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Ivanov I, Ranchev S, Stoychev S. Experimental Ultrasound Approach for Studying Knee Intra-Articular Femur-Tibia Movements under Different Loads. J Funct Morphol Kinesiol 2023; 9:8. [PMID: 38249085 PMCID: PMC10801608 DOI: 10.3390/jfmk9010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
The purpose of the present study was to develop an experimental model for the study of intra-articular knee movements depending on the function of the knee joint and involved muscle groups under isometric stretching conditions with different loads. The experimental procedure included an ultrasound examination of a knee joint after isometric stretching in healthy men (n = 32). The changes (in millimeters) in the distances between the femur and tibia were measured using an ultrasound sonographer at three stages. The first stage was performed on ten (n = 10) healthy men in five different sitting and upright positions. In the second and third experimental model stages, lower limbs loading was applied to 22 participants. Our hypothesis, which was confirmed, was that as a result of increased loads on the participant's back, an intra-articular decrease in the femur-tibia cartilage surface distance would be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model of the mechanical effects during the deformation of knee joint bone cartilage and it can also help outline some future tasks: increasing loading weights, enlarging participant groups, performing comparisons of men and women, and performing comparisons of healthy and pathological individuals.
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Affiliation(s)
- Ivan Ivanov
- National Sports Academy “Vassil Levski”, 1700 Sofia, Bulgaria
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
| | - Sergey Ranchev
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
| | - Stoyan Stoychev
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
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Gremillion MJ, Martinez A, Ghanta RB, Borici N, Kushare I. An assessment of the diagnosis, treatment, and outcomes of lower extremity stress fractures in pediatric and adolescent populations. PHYSICIAN SPORTSMED 2023; 51:572-581. [PMID: 36328959 DOI: 10.1080/00913847.2022.2143247] [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: 02/17/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To present one of the first descriptive case series of pediatric and adolescent lower extremity stress injuries, their management, and outcomes in athletes and non-athletes. METHODS The IRB-approved retrospective study included patients under 18 years at a tertiary children's hospital who were diagnosed with a lower extremity stress fracture/reaction. Demographic data, mechanism of injury, physical exam, radiographic findings, treatment, & outcomes were collected. Descriptive statistical analysis was conducted. RESULTS Ninety-seven patients with stress injuries on clinical exams and on radiographs or MRI were included. The average age when diagnosed was 11.7 years (range 1.1-18 years) and the most common injuries were to the tibia (n = 33, 28.4%) and the least common involved were the cuneiforms (n = 4, 3.4%). Patients under the age of 14 were more likely to experience cuboid and calcaneal stress injuries (mean age 5.5 and 8.3 years respectively). Nineteen patients (19.6%) had high-risk stress fractures, with the average age of 14.9 years versus 11.6 for those with low risk (p-value = 0.01) and return to activity time being 15 weeks compared to 10.5 (p-value = 0.027). The most common forms of treatment were controlled ankle motion (CAM), walker boots (58.6%), and physical therapy (PT) (38.1%). The mean Lower Extremity Function Score of the patient population was 73.8, indicating no clinically important difference from full functionality. CONCLUSION Lower extremity stress injuries in this cohort were most seen in the tibia, although patients younger than 14 had a high number of cuboid and calcaneal stress injuries. Those with high-risk stress fractures were older and took longer to recover from when compared to low-risk injuries. Treatment is commonly conservative, with CAM boots and PT being the most frequently utilized interventions and serving as a successful approach to treatment, with patients returning to activity at an average of 11.4 weeks, which is comparable to similar studies.
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Affiliation(s)
| | | | - Ramesh B Ghanta
- Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Neritan Borici
- Baylor College of Medicine, Houston, TX, USA
- Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Indranil Kushare
- Baylor College of Medicine, Houston, TX, USA
- Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX, USA
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Arévalo Hernández A, Mittlmeier T, Weber MA. [Contemporary imaging examinations for (suspected) stress fractures]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:831-838. [PMID: 37650915 DOI: 10.1007/s00113-023-01358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Abstract
Stress fractures belong to the group of atraumatic fractures. A low-impact and repetitive load is the underlying cause and no fracture would occur under physiological circumstances. The conventional X‑ray examination remains the initial imaging modality when a stress fracture is suspected. In contrast, magnetic resonance imaging (MRI) is the gold standard and is also used to rule out other pathological changes. Computed tomography (CT) should be included if the MRI findings are unclear. New techniques, such as dual energy computed tomography (DECT) and magnetic resonance bone imaging (MR bone) should be used more frequently in practice in the future and become increasingly more important for the correct diagnosis.
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Affiliation(s)
- Andrés Arévalo Hernández
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.
| | - Thomas Mittlmeier
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Marc-André Weber
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland
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Kara E, Sağıroğlu İ, Vurgun H, Eken Ö, Ceylan Hİ, Gabrys T, Barasinska M, Szmatlan-Gabrys U, Valach P. The Risk Factors Associated with Grip Lock Injuries in Artistic Gymnasts: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3589. [PMID: 36834283 PMCID: PMC9965130 DOI: 10.3390/ijerph20043589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Artistic gymnastics (AG) is a sport that demands grace, strength, and flexibility, leading to a broad spectrum of injuries. The dowel grip (DG) is widely used by gymnasts to securely hold onto the high bar or uneven bars. However, incorrect usage of the DG can result in grip lock (GL) injuries. This systematic review aims to (1) identify studies that have investigated the risk factors related to GL injuries among gymnasts and (2) synthesize the key evidence. A comprehensive electronic search was conducted in the following databases: PubMed, ScienceDirect, Elsevier, SportDiscus, and Google Scholar, covering the period from their inception until November 2022. The data extraction and analysis were independently completed by two investigators. A total of 90 relevant studies were initially identified, out of which seven clinical trials met the eligibility criteria. For the quantitative synthesis, five studies were included. The details extracted from each article include: the sample characteristics (number, gender, age, and health status), the study design, the instrumentation or intervention used, and the final results. Our results revealed that the underlying causes of the risk factors of GL injuries were the irregular checking of the dowel grip and the mating surface of the bar, the tearing of the dowel of the leather strap, and the use of the dowel grip in different competition apparatuses. In addition, GL injuries may occur either as severe forearm fractures or mild injuries. Excessive flexion of the forearm and overpronation of the wrist during rotational movements, such as the swing or backward/forward giant circle, may increase the possibility of GL injury on the high bar. Future studies should focus on GL injury prevention strategy and rehabilitation protocol for GL injuries. Further high-quality research is required to establish the validity of these findings.
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Affiliation(s)
- Erhan Kara
- Coaching Education Department, Faculty of Sport Sciences, Tekirdag Namik Kemal University, Tekirdağ 59000, Turkey
| | - İsa Sağıroğlu
- Kirkpinar Faculty of Sport Sciences, Trakya University, Edirne 22030, Turkey
| | - Hikmet Vurgun
- Coaching Education Department, Faculty of Sport Sciences, Manisa Celal Bayar University, Manisa 45040, Turkey
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Inonu University, Malatya 44000, Turkey
| | - Halil İbrahim Ceylan
- Physical Education of Sports Teaching, Faculty of Kazim Karabekir Education, Atatürk University, Erzurum 25030, Turkey
| | - Tomasz Gabrys
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic
| | - Magdalena Barasinska
- Department of Health Sciences, Jan Dlugosz University, 42-200 Czestochowa, Poland
| | - Urszula Szmatlan-Gabrys
- Department of Anatomy, Faculty Rehabilitation, University of Physical Education, 31-571 Krakow, Poland
| | - Peter Valach
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic
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Hegedus EJ, Mulligan EP, Beer BA, Gisselman AS, Wooten LC, Stern BD. How Advancement in Bone Science Should Inform the Examination and Treatment of Femoral Shaft Bone Stress Injuries in Running Athletes. Sports Med 2023; 53:1117-1124. [PMID: 36598744 DOI: 10.1007/s40279-022-01802-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2022] [Indexed: 01/05/2023]
Abstract
Stress fractures likely have a 1-2% incidence in athletes in general. In runners, a more vulnerable population, incidence rates likely range between 3.2 and 21% with female runners having greater susceptibility. The incidence of femoral shaft stress fractures is less well known. New basic and translational science research may impact the way clinicians diagnose and treat femoral stress fractures. By using a fictitious case study, this paper applies bone science to suggest new approaches to evaluating and treating femoral shaft stress fractures in the running population.
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Affiliation(s)
- Eric J Hegedus
- Tufts University Doctor of Physical Therapy Program, 101 E Washington St Ste 950, Phoenix, AZ, 85004, USA.
| | - Edward P Mulligan
- Tufts University Doctor of Physical Therapy Program, 101 E Washington St Ste 950, Phoenix, AZ, 85004, USA
| | | | - Angela Spontelli Gisselman
- Tufts University Doctor of Physical Therapy Program, 101 E Washington St Ste 950, Phoenix, AZ, 85004, USA
| | - Liana C Wooten
- Tufts University Doctor of Physical Therapy Program, 101 E Washington St Ste 950, Phoenix, AZ, 85004, USA
| | - Benjamin D Stern
- Tufts University Doctor of Physical Therapy Program, 101 E Washington St Ste 950, Phoenix, AZ, 85004, USA
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Belluscio V, Orejel Bustos AS, Camomilla V, Rizzo F, Sciarra T, Gabbianelli M, Guerriero R, Morsilli O, Martelli F, Giacomozzi C. Experimental study protocol of the project "MOtor function and VItamin D: Toolkit for motor performance and risk Assessment (MOVIDA)". PLoS One 2021; 16:e0254878. [PMID: 34293019 PMCID: PMC8297846 DOI: 10.1371/journal.pone.0254878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
Musculoskeletal injuries, a public health priority also in the military context, are ascribed to several risk factors, including: increased reaction forces; low/reduced muscle strength, endurance, body mass, Vitamin D level, and bone density; inadequate lifestyles and environment. The MOVIDA Project-funded by the Italian Ministry of Defence-aims at developing a transportable toolkit (assessment instrumentation, assessment protocols and reference/risk thresholds) which integrates motor function assessment with biological, environmental and behavioural factors to help characterizing the risk of stress fracture, stress injury or muscle fatigue due to mechanical overload. The MOVIDA study has been designed following the STROBE guidelines for observational cross-sectional studies addressing healthy adults, both militaries and civilians, with varying levels of physical fitness (sedentary people, recreational athletes, and competitive athletes). The protocol of the study has been designed and validated and is hereby reported. It allows to collect and analyse anamnestic, diagnostic and lifestyle-related data, environmental parameters, and functional parameters measured through portable and wearable instrumentation during adapted 6 minutes walking test. The t-test, one and two-way ANOVA with post-hoc corrections, and ANCOVA tests will be used to investigate relevant differences among the groups with respect to biomechanical parameters; non-parametric statistics will be rather used for non-normal continuous variables and for quantitative discrete variables. Generalized linear models will be used to account for risk and confounding factors.
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Affiliation(s)
- Valeria Belluscio
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Amaranta S Orejel Bustos
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesco Rizzo
- Joint Veterans Defence Center, Army Medical Center, Rome, Italy
| | - Tommaso Sciarra
- Joint Veterans Defence Center, Army Medical Center, Rome, Italy
| | - Marco Gabbianelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Raffaella Guerriero
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Ornella Morsilli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Francesco Martelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
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