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Kuipers S, Godart J, Corbeau A, Sharfo A, Breedveld S, Mens J, Nout R, Hoogeman M. OC-0130 Pareto front analysis for implementing bone marrow sparing VMAT strategy for cervical cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02506-3] [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: 10/18/2022]
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Kolkman-Deurloo I, Schiphof-Godart J, Heerden van L, Erp van G, Christianen M, Mens J, Rijnsdorp R, Luthart L, Nout R, Hoogeman M. OC-0278 First clinical results of integrated EMT for quantification of positional deviations in cervix BT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02536-1] [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: 10/18/2022]
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Reijtenbagh D, Godart J, Mens J, Heijkoop S, Heemsbergen W, Hoogeman M. OC-0111: Patient-reported acute diarrhea in a cervical cancer patient cohort correlates with dose to rectum. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00137-7] [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: 11/28/2022]
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Solari A, Giordano A, Sastre-Garriga J, Köpke S, Rahn AC, Kleiter I, Aleksovska K, Battaglia MA, Bay J, Copetti M, Drulovic J, Kooij L, Mens J, Meza Murillo ER, Milanov I, Milo R, Pekmezovic T, Vosburgh J, Silber E, Veronese S, Patti F, Voltz R, Oliver D. EAN guideline on palliative care of people with severe, progressive multiple sclerosis. Eur J Neurol 2020; 27:1510-1529. [PMID: 32469447 DOI: 10.1111/ene.14248] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Patients with severe, progressive multiple sclerosis (MS) have complex physical and psychosocial needs, typically over several years. Few treatment options are available to prevent or delay further clinical worsening in this population. The objective was to develop an evidence-based clinical practice guideline for the palliative care of patients with severe, progressive MS. METHODS This guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Formulation of the clinical questions was performed in the Patients-Intervention-Comparator-Outcome format, involving patients, carers and healthcare professionals (HPs). No uniform definition of severe MS exists: in this guideline, constant bilateral support required to walk 20 m without resting (Expanded Disability Status Scale score > 6.0) or higher disability is referred to. When evidence was lacking for this population, recommendations were formulated using indirect evidence or good practice statements were devised. RESULTS Ten clinical questions were formulated. They encompassed general and specialist palliative care, advance care planning, discussing with HPs the patient's wish to hasten death, symptom management, multidisciplinary rehabilitation, interventions for caregivers and interventions for HPs. A total of 34 recommendations (33 weak, 1 strong) and seven good practice statements were devised. CONCLUSIONS The provision of home-based palliative care (either general or specialist) is recommended with weak strength for patients with severe, progressive MS. Further research on the integration of palliative care and MS care is needed. Areas that currently lack evidence of efficacy in this population include advance care planning, the management of symptoms such as fatigue and mood problems, and interventions for caregivers and HPs.
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Affiliation(s)
- A Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Department of Psychology, University of Turin, Turin, Italy
| | - J Sastre-Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Köpke
- Institute of Clinical Nursing Science, University of Cologne, Cologne, Germany.,Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A C Rahn
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Kleiter
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany
| | | | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - J Bay
- Multiple Sclerosis International Federation, People with MS Advisory Committee, Copenhagen, Denmark
| | - M Copetti
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - J Drulovic
- Clinic of Neurology, CCS, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - L Kooij
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Mens
- Nieuw Unicum, Zandvoort, The Netherlands
| | - E R Meza Murillo
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Milanov
- Medical University of Sofia, Sofia, Bulgaria
| | - R Milo
- Department of Neurology, Barzilai Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - T Pekmezovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Vosburgh
- Israel Multiple Sclerosis Society, Tel-Aviv, Israel
| | - E Silber
- Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
| | - S Veronese
- FARO Charitable Foundation, Turin, Italy
| | - F Patti
- Neurology Clinic, Multiple Sclerosis Centre, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - R Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.,Center for Health Services Research (ZVFK), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - D Oliver
- The Tizard Centre, University of Kent, Canterbury, UK
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Hodges PW, Cholewicki J, Popovich JM, Lee AS, Aminpour P, Gray SA, Cibulka MT, Cusi M, Degenhardt BF, Fryer G, Gutke A, Kennedy DJ, Laslett M, Lee D, Mens J, Patel VV, Prather H, Sturesson B, Stuge B, Vleeming A. Building a Collaborative Model of Sacroiliac Joint Dysfunction and Pelvic Girdle Pain to Understand the Diverse Perspectives of Experts. PM R 2019; 11 Suppl 1:S11-S23. [PMID: 31169360 DOI: 10.1002/pmrj.12199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Pelvic girdle pain (PGP) and sacroiliac joint (SIJ) dysfunction/pain are considered frequent contributors to low back pain (LBP). Like other persistent pain conditions, PGP is increasingly recognized as a multifactorial problem involving biological, psychological, and social factors. Perspectives differ between experts and a diversity of treatments (with variable degrees of evidence) have been utilized. OBJECTIVE To develop a collaborative model of PGP that represents the collective view of a group of experts. Specific goals were to analyze structure and composition of conceptual models contributed by participants, to aggregate them into a metamodel, to analyze the metamodel's composition, and to consider predicted efficacy of treatments. DESIGN To develop a collaborative model of PGP, models were generated by invited individuals to represent their understanding of PGP using fuzzy cognitive mapping (FCM). FCMs involved proposal of components related to causes, outcomes, and treatments for pain, disability, and quality of life, and their connections. Components were classified into thematic categories. Weighting of connections was summed for components to judge their relative importance. FCMs were aggregated into a metamodel for analysis of the collective opinion it represented and to evaluate expected efficacy of treatments. RESULTS From 21 potential contributors, 14 (67%) agreed to participate (representing six disciplines and seven countries). Participants' models included a mean (SD) of 22 (5) components each. FCMs were refined to combine similar terms, leaving 89 components in 10 categories. Biomechanical factors were the most important in individual FCMs. The collective opinion from the metamodel predicted greatest efficacy for injection, exercise therapy, and surgery for pain relief. CONCLUSIONS The collaborative model of PGP showed a bias toward biomechanical factors. Most efficacious treatments predicted by the model have modest to no evidence from clinical trials, suggesting a mismatch between opinion and evidence. The model enables integration and communication of the collection of opinions on PGP.
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Affiliation(s)
- Paul W Hodges
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - Jacek Cholewicki
- MSU Center for Orthopedic Research, Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI
| | - John M Popovich
- MSU Center for Orthopedic Research, Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI
| | - Angela S Lee
- MSU Center for Orthopedic Research, Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI
| | - Payam Aminpour
- Department of Community Sustainability, Michigan State University, Natural Resource Building, East Lansing, MI
| | - Steven A Gray
- Department of Community Sustainability, Michigan State University, Natural Resource Building, East Lansing, MI
| | | | - Mel Cusi
- School of Medicine, Sydney, University of Notre Dame Australia, Darlinghurst, Australia
| | | | - Gary Fryer
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Annelie Gutke
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Göteborg, Göteborg, Sweden
| | - David J Kennedy
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | - Mark Laslett
- Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand; Southern Musculoskeletal Seminars, New Zealand
| | - Diane Lee
- Diane Lee & Associates, South Surrey, Canada
| | - Jan Mens
- Department of Rehabilitation Medicine & Physical Therapy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Vikas V Patel
- Department of Orthopaedic Surgery, University of Colorado, Denver, CO
| | - Heidi Prather
- Departments of Orthopaedic Surgery and Neurology, Washington University School of Medicine, St Louis, MO
| | - Bengt Sturesson
- Department of Orthopedics, Aleris, Ängelholm Hospital, Ängelholm, Sweden
| | - Brit Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Andry Vleeming
- Department of Anatomy, Medical Osteopathic College of the University of New England, Biddeford, ME.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Belgium
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Van Heerden L, Schiphof-Godart J, Christianen M, Mens J, Franckena M, Maenhout M, Rijnsdorp R, Luthart L, Hoogeman M, Kolkman-Deurloo I. OC-0074 Accuracy of an integrated EMT/BT system for dwell-position detection in pelvic BT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30494-3] [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: 11/30/2022]
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Wortman B, Astreinidou E, Laman M, Lutgens L, Van der Steen-Banasik E, Slot A, Westerveld H, De Winter K, Van den Berg H, Bloemers M, Stam T, Mens J, Zwanenburg L, Bijmolt S, Jürgenliemk-Schulz I, Snyers A, Creutzberg C, Nout R. OC-0394 Brachytherapy quality assurance in the PORTEC-4a trial for high-intermediate risk endometrial cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30814-x] [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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Köpke S, Giordano A, Veronese S, Christin Rahn A, Kleiter I, Basedow-Rajwich B, Fornari A, Battaglia MA, Drulovic J, Kooij L, Koops J, Mens J, Meza Murillo ER, Milanov I, Milo R, Patti F, Pekmezovic T, Sastre-Garriga J, Vosburgh J, Voltz R, Bay J, Oliver DJ, Solari A. Patient and caregiver involvement in the formulation of guideline questions: findings from the European Academy of Neurology guideline on palliative care of people with severe multiple sclerosis. Eur J Neurol 2018; 26:41-50. [PMID: 30035845 DOI: 10.1111/ene.13760] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Patient and public involvement in clinical practice guideline development is recommended to increase guideline trustworthiness and relevance. The aim was to engage multiple sclerosis (MS) patients and caregivers in the definition of the key questions to be answered in the European Academy of Neurology guideline on palliative care of people with severe MS. METHODS A mixed methods approach was used: an international online survey launched by the national MS societies of eight countries, after pilot testing/debriefing on 20 MS patients and 18 caregivers, focus group meetings of Italian and German MS patients and caregivers. RESULTS Of 1199 participants, 951 (79%) completed the whole online survey and 934 from seven countries were analysed: 751 (80%) were MS patients (74% women, mean age 46.1) and 183 (20%) were caregivers (36% spouses/partners, 72% women, mean age 47.4). Participants agreed/strongly agreed on inclusion of the nine pre-specified topics (from 89% for 'advance care planning' to 98% for 'multidisciplinary rehabilitation'), and <5% replied 'I prefer not to answer' to any topic. There were 569 free comments: 182 (32%) on the pre-specified topics, 227 (40%) on additional topics (16 guideline-pertinent) and 160 (28%) on outcomes. Five focus group meetings (three of MS patients, two of caregivers, and overall 35 participants) corroborated the survey findings. In addition, they allowed an explanation of the guideline production process and the exploration of patient-important outcomes and of taxing issues. CONCLUSIONS Multiple sclerosis patient and caregiver involvement was resource and time intensive, but rewarding. It was the key for the formulation of the 10 guideline questions and for the identification of patient-important outcomes.
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Affiliation(s)
- S Köpke
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - A Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - S Veronese
- FARO Charitable Foundation, Turin, Italy
| | - A Christin Rahn
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - I Kleiter
- Kempfenhausen Centre for Treatment of Multiple Sclerosis, Marianne-Strauß-Klinik, Berg, Germany
| | - B Basedow-Rajwich
- Kempfenhausen Centre for Treatment of Multiple Sclerosis, Marianne-Strauß-Klinik, Berg, Germany
| | - A Fornari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - J Drulovic
- Clinic of Neurology, CSS, Faculty of Medicine, University Hospital of Belgrade, Belgrade, Serbia
| | - L Kooij
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Koops
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Mens
- Nieuw Unicum, Zandvoort, The Netherlands
| | - E R Meza Murillo
- MS Centre of Catalonia (Cemcat), University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Milanov
- Neurology Clinic, Medical University of Sofia, Sofia, Bulgaria
| | - R Milo
- Department of Neurology, Barzilai Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - F Patti
- Neurology Clinic, Multiple Sclerosis Centre, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - T Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Sastre-Garriga
- MS Centre of Catalonia (Cemcat), University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Vosburgh
- Israel Multiple Sclerosis Society, Tel-Aviv, Israel
| | - R Voltz
- Department of Palliative Medicine, University Hospital Cologne, Cologne, Germany
| | - J Bay
- Multiple Sclerosis International Federation, People with MS Advisory Committee, Copenhagen, Denmark
| | - D J Oliver
- The Tizard Centre, University of Kent, Canterbury, UK
| | - A Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Heijmen B, Voet P, Dirkx M, Sharfo A, Rossi L, Fransen D, Penninkhof J, Hoogeman M, Petit S, Mens J, Méndez Romero A, Al-Mamgani A, Incrocci L, Breedveld S. Fully Automatic IMRT and VMAT Treatment Planning in Routine Clinical Practice. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2487] [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: 11/26/2022]
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Petit S, Wielopolski P, Rijnsdorp R, Mens J, Kolkman-Deurloo I. OC-0179: MR guided brachytherapy for cervical cancers using a novel titanium applicator and a novel MR sequence. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32485-3] [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: 11/27/2022]
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Weir A, Jansen J, van Keulen J, Mens J, Backx F, Stam H. Corrigendum to “Short and mid-term results of a comprehensive treatment program for longstanding adductor-related groin pain in athletes: A case series” [Physical Therapy in Sport 11 (2010) 99–103]. Phys Ther Sport 2011. [DOI: 10.1016/j.ptsp.2010.11.001] [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: 10/18/2022]
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Weir A, Jansen J, van Keulen J, Mens J, Backx F, Stam H. Short and mid-term results of a comprehensive treatment program for longstanding adductor-related groin pain in athletes: a case series. Phys Ther Sport 2010; 11:99-103. [PMID: 20673858 DOI: 10.1016/j.ptsp.2010.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 06/23/2010] [Accepted: 06/24/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate short and mid-term results of active physical therapy in athletes with longstanding groin pain. DESIGN Case series. SETTING Primary care physical therapy practice. PARTICIPANTS A total of 44 athletes suffering longstanding adductor-related groin pain. INTERVENTION A combination of passive (joint mobilization) and active (exercises) physical therapy interventions. MAIN OUTCOME MEASUREMENTS Return to (the same level of) sports, restriction in sports, and recurrence. RESULTS Directly after treatment, return to the same level and type of sport was successful in 38 athletes (86%), and without symptoms in 34 athletes (77%). At 6.5-51 months follow up, 10/38 (26%) of those that returned to sports had experienced a relapse; 22 (50%) athletes were able to participate in sports without any restrictions at the mid-term follow-up. CONCLUSIONS For athletes with longstanding groin pain, short term results of physical therapy seem positive, whereas mid-term results are moderately positive. The risk for recurrence is high.
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Affiliation(s)
- Adam Weir
- The Hague Medical Centre (MCH), Department of Sports Medicine, Burg Banninglaan 1, 2262 BA, Leidschendam, The Netherlands.
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Jansen J, Weir A, Dénis R, Mens J, Backx F, Stam H. Resting thickness of transversus abdominis is decreased in athletes with longstanding adduction-related groin pain. ACTA ACUST UNITED AC 2010; 15:200-5. [PMID: 20074995 DOI: 10.1016/j.math.2009.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 09/21/2009] [Accepted: 11/26/2009] [Indexed: 11/17/2022]
Abstract
The purpose of the study was to compare thickness of the transversus abdominis (TA) and obliquus internus (OI) muscles between athletes with and without longstanding adduction-related groin pain (LAGP). Forty two athletes with LAGP and 23 controls were included. Thickness of TA and OI were measured with ultrasound imaging on the right side of the body during rest. Relative muscle thickness (compared to rest) was measured during the active straight leg raise (ASLR) left and right, and during isometric hip adduction. TA resting thickness was significantly smaller in injured subjects with left-sided (4.0+/-0.82mm; P<0.001) or right-sided (4.3+/-0.64mm; P=0.015) groin complaints compared with controls (4.9+/-0.90mm). No significant differences between patients and controls in TA or OI relative thickness during the ASLR and isometric hip adduction were found (all cases P>/=0.15). In conclusion, TA resting thickness is smaller in athletes with LAGP and may thus be a risk factor for (recurrent) groin injury. This may have implications for therapy and prevention of LAGP.
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Affiliation(s)
- Jaap Jansen
- University Medical Center Utrecht, Department of Rehabilitation and Sport Medicine, Utrecht, The Netherlands.
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Bondar M, Hoogeman M, Osorio EV, Dhawtal G, Mens J, Heijmen B. TH-D-213A-07: A Novel Inverse-Consistent Feature-Based Non-Rigid Registration Method That Improves the Mapping of Organs with Large-Scale Deformations. Med Phys 2009. [DOI: 10.1118/1.3182719] [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: 11/07/2022] Open
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Bondar M, Hoogeman M, Dhawtal G, Mens J, Osorio EV, de Pree I, Quint S, Ahmad R, Heijmen B. TU-D-BRC-06: Towards Online Image Guided Radiotherapy for Cervical Cancer: Accurate Cervix-Uterus Prediction Based On Measured Bladder Volumes. Med Phys 2009. [DOI: 10.1118/1.3182381] [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: 11/07/2022] Open
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Jansen J, Poot B, Mens J, Backx F, Stam H. Effect Of Experimental Groin Pain On Abdominal Muscle Activity. Med Sci Sports Exerc 2009. [DOI: 10.1249/01.mss.0000354156.94021.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
OBJECTIVE To evaluate the hypothesis that groin pain at isometric hip adduction may not be caused by adductor tendinitis. DESIGN Symptoms and signs in a cross-sectional analysis. SETTING Multicenter primary care institutes. SUBJECTS Athletes with pain in the groin(s), provoked by playing sports, with a duration of complaints for at least 1 month and pain provocation on isometric adduction of the hips. INTERVENTIONS Data on medical history and symptoms were collected. Pain provocation tests and strength measurements were performed. A pelvic belt was used to investigate its influence on pain provocation and strength. MAIN OUTCOME MEASUREMENTS Site of the pain, duration of the complaints, severity of the pain, hip adduction force, pain at isometric hip adduction, restriction to perform active straight leg raising, influence of a pelvic belt on pain and strength of isometric hip adduction and straight leg raising. RESULTS Groin pain was bilateral in 41%; pain was also located at the posterior aspect of the pelvis in 32%; Active Straight Leg Raise (ASLR) test was positive in 39%. When tested with a pelvic belt, the weakness of ASLR improved in all with a positive ASLR, hip adduction force increased significantly in 39% and pain at forceful isometric hip adduction decreased in 68%. CONCLUSIONS Groin pain at isometric hip adduction may not be caused by adductor tendinitis in a large proportion of athletes with adduction-related groin pain. The results suggest that adduction-related groin pain with a positive belt test may be treated by stabilization of the pelvis.
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Affiliation(s)
- Jan Mens
- Division Low Back Pain Research, Rehabilitation Medicine, Erasmus Medical Centre-Faculty, Rotterdam, The Netherlands.
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Mens J, Hoek van Dijke G, Pool-Goudzwaard A, van der Hulst V, Stam H. Possible harmful effects of high intra-abdominal pressure on the pelvic girdle. J Biomech 2006; 39:627-35. [PMID: 16439232 DOI: 10.1016/j.jbiomech.2005.01.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2004] [Accepted: 01/13/2005] [Indexed: 11/17/2022]
Abstract
The present study explores the hypothesis that a high intra-abdominal pressure (IAP) loads the ligaments of the pelvic girdle to such an extent that frequent periods of high IAP might cause pain and/or interfere with recovery of patients with pelvic girdle pain (PGP). In a theoretical model the size of the load of IAP on the pelvic girdle was computed. The diameters of abdomen and pelvis needed for the calculations were measured on MRI scans; the IAP values during activities were gained from literature. In slim, healthy subjects the calculated load on the pelvic ring during activities of daily living was 26.0-52.0 N with peaks to 135 N. During straining, vigorous work or heavy exercises the load could increase to values ranging from 104 to 520 N. The load is higher in subjects with pain or fatigue, or in case of a distended abdomen. When the load on the pelvic ring induced by IAP is larger than 100 N, the force exceeds the force at which a pelvic belt relieves complaints in PGP; at 90 N, the force is larger than the force at which isometric hip adduction provokes pain in PGP. We conclude that the size of the load induced by IAP on the pelvic girdle seems to be sufficient to cause pain in patients with PGP and might interfere with recovery. It seems worthwhile to give patients with PGP instructions to reduce IAP as much as possible during activities.
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Affiliation(s)
- Jan Mens
- Department of Rehabilitation Medicine, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 Rotterdam, GD, The Netherlands.
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Abstract
A case of chronic shoulder pain is reported with marked limitation of both active and passive elevations and a normal range of motion of the glenohumeral joint. X-ray examination demonstrated cloudy calcification in the coracoclavicular region, presumably indicating calcifying supracoracoid bursitis.
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