suh DK, Lee JH, Rhim HC, Cho IY, Han SB, Jang KM. Comparison of muscle strength and neuromuscular control up to 1 year after anterior cruciate ligament reconstruction between patients with dominant leg and non-dominant leg injuries. Knee 2021; 29:15-25. [PMID: 33524658 DOI: 10.1016/j.knee.2021.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/18/2020] [Accepted: 01/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND There has not been an investigation to determine whether leg dominance affects the recovery of quadriceps and hamstring strength, muscle reaction time (acceleration time, AT), and postural stability after anterior cruciate ligament (ACL) reconstruction in recreational-level athletic patients. METHODS A total of 100 patients with isolated ACL injuries (58 patients had dominant leg injuries; 42 patients had non-dominant leg injuries) participated. All patients received an anatomical single-bundle ACL reconstruction using an auto-hamstring tendon graft without preoperative rehabilitation. Leg dominance was defined as the kicking leg. The quadriceps and hamstring strength, AT, and postural stability (overall stability index (OSI)) of both legs were assessed at three different time points (preoperative, 6 months, 12 months), using an isokinetic dynamometer and postural stabilometry system. RESULTS All patients in both groups showed gradual improvement in quadriceps and hamstring muscle strength in the operated legs up to 1 year postoperatively. However, the mean value of quadriceps strength was lower in the operated non-dominant leg than the operated dominant leg 6 months postoperatively (P = 0.048). The AT and OSI of the operated legs in both groups recovered significantly 6 months postoperatively compared with their preoperative values; however, the AT and OSI values after 6 and 12 months were similar. CONCLUSION Quadriceps strength of the operated non-dominant leg was lower than that of the operated dominant leg 6 months postoperatively; however, the strength of the quadriceps and hamstring muscles was not different after 12 months between the operated dominant and non-dominant legs. Clinicians and physical therapists should consider these results during early rehabilitation and identify effective protocols to enhance quadriceps strength, especially in patients with non-dominant leg injuries.
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Affiliation(s)
- Dae Keun Suh
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jin Hyuck Lee
- Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hye Chang Rhim
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Il-Yup Cho
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Seung-Beom Han
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Ki-Mo Jang
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea; Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
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