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Morrissey D, O'Donnell EA, Behan L, McMahon M, Keyes LM. Definitions of serious injury in long-term residential care: a systematic review protocol. HRB Open Res 2023; 6:66. [PMID: 38384972 PMCID: PMC10879755 DOI: 10.12688/hrbopenres.13705.1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 02/23/2024] Open
Abstract
Background: Evidence indicates that the reporting of serious injury in long-term residential care has increased substantially over the past decade. However, what constitutes a serious injury in residential care is poorly and inconsistently defined. This may result in incidences being unnecessarily reported as a serious injury. It is therefore, crucial to develop a consistent definition of serious injury to reduce reporting burden and to facilitate comparison between different residential care settings and across jurisdictions. This protocol describes the methods for a systematic review of existing definitions from the literature to inform the development of a consistent definition of serious injury in long-term residential care. Methods: A wide range of published peer-reviewed and grey literature will be sought for this review, including guidance and policy documents. Searches will be conducted of databases including MEDLINE, CINAHL, SocINDEX, Academic Search Ultimate, and Westlaw International. Grey literature database searches will include Trip and Social Care Online. Country specific searches of government and health and social care websites will be conducted. Quality appraisal will be facilitated using the Quality Assessment for Diverse Studies (QuADS) tool and Tyndall's checklist. The level of confidence in the findings will be assessed using the GRADE CERQual approach. A customised data extraction form will be used to extract data to reduce the risk of bias. Conceptual content analysis of data will facilitate identification of definitions of serious injury and their frequency within texts. Conclusions: The findings will inform the development of a consistent definition of serious injury in long-term residential care that will reduce reporting burden, facilitate the accuracy of data collected and allow for comparison across jurisdictions. A more universal and consistent definition will enable regulators, policy makers, service providers and researchers to develop policy and practical interventions to prevent the occurrence of serious injury in long-term residential care.
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Affiliation(s)
- David Morrissey
- Health Information and Quality Authority (HIQA), Cork, T12 Y2XT, Ireland
| | | | - Laura Behan
- Health Information and Quality Authority (HIQA), Cork, T12 Y2XT, Ireland
| | - Martin McMahon
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, D02 PN40, Ireland
| | - Laura M. Keyes
- Health Information and Quality Authority (HIQA), Cork, T12 Y2XT, Ireland
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Shim J, Pavlova AV, Moss RA, MacLean C, Brandie D, Mitchell L, Greig L, Parkinson E, Tzortziou Brown V, Morrissey D, Alexander L, Cooper K, Swinton PA. Patient ratings in exercise therapy for the management of tendinopathy: a systematic review with meta-analysis. Physiotherapy 2023; 120:78-94. [PMID: 37406460 DOI: 10.1016/j.physio.2023.05.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/26/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE To synthesise exercise therapy intervention data investigating patient rating outcomes for the management of tendinopathy. DESIGN A systematic review and meta-analysis of randomized controlled trials investigating exercise therapy interventions and reporting patient rating outcomes. SETTING Any setting in any country listed as very high on the human development index. PARTICIPANTS People with a diagnosis of any tendinopathy of any severity or duration. INTERVENTIONS Exercise therapy for the management of tendinopathy comprising five different therapy classes: 1) resistance; 2) plyometric; 3) vibration; 4) flexibility, and 5) movement pattern retraining modalities, were considered for inclusion. MAIN OUTCOME MEASURES Outcomes measuring patient rating of condition, including patient satisfaction and Global Rating of Change (GROC). RESULTS From a total of 124 exercise therapy studies, 34 (Achilles: 41%, rotator cuff: 32%, patellar: 15%, elbow: 9% and gluteal: 3%) provided sufficient information to be meta-analysed. The data were obtained across 48 treatment arms and 1246 participants. The pooled estimate for proportion of satisfaction was 0.63 [95%CrI: 0.53-0.73], and the pooled estimate for percentage of maximum GROC was 53 [95%CrI: 38-69%]. The proportion of patients reporting positive satisfaction and perception of change increased with longer follow-up periods from treatment onset. CONCLUSION Patient satisfaction and GROC appear similar and are ranked moderately high demonstrating that patients generally perceive exercise therapies positively. Further research including greater consistency in measurement tools is required to explore and where possible, identify patient- and exercise-related moderating factors that can be used to improve person-centred care. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO ID=CRD42020168187 CONTRIBUTION OF PAPER.
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Affiliation(s)
- J Shim
- School of Health Sciences, Robert Gordon University, Aberdeen, UK.
| | - A V Pavlova
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - R A Moss
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - C MacLean
- Library Services, Robert Gordon University, Aberdeen, UK
| | - D Brandie
- Sportscotland Institute of Sport, Stirling, UK
| | | | - L Greig
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - E Parkinson
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - V Tzortziou Brown
- Wolfson Institute of Population Health, Queen Mary University of London, UK
| | - D Morrissey
- William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - L Alexander
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - K Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - P A Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
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Haettner E, Geissel H, Franczak B, Kostyleva D, Purushothaman S, Tanaka Y, Amjad F, Boscolo D, Dickel T, Graeff C, Hessler C, Hornung C, Kazantseva E, Kuzminchuk N, Morrissey D, Mukha I, Pietri S, Rocco E, Roy P, Roesch H, Schuy C, Schütt P, Weber U, Weick H, Zhao J, Durante M, Parodi K, Scheidenberger C. Production and separation of positron emitters for hadron therapy at FRS-Cave M. Nucl Instrum Methods Phys Res B 2023; 541:114-116. [PMID: 37265512 PMCID: PMC7614599 DOI: 10.1016/j.nimb.2023.04.026] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The FRagment Separator FRS at GSI is a versatile spectrometer and separator for experiments with relativistic in-flight separated short-lived exotic beams. One branch of the FRS is connected to the target hall where the bio-medical cave (Cave M) is located. Recently a joint activity between the experimental groups of the FRS and the biophysics at the GSI and Department of physics at LMU was started to perform biomedical experiments relevant for hadron therapy with positron emitting carbon and oxygen beams. This paper presents the new ion-optical mode and commissioning results of the FRS-Cave M branch where positron emitting 15O-ions were provided to the medical cave for the first time. An overall conversion efficiency of 2.9±0.2×10-4 15O fragments per primary 16O ion accelerated in the synchrotron SIS18 was reached.
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Affiliation(s)
- E. Haettner
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - H. Geissel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- II. Physikalisches Institut, Justus-Liebig-Universität, 35392, Gieβen, Germany
| | - B. Franczak
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - D. Kostyleva
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - S. Purushothaman
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - Y.K. Tanaka
- RIKEN Cluster for Pioneering Research, RIKEN, 351-0198, Saitama, Japan
| | - F. Amjad
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - D. Boscolo
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - T. Dickel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- II. Physikalisches Institut, Justus-Liebig-Universität, 35392, Gieβen, Germany
| | - C. Graeff
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - C. Hessler
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - C. Hornung
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - E. Kazantseva
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - N. Kuzminchuk
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - D. Morrissey
- Department of Chemistry and NSCL, Michigan State University, 48824, East Lansing, USA
| | - I. Mukha
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - S. Pietri
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - E. Rocco
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - P. Roy
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - H. Roesch
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - C. Schuy
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - P. Schütt
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - U. Weber
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - H. Weick
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - J. Zhao
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
| | - M. Durante
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- Institut für Physik Kondensierter Materie, Technische Universität Darmstadt, 64289, Darmstadt, Germany
| | - K. Parodi
- Faculty of Physics, Department of Medical Physics, Ludwig-Maximilians-Universität München, 85748, München, Germany
| | - C. Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- II. Physikalisches Institut, Justus-Liebig-Universität, 35392, Gieβen, Germany
- Helmholtz Research Academy Hesse for FAIR (HFHF), GSI Helmholtz Center for Heavy Ion Research, Campus Gieβen, 35392, Gieβen, Germany
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Ibrahim H, Danish H, Morrissey D, Deasy KF, McCarthy M, Dorgan J, Fleming C, Howlett C, Twohig S, Vagg T, Murphy DM, Maher M, Plant BJ. Individualized approach to elexacaftor/tezacaftor/ivacaftor dosing in cystic fibrosis, in response to self-reported anxiety and neurocognitive adverse events: A case series. Front Pharmacol 2023; 14:1156621. [PMID: 37180712 PMCID: PMC10172465 DOI: 10.3389/fphar.2023.1156621] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
The prevalence of mental health disorders is high among people with Cystic Fibrosis. The psychological symptoms in CF are associated with poor adherence, worse treatment outcomes, and greater health utilization/cost. Mental health and neurocognitive Adverse Events (AEs) have been reported with all available Cystic Fibrosis Transmembrane conductance Regulator (CFTR) modulators in small groups of patients. We report our experience with a dose reduction strategy in 10 of our patients on elexacaftor/tezacaftor/ivacaftor (7.9% of total number of patients) who self-reported developing intense anxiety, irritability, sleep disturbance and/or mental slowness after initiation of full dose treatment. Standard dose elexacaftor/tezacaftor/ivacaftor resulted in 14.3 points improvement in mean Percent Predicted Forced Expiratory Volume in 1 s (ppFEV1), and a mean difference in sweat chloride of -39.3 mmol/L. We initially discontinued and/or reduced therapy according to the AEs severity, with a subsequent planned dose escalation every 4-6 weeks guided by sustainability of clinical effectiveness, absence of AEs recurrence, and patients' preferences. Clinical parameters including lung function and sweat chloride were monitored for up to 12 weeks to assess ongoing clinical response to the reduced dose regimen. Dose reduction resulted in resolution of self-reported mental/psychological AEs, without loss of clinical effectiveness (ppFEV1 was 80.7% on standard dose, and 83.4% at 12 weeks on reduced dose; sweat chloride was 33.4 and 34 mmol/L on standard and reduced dose, respectively). Furthermore, in a subgroup of patients who completed 24 weeks of the reduced dose regimen, repeat low dose Computed Tomography imaging showed a significant response when compared to pre-initiation of elexacaftor/tezacaftor/ivacaftor.
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Affiliation(s)
- Hisham Ibrahim
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - Hammad Danish
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
| | - David Morrissey
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - Kevin F. Deasy
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - Mairead McCarthy
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
| | - James Dorgan
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
| | - Claire Fleming
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
| | - Ciara Howlett
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
| | - Sarah Twohig
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
| | - Tamara Vagg
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - Desmond M. Murphy
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - Michael Maher
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - Barry J. Plant
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, University College Cork, Cork, Ireland
- *Correspondence: Barry J. Plant,
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Alsaleh SA, Murphy N, Miller SC, Morrissey D, Lack SD. Corrigendum to "Local neuromuscular characteristics associated with patellofemoral pain: A systematic review and meta-analysis"[Clinical Biomechanics 90 (2021) 105509]. Clin Biomech (Bristol, Avon) 2022; 98:105718. [PMID: 35850006 DOI: 10.1016/j.clinbiomech.2022.105718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- S A Alsaleh
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom; Medical Services Authority, Ministry of Defence, Kuwait.
| | - N Murphy
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom
| | - S C Miller
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom
| | - D Morrissey
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom
| | - S D Lack
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom
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Gulle H, Prior T, Coskunsu DK, Miller S, Birn-Jeffery A, Morrissey D. The association of demographic, psychological, social and activity factors with foot health in people with plantar heel pain: Case-control study. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.261] [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: 10/19/2022]
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Gulle H, Yuceturk H, Sakar C, Joyner C, Marsh W, Unal E, Morrissey D, Yet B. Can Bayesian statistical approaches reduce the questionnaire burden for respondents when PROMs and PREMs are administered electronically? Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.019] [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: 11/16/2022]
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Tayfur A, Sendil A, Sezik A, Jean-François K, Sancho I, Le Sant G, Donmez G, Duman M, Tayfur B, Pawson J, Uzlasir S, Miller S, Screen H, Morrissey D. Self-reported bio-psycho-social factors partially distinguish patellar tendinopathy from other knee problems and explain severity in jumping athletes: A case–control study. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.052] [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: 10/19/2022]
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Delen M, Şendil A, Jean-François K, Pedret C, Le Sant G, Pawson J, Miller S, Birn-Jeffery A, Morrissey D. Do bio-psycho-social self-reported factors distinguish rotator cuff tendinopathy from other shoulder problems and explain shoulder severity? A case–control study. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.028] [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: 11/26/2022]
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Bremer T, Nicklen P, Fearon A, Morrissey D. Management of gluteal tendinopathy: A systematic review and meta-analysis of all interventions. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.164] [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: 11/25/2022]
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Hill A, Keith-Jopp C, Joyner C, Marsh W, Morrissey D. Developing BENDi: A BayEsian Network DecIsion support tool for managing low back pain. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.052] [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: 10/19/2022]
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Alsaleh SA, Murphy NA, Miller SC, Morrissey D, Lack SD. Local neuromuscular characteristics associated with patellofemoral pain: A systematic review and meta-analysis. Clin Biomech (Bristol, Avon) 2021; 90:105509. [PMID: 34678670 DOI: 10.1016/j.clinbiomech.2021.105509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 04/28/2021] [Revised: 09/28/2021] [Accepted: 10/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Local neuromuscular deficits have been reported in people with patellofemoral pain. We synthesised the neuromuscular characteristics associated with patellofemoral pain to help identify interventional targets and potential mechanisms. METHODS Five databases were searched for local neuromuscular characteristics in case-control studies. Electromyography, flexibility, muscle performance and cross-sectional area data were derived from functional or isolated task investigations and synthesised accordingly. An evidence gap map was constructed. FINDINGS Sixty-seven studies were included. In functional tasks, electromyographic investigations showed moderate evidence of small effect for vastus medialis onset-delays relative to vastus lateralis (0.44 [0.03, 0.85]) during stepping/stair negotiation tasks, and higher biceps femoris mean excitation amplitudes (0.55 [0.06, 1.04]) in single-leg triple-hop test. In isolated tasks, we found moderate evidence of medium effect for lower Hoffman-reflex amplitude of vastus medialis (-1.12 [-1.56, -0.67]). Muscle performance investigations showed; strong evidence with medium and small effects for lower extensors concentric (-0.61 [-0.81, -0.40]) and eccentric (-0.56 [-0.79, -0.33]) strength, and moderate evidence of medium effect of lower isometric (-0.64 [-0.87, -0.41]) strength, moderate evidence with small effect for rate of force development to 30% (-0.55[-0.89, -0.21]), 60% (-0.57[-0.90, -0.25]) and medium effect to 90% (-0.76[-1.43, -0.10]) of maximum voluntary contraction, and small effect for lower flexors concentric strength (-0.46 [-0.74, -0.19]) and extensors total work (-0.48 [-0.90, -0.07]). Flexibility investigations showed tighter hamstrings (-0.57 [-0.99, -0.14]). INTERPRETATION Differences within quadriceps and hamstrings motor-control, hamstrings tightness, and quadriceps and hamstrings weakness are associated with patellofemoral pain, and can be used to guide investigations of treatment effects.
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Affiliation(s)
- S A Alsaleh
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom; Medical Services Authority, Ministry of Defence, Kuwait.
| | - N A Murphy
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom
| | - S C Miller
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom
| | - D Morrissey
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom; Physiotherapy Department, Barts Health NHS Trust, London, UK
| | - S D Lack
- Sports and Exercise Medicine, Queen Mary, University of London, London, United Kingdom; Pure Sports Medicine, London, UK
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Mohan K, Hintze JM, Morrissey D, Molony D. Incidence of avascular necrosis following biceps tenodesis during proximal humerus open reduction and internal fixation. Acta Orthop Belg 2021. [DOI: 10.52628/87.2.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Avascular necrosis (AVN) may occur in up to 77% of proximal humeral fractures and can cause fixation failure. Risk factors include fracture position, calcar length and medial hinge integrity. We routinely perform intra-articular biceps tenotomy with tenodesis at the level of pectoralis major to facilitate fragment identification and potentially ameliorate post-operative pain relief. Concern exists that tenotomising the biceps damages the adjacent arcuate artery, potentially increasing the rate of AVN. The purpose of this study was to evaluate whether biceps tenodesis is associated with an increased risk of radiographically evident humeral head AVN.
61 fractures surgically treated over a 52-month period were retrospectively reviewed and radiographically assessed in accordance with Neer’s classification, calcar-length and medial hinge integrity.
40, 20 and 1 were four-, three- and two-part fractures respectively. 37 had a calcar-length less than 8mm and 26 suffered loss of the medial hinge. The median radiographic follow-up was 23 months. There was radiographic evidence of humeral head AVN in only one case, comparing favourably to rates quoted in current literature.
In our experience, intra-articular biceps tenotomy with the deltopectoral approach was thus not associated with a significantly increased risk of humeral head AVN, even in complex four-part fractures.
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Mohan K, Hintze JM, Morrissey D, Molony D. Incidence of avascular necrosis following biceps tenodesis during proximal humerus open reduction and internal fixation. Acta Orthop Belg 2021; 87:339-346. [PMID: 34529390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Avascular necrosis (AVN) may occur in up to 77% of proximal humeral fractures and can cause fixation failure. Risk factors include fracture position, calcar length and medial hinge integrity. We routinely perform intra-articular biceps tenotomy with tenodesis at the level of pectoralis major to facilitate fragment identification and potentially ameliorate post-operative pain relief. Concern exists that tenotomising the biceps damages the adjacent arcuate artery, potentially increasing the rate of AVN. The purpose of this study was to evaluate whether biceps tenodesis is associated with an increased risk of radiographically evident humeral head AVN. 61 fractures surgically treated over a 52-month period were retrospectively reviewed and radiographically assessed in accordance with Neer's classification, calcar-length and medial hinge integrity. 40, 20 and 1 were four-, three- and two-part fractures respectively. 37 had a calcar-length less than 8mm and 26 suffered loss of the medial hinge. The median radiographic follow-up was 23 months. There was radiographic evidence of humeral head AVN in only one case, comparing favourably to rates quoted in current literature. In our experience, intra-articular biceps tenotomy with the deltopectoral approach was thus not associated with a significantly increased risk of humeral head AVN, even in complex four-part fractures.
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15
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Tayfur A, Salles JI, Miller SC, Screen H, Morrissey D. Patellar tendinopathy outcome predictors in jumping athletes: feasibility of measures for a cohort study. Phys Ther Sport 2020; 44:75-84. [PMID: 32460219 DOI: 10.1016/j.ptsp.2020.05.004] [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] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/27/2020] [Accepted: 05/10/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The main aim was to assess feasibility by testing data collection procedures for a cohort study. Measurements validity and reliability were secondary objectives. DESIGN Feasibility study. SETTING Combination of remote contact, assessment in clinic and biomechanical evaluation. PARTICIPANTS 36 jumping athletes (female:17, male:19) equally spread between those with patellar tendinopathy, other knee problems and controls. MAIN OUTCOME MEASURES Measurements validity, reliability and feasibility. RESULTS There was no systematic difference between administration methods for patient reported outcome measures and miscellaneous questions (range of d = -0.32 to 0.26) without any order effect (all p > 0.05) except KOOS-PF (p = 0.02). Questionnaires' inter-session reliability was moderate to excellent (ICCs = 0.68-0.93). Pain maps were 94% matched between methods. Training load recall percentage decreased until week-3 with only 20% maintaining a training diary completing the full 6 weeks. The graded loaded challenge was clinically applicable, biomechanically valid with increasing load through progression and reliable (ICCs = 0.63-0.98). CONCLUSION The tested questionnaires were valid and reliable for online use, therefore being suitable for clinical and research purposes. A shorter survey to reduce burden and collecting training load using shorter recall duration should improve feasibility. Biomechanical measures were valid and reliable, and a graded loaded challenge, suitable for further testing, has been defined.
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Affiliation(s)
- A Tayfur
- Sports and Exercise Medicine, QMUL, UK; Barts Health NHS trust, London, UK
| | | | | | - H Screen
- School of Engineering Material Sciences, QMUL, UK
| | - D Morrissey
- Sports and Exercise Medicine, QMUL, UK; Barts Health NHS trust, London, UK.
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Hebda-Boon A, Maizen C, Bijlsma P, Firth G, Morrissey D. Maximising impact of gait analysis reports on non-surgical management of children with neurodisability - clinical service evaluation. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.092] [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: 10/24/2022]
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17
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Morton S, Chan O, Ghozlan A, Price J, Perry J, Morrissey D. High volume image guided injections and structured rehabilitation in shoulder impingement syndrome: a retrospective study. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2015.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Morton
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
| | - O. Chan
- BMI London Independent Hospital, London, UK
| | - A. Ghozlan
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
| | - J. Price
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
| | - J. Perry
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
- BMI London Independent Hospital, London, UK
| | - D. Morrissey
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
- BMI London Independent Hospital, London, UK
- Physiotherapy Department, Bart’s Health NHS Trust, London, UK
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18
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Morton S, Chan O, Price J, Pritchard M, Crisp T, Perry J, Morrissey D. High volume image-guided injections and structured rehabilitation improve greater trochanter pain syndrome in the short and medium term: a combined retrospective and prospective case series. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.02.2015.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Morton
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, UK
| | - O. Chan
- Department of Orthopedic Surgery, University of Basel, Switzerland
| | - J. Price
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, UK
| | | | - T. Crisp
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, UK
- BMI London Independent Hospital, UK
| | - J.D. Perry
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, UK
- BMI London Independent Hospital, UK
| | - D. Morrissey
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, UK
- BMI London Independent Hospital, UK
- Physiotherapy Department, Bart’s Health NHS Trust, London, UK
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Morton S, Chan O, King J, Crisp T, Maffulli N, Morrissey D. High volume image-guided Injections for patellar tendinopathy: a combined retrospective and prospective case series. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.02.2014.22] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Morton
- Centre for Sports and Exercise Medicine, William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London, Mile End Hospital, London, UK
| | - O. Chan
- BMI London Independent Hospital
| | - J. King
- Centre for Sports and Exercise Medicine, William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital
| | - T. Crisp
- Centre for Sports and Exercise Medicine, William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital
| | - N. Maffulli
- BMI London Independent Hospital
- Head of Department of Physical and Rehabilitation Medicine, University of Salerno, Azienda Ospedaliera San Giovanni di Dio e Ruggi D’Aragona, Salerno, Italy
| | - D. Morrissey
- Centre for Sports and Exercise Medicine, William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital
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20
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Morton S, Chan O, Webborn N, Pritchard M, Morrissey D. Tears of the fascia cruris demonstrate characteristic sonographic features: a case series analysis. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.04.2015.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Morton
- Centre for Sports and Exercise Medicine, Queen Mary University of London, UK
| | - O. Chan
- BMI London Independent Hospital, London, UK
| | - N. Webborn
- Centre for Sports and Exercise Science and Medicine, University of Brighton, Eastbourne, UK
| | | | - D. Morrissey
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London, UK; BMI London Independent Hospital, London, UK
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21
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Chan O, Havard B, Morton S, Pritchard M, Maffulli N, Crisp T, Padhiar N, Perry J, King J, Morrissey D. Outcomes of prolotherapy for intra-tendinous Achilles tears: a case series. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2017.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- O. Chan
- BMI London Independent Hospital, Stepney Green, London, UK
| | - B. Havard
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
| | - S. Morton
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
| | - M. Pritchard
- BMI London Independent Hospital, Stepney Green, London, UK
| | - N. Maffulli
- BMI London Independent Hospital, Stepney Green, London, UK
| | - T. Crisp
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital, Stepney Green, London, UK
| | - N. Padhiar
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital, Stepney Green, London, UK
| | - J.D. Perry
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital, Stepney Green, London, UK
| | - J. King
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- BMI London Independent Hospital, Stepney Green, London, UK
| | - D. Morrissey
- BMI London Independent Hospital, Stepney Green, London, UK
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- Bart’s Health NHS Trust, London, UK
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22
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Chan O, Morton S, Pritchard M, Parkes T, Malliaras P, Crisp T, Padhiar N, Maffulli N, King J, Morrissey D. Intratendinous tears of the Achilles tendon - a new pathology? Analysis of a large 4-year cohort. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2017.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- O. Chan
- BMI London Independent Hospital, London, UK
| | - S. Morton
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
| | | | - T. Parkes
- BMI London Independent Hospital, London, UK
| | - P. Malliaras
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
| | - T. Crisp
- BMI London Independent Hospital, London, UK>
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- Bart’s Health NHS Trust, London, UK
| | - N. Padhiar
- BMI London Independent Hospital, London, UK>
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
| | - N. Maffulli
- BMI London Independent Hospital, London, UK>
| | - J. King
- BMI London Independent Hospital, London, UK>
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
- Bart’s Health NHS Trust, London, UK
| | - D. Morrissey
- BMI London Independent Hospital, London, UK>
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, London, UK
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23
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Salles JI, Guimarães JM, Filho GM, Morrissey D. Effect of a specific exercise strategy on strength and proprioception in volleyball players with infraspinatus muscle atrophy. Scand J Med Sci Sports 2018; 28:2093-2099. [PMID: 29772095 DOI: 10.1111/sms.13216] [Citation(s) in RCA: 5] [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] [Accepted: 05/04/2018] [Indexed: 11/30/2022]
Abstract
Infraspinatus muscle atrophy is common in professional volleyball players, but it is unclear whether commonly observed strength and proprioception deficits can be reversed with training. Fifty-four participants were recruited into an infraspinatus atrophy group (IAG, n = 18) and a non-atrophy group (NAG, n = 18) of elite volleyballers plus a healthy non-athletic control group (CG, n = 18). IAG were trained with a progressive, specific shoulder external rotator strengthening routine for 32 sessions over 8 weeks. Shoulder external rotation peak torque (SERPT) and threshold to detect passive movement (TTDPM) and joint position sense (JPS) were measured before and after the intervention. At baseline, no significant difference was detected in strength or proprioception between the injured and control groups, but the normal athletes were stronger and had better proprioception than either IAG or CG (P < .001). IAG (d = 2.78) and NAG (d = 0.442) improved strength significantly after training. IAG improved TTDM and JPS (P < .001, d = -0.719 and -2.942, respectively) but were still worse than NAG (P < .001). Elite volleyball players with Infraspinatus muscle atrophy have strength and proprioception deficits which can be improved by a specific exercise program to normal but not elite athlete control levels.
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Affiliation(s)
- J I Salles
- Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, UK.,Fédération Internationale de Volleyball (FIVB) Coach Commission, Lausanne, Switzerland
| | - J M Guimarães
- Research Division, National Institute of Traumatology and Orthopedic (INTO), Rio de Janeiro, RJ, Brazil
| | - G M Filho
- Research Division, National Institute of Traumatology and Orthopedic (INTO), Rio de Janeiro, RJ, Brazil
| | - D Morrissey
- Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, UK.,Phyisotherapy Department, Barts Health NHS Trust, London, UK
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24
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Bourke L, Stevenson R, Turner R, Hooper R, Sasieni P, Greasley R, Morrissey D, Loosemore M, Fisher A, Payne H, Taylor SJC, Rosario DJ. Exercise training as a novel primary treatment for localised prostate cancer: a multi-site randomised controlled phase II study. Sci Rep 2018; 8:8374. [PMID: 29849032 PMCID: PMC5976628 DOI: 10.1038/s41598-018-26682-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 01/19/2018] [Accepted: 05/11/2018] [Indexed: 11/22/2022] Open
Abstract
Alternative management strategies for localised prostate cancer are required to reduce morbidity and overtreatment. The aim of this study was to evaluate the feasibility, safety and acceptability of exercise training (ET) with behavioural support as a primary therapy for low/intermediate risk localised prostate cancer. Men with low/intermediate-risk prostate cancer were randomised to 12 months of ET or usual care with physical activity advice (UCwA) in a multi-site open label RCT. Feasibility included acceptability, recruitment, retention, adherence, adverse events and disease progression. Secondary outcomes included quality of life and cardiovascular health indices. Of the 50 men randomised to ET (n = 25) or UCwA (n = 25), 92% (n = 46) completed 12 month assessments. Three men progressed to invasive therapy (two in UCwA). In the ET group, men completed mean: 140 mins per week for 12 months (95% CI 129,152 mins) (94% of target dose) at 75% Hrmax. Men in the ET group demonstrated improved body mass (mean reduction: 2.0 kg; 95% CI -2.9,-1.1), reduced systolic (mean: 13 mmHg; 95%CI 7,19) and diastolic blood pressure (mean:8 mmHg; 95% CI 5,12) and improved quality of life (EQ.5D mean:13 points; 95% CI 7,18). There were no serious adverse events. ET in men with low/intermediate risk prostate cancer is feasible and acceptable with a low progression rate to radical treatment. Early signals on clinically relevant markers were found which warrant further investigation.
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Affiliation(s)
- L Bourke
- Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
| | - R Stevenson
- Acute Therapy Services, Sheffield Teaching Hospitals, Sheffield, UK
| | - R Turner
- Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
| | - R Hooper
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - P Sasieni
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - R Greasley
- Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
| | - D Morrissey
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - M Loosemore
- Institute of Sport Exercise and Health, University College Hospitals, London, UK
| | - A Fisher
- Department of Behavioural Science & Health, University College London, London, UK
| | - H Payne
- University College Hospitals, London, UK
| | - S J C Taylor
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - D J Rosario
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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25
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Tytherleigh-Strong G, Rashid A, Lawrence C, Morrissey D. Arthroscopic Sternoclavicular Joint Diskectomy for Acute and Chronic Tears. Arthroscopy 2017; 33:1965-1970. [PMID: 28847575 DOI: 10.1016/j.arthro.2017.06.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/07/2017] [Accepted: 06/17/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To describe the results and functional scores in a group of patients who underwent arthroscopic excision of a symptomatic sternoclavicular joint (SCJ) disk tear with a minimum follow-up period of 2 years. METHODS Between April 2010 and December 2014, 14 patients underwent arthroscopic excision of a torn SCJ disk. Patients whose intended surgery was an isolated diskectomy and underwent that surgery only, with no additional procedure, were included. The minimum follow-up period was 24 months. All patients underwent an arthroscopic SCJ diskectomy. Postoperatively, no immobilization was required, and the patients were encouraged to mobilize as pain permitted. The patients were assessed preoperatively and at final follow-up with the visual analog scale score for pain, Rockwood score, and QuickDASH (short version of the Disabilities of the Arm, Shoulder and Hand questionnaire) score. RESULTS The average age at surgery was 29.4 years (range, 19-39 years). Ten of the patients had been symptom free before a specific incident, after which SCJ symptoms developed. The other 4 patients reported a gradual onset of symptoms and were considered to have chronic tears. The average duration of symptoms was 22.8 months (range, 6-48 months). At a mean follow-up of 33.4 months (range, 24-59 months), a significant improvement in the Rockwood score was noted, from 7 (range, 5-9; standard deviation [SD], 1.4) to 13.6 (range, 9-15; SD, 1.9) (P = .001) (minimal clinically important difference not described). The mean QuickDASH score improved from 23.7 points (range, 6.8-40.9 points; SD, 11.8 points) to 8 points (range, 0-29.5 points; SD, 9 points) (P = .0024) (minimal clinically important difference, 13.4 points). There were no reported complications and specifically no instability. CONCLUSIONS The results of this series suggest that arthroscopic SCJ diskectomy is a safe and reproducible procedure for the treatment of patients with symptomatic SCJ disk tears. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Graham Tytherleigh-Strong
- Division of Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, England.
| | - Abbas Rashid
- Division of Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, England
| | - Christopher Lawrence
- Division of Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, England
| | - David Morrissey
- Division of Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, England
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Harris E, Liu Y, Cunniffe G, Morrissey D, Carroll S, Mulhall K, Kelly DJ. Biofabrication of soft tissue templates for engineering the bone-ligament interface. Biotechnol Bioeng 2017. [DOI: 10.1002/bit.26362] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Ella Harris
- Trinity Centre for Bioengineering; Trinity Biomedical Sciences Institute; Trinity College Dublin Dublin Ireland
| | - Yurong Liu
- Trinity Centre for Bioengineering; Trinity Biomedical Sciences Institute; Trinity College Dublin Dublin Ireland
| | - Grainne Cunniffe
- Trinity Centre for Bioengineering; Trinity Biomedical Sciences Institute; Trinity College Dublin Dublin Ireland
- Department of Mechanical and Manufacturing Engineering; School of Engineering; Trinity College Dublin Dublin Ireland
| | | | - Simon Carroll
- Trinity Centre for Bioengineering; Trinity Biomedical Sciences Institute; Trinity College Dublin Dublin Ireland
- Department of Mechanical and Manufacturing Engineering; School of Engineering; Trinity College Dublin Dublin Ireland
| | - Kevin Mulhall
- Trinity Centre for Bioengineering; Trinity Biomedical Sciences Institute; Trinity College Dublin Dublin Ireland
- Royal College of Surgeons in Ireland; Dublin Ireland
| | - Daniel J. Kelly
- Trinity Centre for Bioengineering; Trinity Biomedical Sciences Institute; Trinity College Dublin Dublin Ireland
- Department of Mechanical and Manufacturing Engineering; School of Engineering; Trinity College Dublin Dublin Ireland
- Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER); Royal College of Surgeons in Ireland and Trinity College Dublin; Dublin Ireland
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27
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Tytherleigh-Strong G, Rashid A, Lawrence C, Morrissey D. Arthroscopic Intra-articular Disk Excision of the Sternoclavicular Joint. Arthrosc Tech 2017; 6:e599-e605. [PMID: 28706805 PMCID: PMC5495580 DOI: 10.1016/j.eats.2017.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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] [Received: 10/24/2016] [Accepted: 01/05/2017] [Indexed: 02/03/2023] Open
Abstract
The sternoclavicular joint (SCJ) has a complete intra-articular disk that can be damaged either as a result of trauma or as part of ongoing degenerative joint disease. Although often asymptomatic, SCJ disk tears may lead to mechanical symptoms and pain. Previously, isolated symptomatic SCJ disk tears have only occasionally been mentioned in the literature with a few associated case reports of diskectomy by open arthrotomy. With improved imaging and availability of magnetic resonance imaging scans and the advent of SCJ arthroscopy it is now possible to treat symptomatic SCJ disk tears by arthroscopic excision. In this Technical Note, we describe the diagnosis of a torn SCJ disk and the technique of arthroscopic excision of a torn SCJ disk.
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Affiliation(s)
- Graham Tytherleigh-Strong
- Address correspondence to Graham Tytherleigh-Strong, F.R.C.S. (Orth.), F.F.E.S.M. (U.K.), Division of Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospital Trust, Hills Road, Cambridge CB2 2QQ, UK.Division of OrthopaedicsAddenbrooke's HospitalCambridge University Hospital TrustHills RoadCambridgeCB2 2QQUK
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Neal B, Domone S, Griffiths I, Barton C, Morrissey D. The effects & mechanisms of running retraining in the management of patellofemoral pain: A feasibility study. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.165] [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: 11/29/2022]
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29
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Sahemey R, Malliaras P, Lewis JS, Michael GJ, Shortland P, Morrissey D, Maffulli N. Tendinopathic supraspinatus tenocytes may have a neuroendocrine-like function, secreting CGRP, SP and VEGF: a pilot immunohistochemistry study. J BIOL REG HOMEOS AG 2016; 30:219-227. [PMID: 28002923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We wanted to observe and compare the appearance of neurovascular tissue from tendon ex vivo, in patients with and without painful rotator cuff tendinopathy. Supraspinatus tendons were biopsied from 5 participants with painful tendinopathy and normal tendon from a young male. Slides were stained with haematoxylin and eosin and toluidine blue for histological assessment. Immunohistochemical markers for general nerves (protein gene-product 9.5 and synaptophysin), sensory nerves (calcitonin gene-related peptide; substance-P) and vascularisation (vascular endothelial growth factor) were used. PGP9.5 and CGRP-immunoreactive fibres were associated with vessels in cases and control. Synaptophysinlabelled fibres were observed in close relation to vessels in tendinopathy. PGP9.5, CGRP, SP and VEGF-immunoreaction also labelled tenocyte-like cells in degenerative areas and fibres in regions of fat and collagen. Sensory innervation and vascularity are increased in tendinopathy. The evidence for innervation and vascularity of symptomatic rotator cuff tendon may aid the development of novel investigations and therapies in the management of patients with this ailment.
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Affiliation(s)
- R Sahemey
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - P Malliaras
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - J S Lewis
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - G J Michael
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - P Shortland
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - D Morrissey
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - N Maffulli
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
- Department of Musculoskeletal Surgery, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy
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30
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Abstract
Towards the end of my first year of training, I was on placement on a hospital ward when I heard the alarm bell go off in a bathroom.
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31
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Waugh CM, Morrissey D, Jones E, Riley GP, Langberg H, Screen HRC. In vivo biological response to extracorporeal shockwave therapy in human tendinopathy. Eur Cell Mater 2015; 29:268-80; discussion 280. [PMID: 25978115 DOI: 10.22203/ecm.v029a20] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [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] [Indexed: 01/31/2023] Open
Abstract
Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment for chronic tendinopathies, however little is known about the in-vivo biological mechanisms of ESWT. Using microdialysis, we examined the real-time biological response of healthy and pathological tendons to ESWT. A single session of ESWT was administered to the mid-portion of the Achilles tendon in thirteen healthy individuals (aged 25.7 ± 7.0 years) and patellar or Achilles tendon of six patients with tendinopathies (aged 39.0 ± 14.9 years). Dialysate samples from the surrounding peri-tendon were collected before and immediately after ESWT. Interleukins (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17A, vascular endothelial growth factor and interferon-γ were quantified using a cytometric bead array while gelatinase activity (MMP-2 and -9) was examined using zymography. There were no statistical differences between the biological tissue response to ESWT in healthy and pathological tendons. IL-1β, IL-2, IL-6 and IL-8 were the cytokines predominantly detected in the tendon dialysate. IL-1β and IL-2 did not change significantly with ESWT. IL-6 and IL-8 concentrations were elevated immediately after ESWT and remained significantly elevated for four hours post-ESWT (p < 0.001). Pro-forms of MMP-2 and -9 also increased after ESWT (p < 0.003), whereas there were no significant changes in active MMP forms. In addition, the biological response to ESWT treatment could be differentiated between possible responders and non-responders based on a minimum 5-fold increase in any inflammatory marker or MMP from pre- to post-ESWT. Our findings provide novel evidence of the biological mechanisms underpinning ESWT in humans in vivo. They suggest that the mechanical stimulus provided by ESWT might aid tendon remodelling in tendinopathy by promoting the inflammatory and catabolic processes that are associated with removing damaged matrix constituents. The non-response of some individuals may help to explain why ESWT does not improve symptoms in all patients and provides a potential focus for future research.
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Affiliation(s)
- C M Waugh
- School of Engineering & Materials Science, Queen Mary, University of London, Mile End Road, London, E1 4NS,
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O Mir M, Morrissey D, Noel J, Kelly P. Sports participation amongst children treated with the Ponseti method for Idiopathic Congenital Talipes Equinovarus. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.2012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Daly C, McCarthy Persson U, Twycross-Lewis R, Woledge RC, Morrissey D. The biomechanics of running in athletes with previous hamstring injury: A case-control study. Scand J Med Sci Sports 2015; 26:413-20. [DOI: 10.1111/sms.12464] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 01/13/2023]
Affiliation(s)
- C. Daly
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
| | - U. McCarthy Persson
- School of Public Health, Physiotherapy & Population Science; Health Sciences Centre; University College Dublin; Dublin Ireland
| | - R. Twycross-Lewis
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
| | - R. C. Woledge
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
| | - D. Morrissey
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Bart's and the London School of Medicine and Dentistry; Mile End Hospital; Queen Mary University of London; London U.K
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Weppelmann TA, Alam MT, Widmer J, Morrissey D, Rashid MH, Beau De Rochars VM, Morris JG, Ali A, Johnson JA. Feasibility of the hydrogen sulfide test for the assessment of drinking water quality in post-earthquake Haiti. Environ Monit Assess 2014; 186:8509-8516. [PMID: 25182685 PMCID: PMC4213301 DOI: 10.1007/s10661-014-4020-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 08/21/2014] [Indexed: 05/30/2023]
Abstract
In 2010, a magnitude 7.0 earthquake struck Haiti, severely damaging the drinking and wastewater infrastructure and leaving millions homeless. Compounding this problem, the introduction of Vibrio cholerae resulted in a massive cholera outbreak that infected over 700,000 people and threatened the safety of Haiti's drinking water. To mitigate this public health crisis, non-government organizations installed thousands of wells to provide communities with safe drinking water. However, despite increased access, Haiti currently lacks the monitoring capacity to assure the microbial safety of any of its water resources. For these reasons, this study was designed to assess the feasibility of using a simple, low-cost method to detect indicators of fecal contamination of drinking water that could be implemented at the community level. Water samples from 358 sources of drinking water in the Léogâne flood basin were screened with a commercially available hydrogen sulfide test and a standard membrane method for the enumeration of thermotolerant coliforms. When compared with the gold standard method, the hydrogen sulfide test had a sensitivity of 65 % and a specificity of 93 %. While the sensitivity of the assay increased at higher fecal coliform concentrations, it never exceeded 88 %, even with fecal coliform concentrations greater than 100 colony-forming units per 100 ml. While its simplicity makes the hydrogen sulfide test attractive for assessing water quality in low-resource settings, the low sensitivity raises concerns about its use as the sole indicator of the presence or absence of fecal coliforms in individual or community water sources.
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Affiliation(s)
- Thomas A. Weppelmann
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, PO Box 100188, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
| | - Meer T. Alam
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, PO Box 100188, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
- Laboratwa Sante Piblik Christianville, Haiti
| | - Jocelyn Widmer
- Urban Affairs and Planning, School of Public and International Affairs, Virginia Tech University, 140 Otey Street, Blacksburg, VA 24061, USA
| | | | - Mohammed H. Rashid
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
| | - Valery M. Beau De Rochars
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
- Laboratwa Sante Piblik Christianville, Haiti
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - J. Glenn Morris
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
| | - Afsar Ali
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, PO Box 100188, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
| | - Judith A. Johnson
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
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Joseph C, Morrissey D, Abdur-Rahman M, Hussenbux A, Barton C. Musculoskeletal triage: a mixed methods study, integrating systematic review with expert and patient perspectives. Physiotherapy 2014; 100:277-89. [PMID: 25242531 DOI: 10.1016/j.physio.2014.03.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 06/28/2013] [Accepted: 03/03/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Triage is implemented in healthcare settings to optimise access to appropriate care and manage waiting times. OBJECTIVES To determine the optimum features of triage systems for patients with musculoskeletal conditions. DATA SOURCES AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, MEDLINE, Cochrane Library, Web of Science and Google Scholar. STUDY SELECTION OR ELIGIBILITY CRITERIA Studies that included non-musculoskeletal conditions, concerned patients aged <18 years or were set in emergency departments were excluded. STUDY APPRAISAL AND SYNTHESIS METHODS Study quality was graded using the Downs and Black quality index. Qualitative methods were used to further inform the findings of the literature review. RESULTS Thirty-four studies met the inclusion criteria, with study quality ranging from eight to 24 out of a possible 27. Musculoskeletal triage is conducted via face-to-face consultation, paper referral letter or telephone consultation. Triage performed by physiotherapists, general practitioners, multidisciplinary teams, nurses, occupational therapists and speech therapists has been shown to be effective using a range of outcomes. Qualitative data revealed the value of supportive interdisciplinary teams, and suggested that this support is more important than choice of clinician. Patients trusted, and expressed preferences for, experienced clinicians to perform triage. CONCLUSION Triage can be performed effectively via a number of methods and by a range of clinicians. Satisfaction, cost, diagnostic agreement, appropriateness of referral and waiting list time have been improved though triage. Multidisciplinary support mechanisms are critical elements of successful triage systems. Patients are more concerned with access issues than professional boundaries.
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Affiliation(s)
- C Joseph
- Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK; Clinical Research Centre for Movement Disorders and Gait, Southern Health Centre, Victoria, Australia
| | - D Morrissey
- Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK; Physiotherapy Department, Bart's Health NHS trust, London, UK.
| | - M Abdur-Rahman
- Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - A Hussenbux
- Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - C Barton
- Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK; Complete Sports Care, Melbourne, Victoria, Australia; Musculoskeletal Research Centre, La Trobe University, Bundoora, Victoria, Australia; Pure Sports Medicine, London, UK
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Morton S, Morrissey D, Valle X, Chan O, Langberg H, Malliaras P. Equivalence of online and clinician administration of a patellar tendinopathy risk factor and severity questionnaire. Scand J Med Sci Sports 2014; 25:670-7. [DOI: 10.1111/sms.12334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2014] [Indexed: 12/23/2022]
Affiliation(s)
- S. Morton
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Mile End Hospital; Queen Mary University of London; London UK
| | - D. Morrissey
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Mile End Hospital; Queen Mary University of London; London UK
- BMI London Independent Hospital; London UK
- Bart's Health NHS Trust; London UK
| | - X. Valle
- FC Barcelona; Ciutat Esportiva Joan Gamper; Barcelona UK
| | - O. Chan
- BMI London Independent Hospital; London UK
| | - H. Langberg
- Department of Public Health; Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - P. Malliaras
- Centre for Sports and Exercise Medicine; William Harvey Research Institute; Mile End Hospital; Queen Mary University of London; London UK
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Hussenbux A, Morrissey D, Joseph C, McClellan CM. Intermediate care pathways for musculoskeletal conditions--are they working? A systematic review. Physiotherapy 2014; 101:13-24. [PMID: 25442485 DOI: 10.1016/j.physio.2014.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 03/23/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Musculoskeletal condition assessment and management is increasingly delivered at the primary to secondary care interface, by inter-disciplinary triage and treat services. OBJECTIVES This review aimed to describe Intermediate Care pathways, evaluate effectiveness, describe outcomes and identify gaps in the evidence. DATA SOURCES PubMed, ISI Web of Science, EMBASE, Ovid Medline, PEDro, Google Scholar to October 2013. STUDY SELECTION/ELIGIBILITY CRITERIA Studies in English that evaluated relevant services were considered for inclusion. Studies evaluating paediatric or emergency medicine and self-referral were excluded. RESULTS Twenty-three studies were identified. Between 72% and 97% of patients could be managed entirely within Intermediate Care with a 20% to 60% resultant reduction in orthopaedic referral rate. Patient reported outcome measures typically showed significant symptom improvements. Knee conditions were most commonly referred on to secondary care (35% to 56%), with plain films (5% to 23%) and MRI (10% to 18%) the commonest investigations. Physiotherapists' clinical decision making and referral accuracy were comparable to medical doctors in 68% to 96% of cases. Intermediate Care consistently leads to significantly reduced orthopaedic waiting times and high patient satisfaction. LIMITATIONS These findings are not based on strong evidence and there is an urgent need for high-quality, prospective, comprehensive evaluation of Intermediate Care provision, including cost-effectiveness and impact on other services. FUNDING Part funded by EPSRC and AXA-PPP. CONCLUSION Intermediate Care consistently improves patient outcome, typically results in appropriate referral and management, reduces waiting times and increases patient satisfaction. There is a case for wider provision of Intermediate Care services to effectively manage non-surgical musculoskeletal patients.
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Affiliation(s)
- A Hussenbux
- Centre for Sports and Exercise Medicine, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, Bancroft Road, London E1 4DG, UK
| | - D Morrissey
- Centre for Sports and Exercise Medicine, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, Bancroft Road, London E1 4DG, UK; Physiotherapy Department, Bart's Health NHS Trust, London, UK.
| | - C Joseph
- Centre for Sports and Exercise Medicine, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, Bancroft Road, London E1 4DG, UK
| | - C M McClellan
- Academic Department of Emergency Care, Adult Emergency Department, Bristol Royal Infirmary, University Hospitals NHS Foundation Trust, Bristol BS28HW, UK
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Kassam H, Tzortziou Brown V, O'Halloran P, Wheeler P, Fairclough J, Maffulli N, Morrissey D. General practitioners' attitude to sport and exercise medicine services: a questionnaire-based survey. Postgrad Med J 2014; 90:680-4. [PMID: 25352675 DOI: 10.1136/postgradmedj-2013-132245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM Sport and exercise medicine (SEM) aims to manage sporting injuries and promote physical activity. This study explores general practitioners' (GPs) awareness, understanding and utilisation of their local SEM services. DESIGN A questionnaire survey, including patient case scenarios, was administered between February and May 2011. PARTICIPANTS AND SETTING 693 GPs working in Cardiff and Vale, Leicester and Tower Hamlets were invited to participate. RESULTS 244 GPs responded to the questionnaire (35.2% response rate). Less than half (46%; 112/244) were aware of their nearest SEM service and only 38% (92/244) had a clear understanding on referral indications. The majority (82%; 199/244) felt confident advising less active patients about exercise. There were divergent management opinions about the case scenarios of patients who were SEM referral candidates. Overall, GPs were significantly more likely to refer younger patients and patients with sport-related problems rather than patients who would benefit from increasing their activity levels in order to prevent or manage chronic conditions (p<0.01). GPs with previous SEM training were significantly more likely to refer (p<0.01). The majority (62%; 151/244) had never referred patients to their local SEM clinics but of those who had 75% (70/93) rated the service as good. CONCLUSIONS There is a lack of awareness and understanding among GPs on the role of SEM within the National Health Service which may be resulting in suboptimal utilisation especially for patients who could benefit from increasing their activity levels.
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Affiliation(s)
- H Kassam
- Centre for Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mann Ward, Mile End Hospital, London, UK
| | - V Tzortziou Brown
- Centre for Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mann Ward, Mile End Hospital, London, UK
| | - P O'Halloran
- Centre for Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mann Ward, Mile End Hospital, London, UK
| | - P Wheeler
- Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK School of Sport, Exercise and Health Sciences, Loughborough University, Bath, UK
| | - J Fairclough
- Department of Trauma and Orthopaedics, Cardiff and Vale University Local Health Board Headquarters, Whitchurch Hospital, Cardiff, UK
| | - N Maffulli
- Centre for Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mann Ward, Mile End Hospital, London, UK Department of Musculoskeletal Disorders, University of Salerno Medical School, Salerno, Italy
| | - D Morrissey
- Centre for Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mann Ward, Mile End Hospital, London, UK
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Drumm O, Chan O, Malliaras P, Morrissey D, Maffulli N. High-volume image-guided injection for recalcitrant medial collateral ligament injuries of the knee. Clin Radiol 2014; 69:e211-5. [PMID: 24568783 DOI: 10.1016/j.crad.2013.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 12/07/2013] [Accepted: 12/24/2013] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the effectiveness of a novel injection technique in the management of recalcitrant medial collateral ligament (MCL) injuries of the knee. MATERIALS AND METHODS The injection, comprising 10 ml local anaesthetic with 25-50 mg hydrocortisone, is directed beneath the periosteal attachment of the MCL. Twenty-eight patients who received the intervention were asked to complete a questionnaire, a visual analogue scale (VAS) and the International Knee Documentation Committee (IKDC) subjective knee form to quantify symptoms pre-injection and at follow-up. Data were assessed using descriptive statistics. Further analysis was conducted using the Wilcoxon signed-rank test and Fisher's exact test. RESULTS Sixty-eight percent (n = 19) of patients responded. Three patients were excluded according to the exclusion criteria. Of those studied, 37.5% (n = 6) were professional athletes. At follow-up, patients reported a mean improvement on the VAS of 75.5% (SD = 23.6). There was a significant improvement in IKDC scores (mean difference 42%, SD = 14.2) pre- and post-injection (Wilcoxon signed-rank test, p < 0.001). No residual symptoms were reported by 50% (n = 8) of patients, and a further 37.5% (n = 6) of patients had improved. Of those patients who played sport, two-thirds (n = 10) had returned to their previous level of sport at follow-up, including all of the professional athletes. CONCLUSION Periosteal high-volume image-guided injection is a useful treatment for recalcitrant MCL injury. Results are encouraging, particularly amongst the professional athletes studied.
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Affiliation(s)
- O Drumm
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK.
| | - O Chan
- Department of Radiology, London Independent Hospital, London, UK
| | - P Malliaras
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - D Morrissey
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - N Maffulli
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK; Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Surgery, Salerno, Italy
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Watura C, O'Halloran P, Maffulli N, Hughes C, Morrissey D. THE PROFILE OF PATIENTS ATTENDING NATIONAL HEALTH SERVICE SPORT AND EXERCISE MEDICINE CLINICS: A QUESTIONNAIRE BASED SURVEY. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.2] [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: 11/03/2022]
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Watura C, Barton C, Webborn N, Maffulli N, Morrissey D. SPORTS INJURIES AT THE OLYMPICS: A REVIEW OF INCIDENCE RELATED DATA FROM PAST GAMES AND THE IMPLICATIONS FOR FUTURE MULTI-SPORT EVENTS. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ferrer A, Chukwumerije K, Twycross-Lewis R, Woledge R, Morrissey D, Maffulli N. BIOMECHANICAL ANALYSIS OF THE ANTERIOR CRUCIATE LIGAMENT DEFICIENCY IN THE TRANSVERSE PLANE. A LABORATORY IN VIVO CONTROLLED STUDY. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092558.35] [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: 11/03/2022]
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Boos JA, Kirk DW, Piccolotto ML, Zuercher W, Gfeller S, Neuner P, Dattler A, Wishart WL, Von Arx F, Beverly M, Christensen J, Litherland K, van de Kerkhof E, Swart PJ, Faller T, Beyerbach A, Morrissey D, Hunziker J, Beuvink I. Whole-body scanning PCR; a highly sensitive method to study the biodistribution of mRNAs, noncoding RNAs and therapeutic oligonucleotides. Nucleic Acids Res 2013; 41:e145. [PMID: 23766292 PMCID: PMC3753639 DOI: 10.1093/nar/gkt515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Efficient tissue-specific delivery is a crucial factor in the successful development of therapeutic oligonucleotides. Screening for novel delivery methods with unique tissue-homing properties requires a rapid, sensitive, flexible and unbiased technique able to visualize the in vivo biodistribution of these oligonucleotides. Here, we present whole body scanning PCR, a platform that relies on the local extraction of tissues from a mouse whole body section followed by the conversion of target-specific qPCR signals into an image. This platform was designed to be compatible with a novel RT-qPCR assay for the detection of siRNAs and with an assay suitable for the detection of heavily chemically modified oligonucleotides, which we termed Chemical-Ligation qPCR (CL-qPCR). In addition to this, the platform can also be used to investigate the global expression of endogenous mRNAs and non-coding RNAs. Incorporation of other detection systems, such as aptamers, could even further expand the use of this technology.
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Affiliation(s)
- Julien A Boos
- Novartis Institutes for Biomedical Research (NIBR), Novartis Pharma AG, Basel, Basel-Stadt CH-4056, Switzerland and NIBR, Novartis Pharma AG, Cambridge, Massachusetts, MA 02139, USA
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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, Stanley K, Morrissey D, Parsons S, Kuttikat A, Shenker N, Garrood T, Medley S, Ferguson AM, Keeling D, Duffort P, Irving K, Goulston L, Culliford D, Coakley P, Taylor P, Hart D, Spector T, Hakim A, Arden N, Mian A, Garrood T, Magan T, Chaudhary M, Lazic S, Sofat N, Thomas MJ, Moore A, Roddy E, Peat G, Rees F, Lanyon P, Jordan N, Chaib A, Sangle S, Tungekar F, Sabharwal T, Abbs I, Khamashta M, D'Cruz D, Dzifa Dey I, Isenberg DA, Chin CW, Cheung C, Ng M, Gao F, Qiong Huang F, Thao Le T, Yong Fong K, San Tan R, Yin Wong T, Julian T, Parker B, Al-Husain A, Yvonne Alexander M, Bruce I, Jordan N, Abbs I, D'cruz D, McDonald G, Miguel L, Hall C, Isenberg DA, Magee A, Butters T, Jury E, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Lazarus MN, Isenberg DA, Ehrenstein M, Carter LM, Isenberg DA, Ehrenstein MR, Chanchlani N, Gayed M, Yee CS, Gordon C, Ball E, Rooney M, Bell A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Sutton EJ, Watson KD, Isenberg D, Rahman A, Gordon C, Yee CS, Lanyon P, Jayne D, Akil M, D'Cruz D, Khamashta M, Lutalo P, Erb N, Prabu A, Edwards CJ, Youssef H, McHugh N, Vital E, Amft N, Griffiths B, Teh LS, Zoma A, Bruce I, Durrani M, Jordan N, Sangle S, D'Cruz D, Pericleous C, Ruiz-Limon P, Romay-Penabad Z, Carrera-Marin A, Garza-Garcia A, Murfitt L, Driscoll PC, Giles IP, Ioannou Y, Rahman A, Pierangeli SS, Ripoll VM, Lambrianides A, Heywood WE, Ioannou J, Giles IP, Rahman A, Stevens C, Dures E, Morris M, Knowles S, Hewlett S, Marshall R, Reddy V, Croca S, Gerona D, De La Torre Ortega I, Isenberg DA, Leandro M, Cambridge G, Reddy V, Cambridge G, Isenberg DA, Glennie M, Cragg M, Leandro M, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Artim Esen B, Pericleous C, MacKie I, Ioannou Y, Rahman A, Isenberg DA, Giles I, Skeoch S, Haque S, Pemberton P, Bruce I. BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Barton C, Hemmings S, Tufail S, Morrissey D. Conservative management of patellofemoral pain syndrome: Integrating the evidence base with physiotherapists’ clinical reasoning. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.593] [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: 11/26/2022]
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Rowe V, Hemmings S, Barton C, Malliaras P, Maffulli N, Morrissey D. Conservative management of Achilles tendinopathy: A mixed methods study, integrating a systematic review and clinical reasoning. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.236] [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: 11/16/2022]
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Shaikh Z, Perry M, Morrissey D, Ahmad M, Del Buono A, Maffulli N. Achilles Tendinopathy in Club Runners. Int J Sports Med 2012. [DOI: 10.1055/s-0032-1313785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Z. Shaikh
- Barts and The London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, United Kingdom
| | - M. Perry
- Barts and The London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, United Kingdom
| | - D. Morrissey
- Barts and The London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, United Kingdom
| | - M. Ahmad
- Barts and The London School of Medicine and Dentistry, Radiology, Queen Mary University of London, United Kingdom
| | - A. Del Buono
- Department of Orthopaedic and Trauma Surgery, University Campus Bio Medico, Rome, Italy
| | - N. Maffulli
- Barts and The London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, United Kingdom
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Campbell R, Hofmann D, Hatch S, Gordon P, Lempp H, Das L, Blumbergs P, Limaye V, Vermaak E, McHugh N, Edwards MH, Jameson K, Sayer AA, Dennison E, Cooper C, Salvador FB, Huertas C, Isenberg D, Jackson EJ, Middleton A, Churchill D, Walker-Bone K, Worsley PR, Mottram S, Warner M, Morrissey D, Gadola S, Carr A, Cooper C, Stokes M, Srivastava RN, Sanghi D, Srivastava RN, Sanghi D, Elbaz A, Mor A, Segal G, Drexler M, Norman D, Peled E, Rozen N, Goryachev Y, Debbi EM, Haim A, Rozen N, Wolf A, Debi R, Mor A, Segal G, Debbi EM, Cohen MS, Igolnikov I, Bar Ziv Y, Benkovich V, Bernfeld B, Rozen N, Elbaz A, Collins J, Moots RJ, Clegg PD, Milner PI, Ejtehadi HD, Nelson PN, Wenham C, Balamoody S, Hodgson R, Conaghan P, Wilkie R, Blagojevic M, Jordan KP, Mcbeth J, Peffers MJ, Beynon RJ, Thornton DJ, Clegg PD, Chapman R, Chapman V, Walsh D, Kelly S, Hui M, Zhang W, Doherty S, Rees F, Muir K, Maciewicz R, Doherty M, Snelling S, Davidson RK, Swingler T, Price A, Clark I, Stockley E, Hathway G, Faas H, Auer D, Chapman V, Hirsch G, Hale E, Kitas G, Klocke R, Abraham A, Pearce MS, Mann KD, Francis RM, Birrell F, Tucker M, Mellon SJ, Jones L, Price AJ, Dieppe PA, Gill HS, Ashraf S, Chapman V, Walsh DA, McCollum D, McCabe C, Grieve S, Shipley J, Gorodkin R, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Rajak R, Bennett C, Williams A, Martin JC, Abdulkader R, MacNicol C, Brixey K, Stephenson S, Clunie G, Andrews RN, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Clark EM, Gould VC, Carter L, Morrison L, Tobias JH, Pye SR, Vanderschueren D, O'Neill TW, Lee DM, Jans I, Billen J, Gielen E, Laurent M, Claessens F, Adams JE, Ward KA, Bartfai G, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi I, Kula K, Lean ME, Pendleton N, Punab M, Wu FC, Boonen S, Mercieca C, Webb J, Shipley J, Bhalla A, Fairbanks S, Moss KE, Collins C, Sedgwick P, Clark EM, Gould VC, Morrison L, Tobias JH, Parker J, Greenbank C, Evans B, Oldroyd AG, Bukhari M, Harvey NC, Cole ZA, Crozier SR, Ntani G, Mahon PA, Robinson SM, Inskip HM, Godfrey KM, Dennison EM, Cooper C, Bridges M, Ruddick S, Holroyd CR, Mahon P, Crozier SR, Godfrey K, Inskip HM, Cooper C, Harvey NC, Bridges M, Ruddick S, McNeilly T, McNally C, Beringer T, Finch M, Coda A, Davidson J, Walsh J, Fowlie P, Carline T, Santos D, Patil P, Rawcliffe C, Olaleye A, Moore S, Fox A, Sen D, Ioannou Y, Nisar S, Rankin K, Birch M, Finnegan S, Rooney M, Gibson DS, Malviya A, Ferris CM, Rushton SP, Foster HE, Hanson H, Muthumayandi K, Deehan DJ, Birt L, Poland F, MacGregor A, Armon K, Pfeil M, McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Gibson DS, Finnegan S, Newell K, Evans A, Manning G, Scaife C, McAllister C, Pennington SR, Duncan M, Moore T, Rooney M, Pericleous C, Croca SC, Giles I, Alber K, Yong H, Isenberg D, Midgely A, Beresford MW, Rahman A, Ioannou Y, Rzewuska M, Mallen C, Strauss VY, Belcher J, Peat G, Byng-Maddick R, Wijendra M, Penn H, Roddy E, Muller S, Hayward R, Mallen C, Kamlow F, Pakozdi A, Jawad A, Green DJ, Muller S, Mallen C, Hider SL, Singh Bawa S, Bawa S, Turton A, Palmer M, Grieve S, Lewis J, Moss T, McCabe C, Goodchild CE, Tang N, Scott D, Salkovskis P, Selvan S, Williamson L, Selvan S, Williamson L, Thalayasingam N, Higgins M, Saravanan V, Rynne M, Hamilton JD, Heycock C, Kelly C, Norton S, Sacker A, Done J, Young A, Smolen JS, Fleischmann RM, Emery P, van Vollenhoven RF, Guerette B, Santra S, Kupper H, Redden L, Kavanaugh A, Keystone EC, van der Heijde D, Weinblatt ME, Mozaffarian N, Guerette B, Kupper H, Liu S, Kavanaugh A, Zhang N, Wilkinson S, Riaz M, Ostor AJ, Nisar MK, Burmester G, Mariette X, Navarro-Blasco F, Oezer U, Kary S, Unnebrink K, Kupper H, Jobanputra P, Maggs F, Deeming A, Carruthers D, Rankin E, Jordan A, Faizal A, Goddard C, Pugh M, Bowman S, Brailsford S, Nightingale P, Tugnet N, Cooper SC, Douglas KM, Edwin Lim CS, Bee Lian Low S, Joy C, Hill L, Davies P, Mukherjee S, Cornell P, Westlake SL, Richards S, Rahmeh F, Thompson PW, Breedveld F, Keystone E, van der Heijde D, Landewe R, Smolen JS, Guerette B, McIlraith M, Kupper H, Liu S, Kavanaugh A, Byng-Maddick R, Penn H, Abdulkader R, Dharmapalaiah C, Shand L, Rose G, Clunie G, Watts R, Eldashan A, Dasgupta B, Borg FA, Bell GM, Anderson AE, Harry RA, Stoop JN, Hilkens CM, Isaacs J, Dickinson A, McColl E, Banik S, Smith L, France J, Bawa S, Rutherford A, Scott Russell A, Smith J, Jassim I, Withrington R, Bacon P, De Lord D, McGregor L, Morrison I, Stirling A, Porter DR, Saunders SA, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Baguley E, Patel Y, Alzabin S, Abraham S, Taher TE, Palfeeman A, Hull D, McNamee K, Jawad A, Pathan E, Kinderlerer A, Taylor P, Williams RO, Mageed RA, Iaremenko O, Mikitenko G, Ferrari M, Kamalati T, Pitzalis C, Tugnet N, Pearce F, Tosounidou S, Obrenovic K, Erb N, Packham J, Sandhu R, White C, Cardy CM, Justice E, Frank M, Li L, Lloyd M, Ahmed A, Readhead S, Ala A, Fittall M, Manson J, Ioannou Y, Sibilia J, Marc Flipo R, Combe B, Gaillez C, Le Bars M, Poncet C, Elegbe A, Westhovens R, Hassanzadeh R, Mangan C, France J, Bawa S, Weinblatt ME, Fleischmann R, van Vollenhoven R, Emery P, Huizinga TWJ, Goldermann R, Duncan B, Timoshanko J, Luijtens K, Davies O, Dougados M, Hewitt J, Owlia M, Dougados M, Gaillez C, Le Bars M, Poncet C, Elegbe A, Schiff M, Alten R, Kaine JL, Keystone E, Nash PT, Delaet I, Qi K, Genovese MC, Clark J, Kardash S, Wong E, Hull R, McCrae F, Shaban R, Thomas L, Young-Min S, Ledingham J, Genovese MC, Covarrubias Cobos A, Leon G, Mysler EF, Keiserman MW, Valente RM, Nash PT, Abraham Simon Campos J, Porawska W, Box JH, Legerton CW, Nasonov EL, Durez P, Pappu R, Delaet I, Teng J, Alten R, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Choy E, McAuliffe S, Roberts K, Sargeant I, Emery P, Sarzi-Puttini P, Moots RJ, Andrianakos A, Sheeran TP, Choquette D, Finckh A, Desjuzeur ML, Gemmen EK, Mpofu C, Gottenberg JE, Bukhari M, Shah P, Kitas G, Cox M, Nye A, O'Brien A, Jones P, Sargeant I, Jones GT, Paudyal P, MacPherson H, Sim J, Doherty M, Ernst E, Fisken M, Lewith G, Tadman J, Macfarlane GJ, Mariette X, Bertin P, Arendt C, Terpstra I, VanLunen B, de Longueville M, Zhou H, Cai A, Lacy E, Kay J, Keystone E, Matteson E, Hu C, Hsia E, Doyle M, Rahman M, Shealy D, Scott DL, Ibrahim F, Abozaid H, Choy E, Hassell A, Plant M, Richards S, Walker D, Simpson G, Kowalczyk A, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Nash PT, Ludivico CL, Delaet I, Qi K, Murthy B, Corbo M, Kaine JL, Emery P, Smolen JS, Samborski W, Berenbaum F, Davies O, Ambrugeat J, Bennett B, Burkhardt H, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Bykerk V, Ostor AJ, Roman Ivorra J, Wollenhaupt J, Stancati A, Bernasconi C, Sibilia J, Scott DGI, Claydon P, Ellis C, Buchan S, Pope J, Fleischmann R, Dougados M, Bingham CO, Massarotti EM, Wollenhaupt J, Duncan B, Coteur G, Weinblatt M, Hull D, Ball C, Abraham S, Ainsworth T, Kermik J, Woodham J, Haq I, Quesada-Masachs E, Carolina Diaz A, Avila G, Acosta I, Sans X, Alegre C, Marsal S, McWilliams D, Kiely PD, Young A, Walsh DA, Fleischmann R, Bolce R, Wang J, Ingham M, Dehoratius R, Decktor D, Rao V, Pavlov A, Klearman M, Musselman D, Giles J, Bathon J, Sattar N, Lee J, Baxter D, McLaren JS, Gordon MM, Thant KZ, Williams EL, Earl S, White P, Williams J, Westlake SL, Ledingham J, Jan AK, Bhatti AI, Stafford C, Carolan M, Ramakrishnan SA. Muscle disorders * 111. The impact of fatigue in patients with idiopathic inflammatory myopathy: a mixed method study. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes109] [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: 11/13/2022] Open
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Malliaras P, Chan O, Simran G, Martinez de Albornoz P, Morrissey D, Maffulli N. Doppler ultrasound signal in Achilles tendinopathy reduces immediately after activity. Int J Sports Med 2012; 33:480-4. [PMID: 22499574 DOI: 10.1055/s-0032-1304636] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND A relationship has been identified between vascularization on Doppler ultrasound (Doppler signal) and Achilles tendon pain. Doppler signal may increase minutes after prolonged activity, but the immediate effect is unknown. The aim of the study was to investigate the immediate effect of short term activity on Achilles tendon Doppler signal. Achilles tendinopathy patients (7 patients, 10 tendons) and asymptomatic controls (6 controls, 12 tendons) performed 2 activity tasks; a 2 minute continuous step task and one minute continuous calf raise task. Doppler signal was measured at rest and within a minute after each activity. The presence of Doppler signal was quantified using both semi quantitative (modified Ohberg scale; 0=no signal, 5 = > 90% of pathological area contains Doppler signal) and quantitative methods (pixel number). Doppler signal was present in 90% of symptomatic individuals and in none of the asymptomatic controls. The modified Ohberg scale and pixel number reduced significantly after both activity tasks and heart rate increased significantly (p < 0.05). Doppler signal in Achilles tendinopathy may decrease immediately after activities that load the calf muscle and increase heart rate, suggesting that this activity should be avoided prior to imaging to avoid false negative results.
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Affiliation(s)
- P Malliaras
- Sports and Exercise Medicine, Queen Mary, University of London, United Kingdom.
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