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Bowers LC, Gribble PA, Hoch MC, Villasante Tezanos AG, Kosik KB. Physical therapy referral and medication for ankle sprain visits to physician offices: an analysis of the national ambulatory medical care survey. PHYSICIAN SPORTSMED 2021; 49:176-181. [PMID: 32729762 DOI: 10.1080/00913847.2020.1800369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Supervised physical therapy is the recommended care for an ankle sprain. Yet, recent evidence indicates some ankle sprain patients may not receive the recommended care, and instead, prescribed medication to alleviate symptoms. Therefore, the purpose of this study is to describe the percentage of patients reporting to an office-based physician in the U.S. that were or were not referred to physical therapy. Secondly, to describe the percentage of ankle sprain patients with or without medication administered, supplied or ordered. METHODS This was a secondary analysis of the cross-sectional National Ambulatory Medical Care Survey (NAMCS) from 2007 to 2016. The NAMCS is a multi-stage probability sample survey of visits to office-based physicians. The percentage and associated 95% confidence intervals (CI) were calculated for visits that had a physical therapy referral or a non-steroidal anti-inflammatory drug (NSAID), opioid and non-opioid analgesics administered, supplied or ordered. Sampled data were weighted to produce national-level estimates. RESULTS A physical therapy referral was given for 16.8% (95% CI: 13.2, 21.2) of ankle sprain visits. Approximately 34.5% (95%CI: 30.5, 38.7) of all ankle sprain visits had a medication administered, supplied or ordered. NSAIDs (72.1%; 95% CI: 66.9,76.8) and opioids (21.0%; 95% CI: 16.3, 26.5) were the two most common types of medication. CONCLUSIONS NSAIDs and opioid medication combined were administered, supplied or ordered more frequently than a referral to physical therapy. These findings provide evidence that suggests many ankle sprain patients reporting to an office-based physician are not receiving the recommended care; physical therapy. Rather, medication appears to be the primary type of care provided to patients. These data are important because it gives a focused area to improve the treatment of an ankle sprain by developing strategies that ensure all patients are provided the recommended care from the onset of entering the healthcare system.
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Affiliation(s)
- Lucy C Bowers
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Phillip A Gribble
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Matthew C Hoch
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | | | - Kyle B Kosik
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
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2
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Long DE, Peck BD, Tuggle SC, Villasante Tezanos AG, Windham ST, Bamman MM, Kern PA, Peterson CA, Walton RG. Associations of muscle lipid content with physical function and resistance training outcomes in older adults: altered responses with metformin. GeroScience 2021; 43:629-644. [PMID: 33462708 PMCID: PMC8110673 DOI: 10.1007/s11357-020-00315-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
Preserving muscle mass and strength is critical for long-term health and longevity. Age-related muscle lipid accumulation has been shown to be detrimental to muscle health. In healthy older individuals, we sought to determine whether muscle lipid content, determined from computed tomography, is associated with self-reported physical function, laboratory-measured performance, and the response to progressive resistance training (PRT), and how metformin may alter these responses (N = 46 placebo, 48 metformin). Using multiple linear regression models adjusted for confounders in a large cohort, we show that intermuscular adipose tissue (IMAT) was not associated with baseline function or response to PRT, contrary to previous reports. On the other hand, thigh muscle density (TMD), as an indicator of intra- and extramyocellular lipid (IMCL and EMCL), remained strongly and independently positively associated with physical function and performance following adjustment. Baseline TMD was inversely associated with gains in strength, independent of muscle mass. Percent change in TMD was positively associated with improved chair stand and increased type II fiber frequency but was not associated with muscle hypertrophy or overall strength gain following PRT. For the first time, we show that metformin use during PRT blunted density and strength gains by inhibiting fiber type switching primarily in those with low baseline TMD. These results indicate that participants with higher muscle lipid content derive the most performance benefit from PRT. Our results further indicate that muscle density may be as influential as muscle size for strength, physical function, and performance in healthy older adults. ClinicalTrials.gov , NCT02308228, Registered on 25 November 2014.
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Affiliation(s)
- Douglas E Long
- Department of Physical Therapy and Center for Muscle Biology, University of Kentucky, Charles T. Wethington Bldg., Lexington, KY, 40536-0200, USA.
| | - Bailey D Peck
- Department of Physical Therapy and Center for Muscle Biology, University of Kentucky, Charles T. Wethington Bldg., Lexington, KY, 40536-0200, USA
| | - Steven C Tuggle
- Center for Exercise Medicine and Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Samuel T Windham
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcas M Bamman
- Center for Exercise Medicine and Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Philip A Kern
- Department of Internal Medicine, Division of Endocrinology, and Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY, USA
| | - Charlotte A Peterson
- Department of Physical Therapy and Center for Muscle Biology, University of Kentucky, Charles T. Wethington Bldg., Lexington, KY, 40536-0200, USA
| | - Rosicka G Walton
- Department of Physical Therapy and Center for Muscle Biology, University of Kentucky, Charles T. Wethington Bldg., Lexington, KY, 40536-0200, USA
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Mayer KP, Henning AN, Gaines KM, Cassity EP, Morris PE, Villasante Tezanos AG, Johnson CA, Lee JT, Baz M, Dupont-Versteegden EE. Physical Function Measured Prior to Lung Transplantation Is Associated With Posttransplant Patient Outcomes. Transplant Proc 2020; 53:288-295. [PMID: 32950260 DOI: 10.1016/j.transproceed.2020.07.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/15/2020] [Accepted: 07/11/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The primary objective of this study was to determine whether pretransplant physical function is correlated with posttransplantation outcomes. METHODS We performed a retrospective study of patients that participated in pretransplantation screening and subsequently underwent lung transplantation. Pretransplant variables of interest included demographics, muscle mass, body composition, physical function, and physical frailty. Correlation tests were performed to assess relationships with significance set at 0.05. RESULTS Twenty-five patients with a mean age of 57 ± 13 years (68% male) with pretransplant lung allocation score of 45 ± 14 were included. This cohort had a 3-year mortality rate of 32% (n = 8). Pretransplant 4-m gait speed was significantly related to performance on the Short Physical Performance Battery (r = 0.74, P = .02) and distance ambulated on the 6-minute walk test (r = 0.62, P = .07) at hospital discharge. Older age was associated with slower gait speed and worse performance on sit-to-stand testing at hospital discharge (r = -0.76, P = .01 and r = -0.75, P = .01, respectively). Statistically, only diagnosis of cystic fibrosis was associated with 3-year mortality. DISCUSSION Our study demonstrates that demographic, clinical, and physical function assessed prior to lung transplantation may be indicators of functional recovery.
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Affiliation(s)
- Kirby P Mayer
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky.
| | - Angela N Henning
- Inpatient Rehabilitation Department, Chandler Medical Center, University of Kentucky, Lexington, Kentucky
| | - Kathryn M Gaines
- Inpatient Rehabilitation Department, Chandler Medical Center, University of Kentucky, Lexington, Kentucky
| | - Evan P Cassity
- Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky
| | - Peter E Morris
- Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky
| | | | - Carrie A Johnson
- Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky
| | - James T Lee
- Department of Radiology, University of Kentucky, Lexington, Kentucky
| | - Maher Baz
- Cardiovascular and Thoracic Surgery, Lung Transplant, University of Kentucky, Lexington, Kentucky
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Long DE, Tuggle SC, Villasante Tezanos AG, Bamman MM, Kern PA, Peterson CA, Walton RG. Associations Of Skeletal Muscle Lipid Infiltration With Hypertrophy And Physical Performance Outcomes In Older Adults. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000677540.18974.3b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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King JD, Rowland G, Villasante Tezanos AG, Warwick J, Kraus VB, Lattermann C, Jacobs CA. Joint Fluid Proteome after Anterior Cruciate Ligament Rupture Reflects an Acute Posttraumatic Inflammatory and Chondrodegenerative State. Cartilage 2020; 11:329-337. [PMID: 30033738 PMCID: PMC7298591 DOI: 10.1177/1947603518790009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate changes in the synovial fluid proteome following acute anterior cruciate ligament (ACL) injury. DESIGN This study represents a secondary analysis of synovial fluid samples collected from the placebo group of a previous randomized trial. Arthrocentesis was performed twice on 6 patients with an isolated acute ACL tear at a mean of 6 and 14 days postinjury. Synovial fluid was analyzed by a highly multiplexed assay of 1129 proteins (SOMAscan version 3, SomaLogic, Inc., Boulder, CO). Pathway analysis using DAVID was performed; genes included met 3 criteria: significant change between the 2 study time points using a paired t test, significant change between the 2 study time points using a Mann-Whitney nonparametric test, and significant Benjamini post hoc analysis. RESULTS Fifteen analytes demonstrated significant increases between time points. Five of the 15 have been previously associated with the onset and/or severity of rheumatoid arthritis, including apoliopoprotein E and isoform E3, vascular cell adhesion protein 1, interleukin-34, and cell surface glycoprotein CD200 receptor 1. Chondrodegenerative enzymes and products of cartilage degeneration all increased over time following injury: MMP-1 (P = 0.08, standardized response mean [SRM] = 1.00), MMP-3 (P = 0.05, SRM = 0.90), ADAM12 (P = 0.03, SRM = 1.31), aggrecan (P = 0.08, SRM = 1.13), and CTX-II (P = 0.07, SRM = 0.56). Notable pathways that were differentially expressed following injury were the cytokine-cytokine receptor interaction and osteoclast differentiation pathways. CONCLUSIONS The proteomic results and pathway analysis demonstrated a pattern of cartilage degeneration, not only consistent with previous findings but also changes consistent with an inflammatory arthritogenic process post-ACL injury.
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Affiliation(s)
- John D. King
- Department of Orthopedic Surgery,
University of Kentucky, Lexington, KY, USA
| | - Grant Rowland
- Central Texas Sports Medicine &
Orthopedics, Bryan, TX, USA
| | | | - James Warwick
- College of Medicine, University of
Kentucky, Lexington, KY, USA
| | - Virginia B. Kraus
- Duke Molecular Physiology Institute,
Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Division of Rheumatology, Department of
Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Christian Lattermann
- Department of Orthopaedic Surgery,
Harvard Medical School and Brigham and Women’s Hosptial, Chestnut Hill, MS,
USA
| | - Cale A. Jacobs
- Department of Orthopedic Surgery,
University of Kentucky, Lexington, KY, USA,Cale A. Jacobs, Department of Orthopedic
Surgery & Sports Medicine, University of Kentucky, 740 South Limestone
Street, Room K426, Lexington, KY 40536-0284, USA.
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Walton RG, Dungan CM, Long DE, Tuggle SC, Kosmac K, Peck BD, Bush HM, Villasante Tezanos AG, McGwin G, Windham ST, Ovalle F, Bamman MM, Kern PA, Peterson CA. Metformin blunts muscle hypertrophy in response to progressive resistance exercise training in older adults: A randomized, double-blind, placebo-controlled, multicenter trial: The MASTERS trial. Aging Cell 2019; 18:e13039. [PMID: 31557380 PMCID: PMC6826125 DOI: 10.1111/acel.13039] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/14/2019] [Accepted: 08/25/2019] [Indexed: 12/25/2022] Open
Abstract
Progressive resistance exercise training (PRT) is the most effective known intervention for combating aging skeletal muscle atrophy. However, the hypertrophic response to PRT is variable, and this may be due to muscle inflammation susceptibility. Metformin reduces inflammation, so we hypothesized that metformin would augment the muscle response to PRT in healthy women and men aged 65 and older. In a randomized, double‐blind trial, participants received 1,700 mg/day metformin (N = 46) or placebo (N = 48) throughout the study, and all subjects performed 14 weeks of supervised PRT. Although responses to PRT varied, placebo gained more lean body mass (p = .003) and thigh muscle mass (p < .001) than metformin. CT scan showed that increases in thigh muscle area (p = .005) and density (p = .020) were greater in placebo versus metformin. There was a trend for blunted strength gains in metformin that did not reach statistical significance. Analyses of vastus lateralis muscle biopsies showed that metformin did not affect fiber hypertrophy, or increases in satellite cell or macrophage abundance with PRT. However, placebo had decreased type I fiber percentage while metformin did not (p = .007). Metformin led to an increase in AMPK signaling, and a trend for blunted increases in mTORC1 signaling in response to PRT. These results underscore the benefits of PRT in older adults, but metformin negatively impacts the hypertrophic response to resistance training in healthy older individuals. ClinicalTrials.gov Identifier: NCT02308228.
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Affiliation(s)
- R. Grace Walton
- Center for Muscle Biology College of Health Sciences University of Kentucky Lexington Kentucky
| | - Cory M. Dungan
- Center for Muscle Biology College of Health Sciences University of Kentucky Lexington Kentucky
| | - Douglas E. Long
- Center for Muscle Biology College of Health Sciences University of Kentucky Lexington Kentucky
| | - S. Craig Tuggle
- UAB Center for Exercise Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Kate Kosmac
- Center for Muscle Biology College of Health Sciences University of Kentucky Lexington Kentucky
| | - Bailey D. Peck
- Center for Muscle Biology College of Health Sciences University of Kentucky Lexington Kentucky
| | - Heather M. Bush
- Department of Biostatistics College of Public Health University of Kentucky Lexington Kentucky
| | | | - Gerald McGwin
- UAB Center for Exercise Medicine University of Alabama at Birmingham Birmingham Alabama
- Department of Epidemiology School of Public Health University of Alabama at Birmingham Birmingham Alabama
| | - Samuel T. Windham
- UAB Center for Exercise Medicine University of Alabama at Birmingham Birmingham Alabama
- Department of Surgery School of Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Fernando Ovalle
- Department of Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Marcas M. Bamman
- UAB Center for Exercise Medicine University of Alabama at Birmingham Birmingham Alabama
- Department of Medicine University of Alabama at Birmingham Birmingham Alabama
- Department of Cell, Developmental & Integrative Biology School of Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Philip A. Kern
- Division of Endocrinology Department of Medicine University of Kentucky Lexington Kentucky
| | - Charlotte A. Peterson
- Center for Muscle Biology College of Health Sciences University of Kentucky Lexington Kentucky
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Kosik KB, Hoch MC, Humphries RL, Villasante Tezanos AG, Gribble PA. Medications Used in U.S. Emergency Departments for an Ankle Sprain: An Analysis of the National Hospital Ambulatory Medical Care Survey. J Emerg Med 2019; 57:662-670. [PMID: 31606229 DOI: 10.1016/j.jemermed.2019.08.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/24/2019] [Accepted: 08/07/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND An ankle sprain is a common musculoskeletal injury treated in the emergency department. Rest, ice, compression, and elevation is the preferred method for managing the symptoms after an ankle sprain. However, many patients receive a medication, such as a nonsteroidal anti-inflammatory drug (NSAID) or an opioid. OBJECTIVES We sought to quantify the type of medication(s) used for an ankle sprain and to examine those across age and sex. METHODS This was a retrospective review of the publicly available data collected through the National Hospital Ambulatory Medical Care Survey from 2006-2015. All cases with an isolated diagnosis of an ankle sprain were identified. Medication listed for each case was classified based on its detailed category and further explored across all 10 years, age, and sex. RESULTS An estimated 9,052,678 ankle sprain visits occurred in emergency departments from 2006-2015. NSAIDs (56.1%) and opioid analgesic combination (28.4%) were the 2 most common medications. Regardless of the type, most medications were prescribed at discharge. The use of NSAIDs appears to have increased while opioid analgesic combinations decreased in 2010. NSAIDs were the most common medication identified with each age cohort; however, there was no apparent trend in medication for sex. CONCLUSIONS NSAIDs are the most common medication used for ankle sprain visits to the ED. Nevertheless, an opioid is also used at a relatively high rate for this injury. These findings provide awareness and opportunity to focus on strategies for reduction of opioid use.
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Affiliation(s)
- Kyle B Kosik
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky
| | - Matthew C Hoch
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky
| | - Roger L Humphries
- Department of Emergency Medicine, University of Kentucky, Lexington, Kentucky
| | | | - Phillip A Gribble
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky
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Long DE, Villasante Tezanos AG, Wise JN, Kern PA, Bamman MM, Peterson CA, Dennis RA. A guide for using NIH Image J for single slice cross-sectional area and composition analysis of the thigh from computed tomography. PLoS One 2019; 14:e0211629. [PMID: 30730923 PMCID: PMC6366874 DOI: 10.1371/journal.pone.0211629] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/17/2019] [Indexed: 12/25/2022] Open
Abstract
Reports using computed tomography (CT) to estimate thigh skeletal muscle cross-sectional area and mean muscle attenuation are often difficult to evaluate due to inconsistent methods of quantification and/or poorly described analysis methods. This CT tutorial provides step-by-step instructions in using free, NIH Image J software to quantify both muscle size and composition in the mid-thigh, which was validated against a robust commercially available software, SliceOmatic. CT scans of the mid-thigh were analyzed from 101 healthy individuals aged 65 and older. Mean cross-sectional area and mean attenuation values are presented across seven defined Hounsfield unit (HU) ranges along with the percent contribution of each region to the total mid-thigh area. Inter-software correlation coefficients ranged from R2 = 0.92–0.99 for all specific area comparisons measured using the Image J method compared to SliceOmatic. We recommend reporting individual HU ranges for all areas measured. Although HU range 0–100 includes the majority of skeletal muscle area, HU range -29 to 150 appears to be the most inclusive for quantifying total thigh muscle. Reporting all HU ranges is necessary to determine the relative contribution of each, as they may be differentially affected by age, obesity, disease, and exercise. This standardized operating procedure will facilitate consistency among investigators reporting computed tomography characteristics of the thigh on single slice images. Trial Registration: ClinicalTrials.gov NCT02308228.
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Affiliation(s)
- Douglas E. Long
- College of Health Sciences and Center for Muscle Biology, University of Kentucky, Lexington, KY, United States of America
- * E-mail:
| | | | - James N. Wise
- College of Medicine, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Philip A. Kern
- Department of Internal Medicine, Division of Endocrinology, and Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY, United States of America
| | - Marcas M. Bamman
- Center for Exercise Medicine and Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Charlotte A. Peterson
- College of Health Sciences and Center for Muscle Biology, University of Kentucky, Lexington, KY, United States of America
| | - Richard A. Dennis
- Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR, United States of America
- Donald W Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
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Wolfe H, Poole K, Tezanos AGV, English R, Uhl TL. VOLLEYBALL OVERHEAD SWING VOLUME AND INJURY FREQUENCY OVER THE COURSE OF A SEASON. Int J Sports Phys Ther 2019; 14:88-96. [PMID: 30746295 PMCID: PMC6350665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Overuse injuries are common in volleyball; however, few studies exist that quantify the workload of a volleyball athlete in a season. The relationship between workload and shoulder injury has not been extensively studied in women's collegiate volleyball athletes. HYPOTHESIS/PURPOSE This study aims to quantify shoulder workloads by counting overhead swings during practice and matches. The purpose of the current study is to provide a complete depiction of typical overhead swings, serves, and hits, which occur in both practices and matches. The primary hypothesis was that significantly more swings will occur in practices compared to matches. The secondary hypothesis was that greater swing volume and greater musculoskeletal injury frequency will occur in the pre-season than during the season. STUDY DESIGN Prospective cohort. METHODS Researchers observed practice and match videos and counted overhead serves and attacks of 19 women's collegiate volleyball players for two seasons. Serves, overhead hits, and total swings (serves + hits) were the dependent variables; event (matches and practice) along with position (defensive specialists, setter, outside hitter, and middle blocker) were the independent variables. Musculoskeletal injury frequency and swing volume workload were compared across pre-season and competitive season time periods. RESULTS Across all positions except outside hitters twice as many total swings occurred in practices compared to matches (p=.002) resulting in an average of 19 (CI95 16.5, 21.5) more swings in practice than in matches. The average number of total swings during the pre-season 47.1 (CI95 44.1, 50.1) was significantly greater than average swings per session during the competitive season 37.7 (CI95 36.4, 38.9) (p < 0.001) resulting in a mean difference of 9.4 (CI95 6.1, 12.7) swings. The number of athletes limited in participation or out due to a musculoskeletal injury during the pre-season (2.9%) was greater than during the season (1.1%) (p=0.042). CONCLUSION These findings support the primary hypothesis that women's collegiate volleyball athletes swing more during practices than in matches. The higher average number of serves in the pre-season and the greater frequency of musculoskeletal injuries requiring participation restriction or removal from participation suggest that a concordant relationship may exist between workload and injury variables. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Heather Wolfe
- Director of Sports Medicine, Associate Athletic Trainer, Lincoln University Department of Athletics and NovaCare Rehabilitation, Lincoln University, PA, USA
| | - Katherine Poole
- University of Kentucky Athletics Association, Head Volleyball Athletic Trainer, University of Kentucky, Lexington, KY, USA
| | | | - Robert English
- Division of Physical Therapy, Department of Rehabilitation Sciences, College of Health Science, University of Kentucky, Lexington, KY, USA
| | - Tim L. Uhl
- Division of Athletic Training, Department of Rehabilitation Sciences, College of Health Science, University of Kentucky, Lexington, KY, USA
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Mccoy SW, Effgen SK, Chiarello LA, Jeffries LM, Villasante Tezanos AG. School-based physical therapy services and student functional performance at school. Dev Med Child Neurol 2018; 60:1140-1148. [PMID: 29603734 DOI: 10.1111/dmcn.13748] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2018] [Indexed: 11/27/2022]
Abstract
AIM We explored relationships of school-based physical therapy to standardized outcomes of students receiving physical therapy. METHOD Using a practice-based evidence research design, School Function Assessment (SFA) outcomes of 296 students with disabilities (mean age 7y 4mo [standard deviation 2y]; 166 males, 130 females), served by 109 physical therapists, were explored. After training, therapists completed 10 SFA scales on students at the beginning and end of the school year. Therapists collected detailed weekly data on services (activities, interventions, types, student participation) using the School-Physical Therapy Interventions for Pediatrics (S-PTIP) system. Stepwise linear regressions were used to investigate S-PTIP predictors of SFA outcomes. RESULTS Predictors of SFA section outcomes varied in strength, with the coefficient of determination (R2 ) for each outcome ranging from 0.107 to 0.326. Services that correlated positively with the SFA outcomes included mobility, sensory, motor learning, aerobic/conditioning, functional strengthening, playground access interventions, and higher student participation during therapy (standardized β=0.11-0.26). Services that correlated negatively with the SFA outcomes included providing services within student groups, within school activity, with students not in special education, during recreation activities, and with positioning, hands-on facilitation, sensory integration, orthoses, and equipment interventions (standardized β=-0.14 to -0.22). INTERPRETATION Consideration of outcomes is prudent to focus services. Overall results suggest we should emphasize active mobility practice by using motor learning interventions and engaging students within therapy sessions. WHAT THIS PAPER ADDS No specific interventions predicted positively on all School Function Assessment (SFA) outcomes. Active movement practice seems related to overall better SFA outcomes. Active mobility practice improved SFA participation, mobility, recreation, and activities of daily living. Engaging students in therapy activities and interventions improved outcomes.
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Affiliation(s)
- Sarah Westcott Mccoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Susan K Effgen
- Department of Rehabilitation Sciences, College of Health Sciences, University of Kentucky, Lexington, KY, USA
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Lynn M Jeffries
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
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Dennis RA, Villasante Tezanos AG, Landes RD, Wise JN, Padala KP, Kern PA, Garner KK, Padala PR, Bamman MM, Sullivan DH, Peterson CA, Long DE. Measuring Thigh Cross-sectional Areas From CT Scans. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536490.55537.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Johnson AM, Henning AN, Morris PE, Tezanos AGV, Dupont-Versteegden EE. Timing and Amount of Physical Therapy Treatment are Associated with Length of Stay in the Cardiothoracic ICU. Sci Rep 2017; 7:17591. [PMID: 29242519 PMCID: PMC5730602 DOI: 10.1038/s41598-017-17624-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/15/2017] [Indexed: 01/06/2023] Open
Abstract
Significant variability exists in physical therapy early mobilization practice. The frequency of physical therapy or early mobilization of patients in the cardiothoracic intensive care unit and its effect on length of stay has not been investigated. The goal of our research was to examine variables that influence physical therapy evaluation and treatment in the intensive care unit using a retrospective chart review. Patients (n = 2568) were categorized and compared based on the most common diagnoses or surgical procedures. Multivariate semi-logarithmic regression analyses were used to determine correlations. Differences among patient subgroups for all independent variables other than age and for length of stay were found. The regression model determined that time to first physical therapy evaluation, Charlson Comorbidity Index score, mean days of physical therapy treatment and mechanical ventilation were associated with increased hospital length of stay. Time to first physical therapy evaluation in the intensive care unit and the hospital, and mean days of physical therapy treatment associated with hospital length of stay. Further prospective study is required to determine whether shortening time to physical therapy evaluation and treatment in a cardiothoracic intensive care unit could influence length of stay.
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Affiliation(s)
- Audrey M Johnson
- Department of Rehabilitation Sciences, College of Health Sciences, University of Kentucky, Lexington, Kentucky, United States of America.
| | - Angela N Henning
- Rehabilitation Department, UK HealthCare, Lexington, Kentucky, United States of America
| | - Peter E Morris
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Lexington, Kentucky, United States of America
| | - Alejandro G Villasante Tezanos
- Department of Statistics, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, United States of America
| | - Esther E Dupont-Versteegden
- Department of Rehabilitation Sciences, College of Health Sciences, University of Kentucky, Lexington, Kentucky, United States of America
- Center for Muscle Biology, College of Health Sciences, University of Kentucky, Lexington, Kentucky, United States of America
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