Functional Performance Tests Research Articles

Exercise-therapy and education for individuals one year after anterior cruciate ligament reconstruction: a pilot randomised controlled trial

BackgroundGuided rehabilitation beyond 6-months is rare following anterior cruciate ligament reconstruction (ACLR), despite high prevalence of unacceptable symptoms and quality of life (QoL). Our primary aim was to determine the feasibility of a randomised controlled trial (RCT) evaluating a physiotherapist-guided intervention for individuals 1-year post-ACLR with persistent symptoms. Our secondary aim was to determine if a worthwhile treatment effect could be observed for the lower-limb focussed intervention (compared to the trunk-focussed intervention), for improvement in knee-related QoL, symptoms, and function.DesignParticipant- and assessor-blinded, pilot feasibility RCT.MethodsParticipant eligibility criteria: i) 12–15 months post-ACLR; ii) < 87.5/100 on the Knee injury and Osteoarthritis Outcome Score (KOOS) QoL subscale; and either a one-leg rise test < 22 repetitions, single-hop < 90% limb symmetry; or Anterior Knee Pain Scale < 87/100. Participants were randomised to lower-limb or trunk-focussed focussed exercise and education. Both interventions involved 8 face-to-face physiotherapy sessions over 16-weeks. Feasibility was assessed by eligibility rate (> 1 in 3 screened), recruitment rate (> 4 participants/month), retention (< 20% drop-out), physiotherapy attendance and unsupervised exercise adherence (> 80%). Between-group differences for knee-related QoL (KOOS-QoL, ACL-QoL), symptoms (KOOS-Pain, KOOS-Symptoms), and function (KOOS-Sport, functional performance tests) were used to verify that the worthwhile effect (greater than the minimal detectable change for each measure) was contained within the 95% confidence interval.Results47% of those screened were eligible, and 27 participants (3 participants/month; 48% men, 34±12 years) were randomised. Two did not commence treatment, and two were lost to follow-up (16% drop-out). Physiotherapy attendance was > 80% for both groups but reported adherence to unsupervised exercise was low (< 55%). Both interventions had potentially worthwhile effects for KOOS-QoL and ACL-QoL, while the lower-limb focussed intervention had potentially greater effects for KOOS-Sport, KOOS-Pain, and functional performance.ConclusionsA larger-scale RCT is warranted. All feasibility criteria were met, or reasonable recommendations could be made to achieve the criteria in future trials. Strategies to increase recruitment rate and exercise adherence are required. The potential worthwhile effects for knee-related QoL, symptoms, and function indicates a fully-powered RCT may detect a clinically meaningful effect.Trial registrationProspectively registered (ACTRN12616000564459).

INTERNET ELECTROCARDIOGRAPHY IN PEDIATRICS

&lt;b&gt;Introduction.&lt;/b&gt; Internet electrocardiography (internet-ECG) is becoming one of the most deman-ded areas of telemedicine; it becomes especially important in conditions of remoteness from medical and diagnostic institutions and impossibility of real consulting assistance of specialists. The general principle of operation of the internet-ECG devices is transferring the record to a server with subsequent processing and obtaining an automatic conclusion on the rhythm and morphology of the atrial-ventricular complex. At present, internet-ECG is widely used in adult network, while its possibilities in pediatrics are poorly covered. &lt;br&gt;&lt;b&gt;Materials and methods.&lt;/b&gt; The archive of children's ECGs recorded using the Cardiometer-MT system in the period from 2013 to 2021 has been analyzed. 3 groups of children were identified. 1&lt;sup&gt;st&lt;/sup&gt; - screening of practically healthy children of primary school age (2153 children), 2&lt;sup&gt;nd&lt;/sup&gt; group - school-age children examined in children's city polyclinics, who underwent stress and vegetative tests (2500 children), 3&lt;sup&gt;rd&lt;/sup&gt; group - 200 healthy full-term newborn children who had a standard resting ECG on 1-2 days of life. &lt;br&gt;&lt;b&gt;Results.&lt;/b&gt; The advantages of using such systems in the mass examination of children of various ages in the framework of screening programs are shown. The results of an ECG examination of 2153 healthy children of primary school age are presented. The results of the automatic and medical conclusion are compared, sensitivity and specificity in the detection of cardiac arrhythmias and conduction are determined. The advantages of internet-ECG in carrying out vegetative and stress tests in the examination of adolescent children are substantiated. Performance of functional (including vegetative) and stress tests using internet-ECG systems allows to estimate reliably the functional state of the cardiovascular system, to determine adaptive capabilities of the vegetative nervous system, to reveal hypertension at early stages. &lt;br&gt;&lt;b&gt;Conclusion.&lt;/b&gt; The internet-ECG makes it possible to significantly simplify and streamline the ECG examination of children, forming an electronic archive of records, which is relevant for field exa-minations in children's groups and in conditions of a shortage of qualified specialists in functional diagnostics.

Medical Monitoring and Management System of Mobile Thyroid Surgery Based on Internet of Things and Cloud Computing

With the rapid development of the Internet of Things and cloud computing technologies, the Internet of Things technology based on comprehensive perception and interconnection and cloud computing based on virtualization, dynamic resources, and parallel computing have become the driving force for the innovation and development of informatization and intelligence. The cloud‐based Internet of Things mobile medical is an ecosystem of health information and medical information, with the medical Internet of Things at its core and highly mobile and highly shared information. Therefore, in the context of in‐depth research on mobile medical care, research on mobile postoperative thyroid monitoring and management systems based on the Internet of Things and cloud computing is a practical tool for promoting the development of mobile medical systems. Monitoring and Management. In this experiment, 48 cases of patients undergoing thyroid surgery were selected from a hospital. The experimental group was informed by the experiment that they need to be equipped with sensors. The control panel and GPS positioning module are used to obtain the exact position of the patient at the first time. The loading of the sensor is agreed by the patient and the patient’s family. Afterward, the control group will not be processed. It will conduct functional tests and software performance tests on the mobile medical monitoring and management system and analyze the satisfaction of medical staff with the mobile medical monitoring and management system. Experiments have proved that the cloud computing medical monitoring and management system is used to obtain the exact location of the patient in the first time, and the response time needs to be shorter. The response time of the system increases with the increase of the number of sensors (P &lt; 0.05), which shows that the mobile medical monitoring and management system is essential for medical care and medical care. Obtaining the exact position of the patient for the first time is of great importance for the successful rescue of the patient.

Bilateral deficit: relationships with training history and functional performance

The purpose of the study was to investigate the magnitude of bilateral deficit (BLD) in trained males and examine its relationship with functional performance and recent resistance training history. Ten physically active males (age: 23.02±1.27 years) self-reported the number of unilateral and bilateral exercises within their structured resistance training schedule. During two visits to the laboratory, participants performed unilateral and bilateral squat jumps (SJ) and isometric leg extensions (ILE) for the quantification of BLD. Participants also performed bilateral countermovement jumps (CMJ) and a change of direction (COD) test to quantify functional performance. The performance outcomes and information regarding training history were then correlated with the bilateral index (BLI) metric. The key findings were that: (a) a lower BLD in SJ peak power related to a greater CMJ peak force (r=.728; p=.02) and peak power (r=.750; p=.01), (b) the BLI in the ILE was unrelated to performance outcomes, and (c) BLI was unrelated to the mean number of bilateral and unilateral exercises in the structured resistance training programme of participants. In conclusion, lower levels of BLD may be advantageous for bilateral tests of functional performance (i.e. jumps) however there is a need to consider the mechanical similarity between the performance and BLD measure. Finally, the balance of unilateral and bilateral exercises in an individual’s recent resistance training history is not sensitive to the BLI measured during dynamic or isometric assessments.

Effect of Proprioceptive Training on Fear of Re-Injury and Functional Performance in Athletes with Lateral Ankle Sprain (LAS)

Introduction Lateral ankle sprain LAS is most frequently accounted musculoskeletal injury characterized by pain swelling and tenderness on the lateral aspect of ankle joint that is caused due to excessive inversion of foot at a high velocity which can lead to loss of function decrease movement and painful limping. The injury also has impact on psychological and physiological aspects that can further affect decrease physical activity thus leading to functional instability.Materials and methods A total of 30 male subjects within the age group of 18-35 years with the history of lateral ankle sprain more than once on the same limb positive talar and anterior drawer test were assigned randomly in two groups after fulfilling the inclusion and exclusion criteria. They participated in 4 weeks of intervention for 3 times a week in focus to fear of re-injury and functional performance. Experimental group performed strengthening exercise with proprioceptive training while control group performed only strengthening exercises. Tampa scale of kinesiophobia TSK functional performance tests FPT and visual analog scale VAS were used to assess fear of re-injury functional performance and pain respectively prior and post treatment.Results Proprioceptive training with strengthening exercises and strengthening exercises only on fear of re-injury and functional performance in athletes with LAS showed statistically significant improvement individually within both the group plt0.001 and while comparing in between the groups plt0.05.Conclusion Study showed improvement in both the groups. Statistical analysis indicated that subjects who received strengthening exercises with proprioceptive training was more effective than strengthening exercises onlyTake home message Any ligament injuries especially lateral ligament of ankle that undergoes recurrent injuries should be assessed about mechanical and psychological aspect of athlete which also can be addressed by incorporating graded forms of proprioceptive and strengthening exercises in rehabilitation.

Preseason functional testing in young basketball players: asymmetries and intercorrelations.

[Purpose] The present study aimed to examine the existence and degree of possible asymmetries of functional test performance and their intercorrelations in the lower extremities of young basketball players. [Participants and Methods] Twenty-seven healthy male basketball players (age: 15.52 ± 1.37 years) were examined for the symmetric function of their lower extremities using triple hop for distance tests in the sagittal and frontal plane (medial-lateral), the Y-balance test and a vertical jump test. [Results] Participants exhibited statistically significant side-to-side differences in only the medial triple hop test, as they jumped further on their non-dominant for stability lower limb. No other asymmetries were observed in the rest of the functional tests. Significant correlations were also indicated between the vertical jumptest and the three directions of the triple hop test for both lower limbs. [Conclusion] Our findings proved that young basketball players present a symmetrical picture of functional performance, as revealed by the evaluation of various functional tests. The only significant asymmetric adaptation observed in the medial triple hop test will have to be strengthened by future studies to be implemented in injury prevention programs.

The Associations between Functional Fitness Test Performance and Abdominal Obesity in Healthy Elderly People: Results from the National Physical Fitness Examination Survey in Taiwan.

The relationships between different functional fitness performance and abdominal obesity among the elderly have not been widely discussed in the literature. The present study aimed to investigate the associations between functional fitness test performance and abdominal obesity in Taiwanese elderly people. A total of 22,399 items of data from the National Physical Fitness Survey Databases in Taiwan (NPFSD 2014-15) were reviewed and analyzed. The quartiles of functional fitness test results were identified as the dependent variable in the multiple linear regression analysis to examine the association between functional fitness and abdominal obesity status. The results showed that body balance (odds ratios (ORs) listed from 1.18 to 2.29, p < 0.05) and flexibility (ORs listed from 1.23 to 2.16, p < 0.05) were critically associated with abdominal obesity. However, measurements related to muscle strength revealed the limited effect sizes for abdominal obesity. From a disability prevention perspective, the development of muscle strength in the elderly should be emphasized and encouraged to maintain their daily capabilities instead of satisfaction with a lean body.

Interstitial Pneumonia with Autoimmune Features: Why Rheumatologist-Pulmonologist Collaboration Is Essential.

In 2015 the European Respiratory Society (ERS) and the American Thoracic Society (ATS) “Task Force on Undifferentiated Forms of Connective Tissue Disease-associated Interstitial Lung Disease” proposed classification criteria for a new research category defined as “Interstitial Pneumonia with Autoimmune Features” (IPAF), to uniformly define patients with interstitial lung disease (ILD) and features of autoimmunity, without a definite connective tissue disease. These classification criteria were based on a variable combination of features obtained from three domains: a clinical domain consisting of extra-thoracic features, a serologic domain with specific autoantibodies, and a morphologic domain with imaging patterns, histopathological findings, or multicompartment involvement. Features suggesting a systemic vasculitis were excluded. Since publication of ERS/ATS IPAF research criteria, various retrospective studies have been published focusing on prevalence; clinical, morphological, and serological features; and prognosis of these patients showing a broad heterogeneity in the results. Recently, two prospective, cohort studies were performed, confirming the existence of some peculiarities for this clinical entity and the possible progression of IPAF to a defined connective tissue disease (CTD) in about 15% of cases. Moreover, a non-specific interstitial pneumonia pattern, an anti-nuclear antibody positivity, and a Raynaud phenomenon were the most common findings. In comparison with idiopathic pulmonary fibrosis (IPF), IPAF patients showed a better performance in pulmonary function tests and less necessity of oxygen delivery. However, at this stage of our knowledge, we believe that further prospective studies, possibly derived from multicenter cohorts and through randomized control trials, to further validate the proposed classification criteria are needed.

The correlation between motor and cognitive dysfunction in multiple sclerosis

The correlation between motor and cognitive dysfunction in multiple sclerosis Konstantin K. Mineev, Andrey M. Petrov, Marina V. Votintseva, Igor' D. Stolyarov N.P. Beсhtereva Institute of Human Brain of the Russian Academy of Sciences, St. Petersburg, Russia Introduction. Impaired ambulation is one of the most common and disabling symptoms in multiple sclerosis (MS). Cognitive impairment occurs in the early stages of MS and worsens as the disease progresses. The aim of the study was to investigate the correlation between walking speed and distance and the severity of neurological and cognitive impairment in MS. Materials and methods. We examined 59 patients with relapsing-remitting MS in clinical remission. Motor function was evaluated using the timed 25-foot walk (mobility and leg function performance test based on a timed 25-walk), the nine-hole peg test was used to assess upper limb motor function, the Ashworth Scale was used to evaluate lower limb spasticity, the EDSS scale (pyramidal function) was used to evaluate gait spasticity, and tests for sustained attention, counting skills, short-term and delayed memory, mathematical logic, speech fluency, and sensorimotor reaction speed were used to assess cognitive function. Results. In MS, an increased score on the disability scale was accompanied by increased motor disturbances, reduced distance covered when walking, decreased walking speed, and slower hand movements. Increased spasticity was accompanied by a deterioration in cognitive test performance. The study showed a high correlation between spasticity and reduced computational abilities, mathematical logic, and the ability to remember shapes. Walking distance correlated with attention span and short-term and delayed memory while walking speed characteristics correlated with the movement speed of the non-dominant hand. Slower hand activity correlated with the conducted cognitive tests, with the most significant differences recorded in the non-dominant hand. Conclusion. The study results indicate significant and varied motor and cognitive dysfunction in MS patients, caused by damage to both the conduction pathways in the brain and spinal cord and the cortical grey matter. The obtained data on the close correlation between motor and cognitive impairments allow us to better understand the mechanisms of MS development and to apply this knowledge in clinical practice.

Relationship Between Type 2 Diabetes and White Matter Hyperintensity: A Systematic Review.

White matter (WM) disease is recognized as an important cause of cognitive decline and dementia. White matter lesions (WMLs) appear as white matter hyperintensities (WMH) on T2-weighted magnetic resonance imaging (MRI) scans of the brain. Previous studies have shown that type 2 diabetes (T2DM) is associated with WMH. In this review, we reviewed the literature on the relationship between T2DM and WMH in PubMed and Cochrane over the past five years and explored the possible links among the presence of T2DM, the course or complications of diabetes, and WMH. We found that: (1) Both from a macro- and micro-scopic point of view, most studies support the relationship of a larger WMH and a decrease in the integrity of WMH in T2DM; (2) From the relationship between brain structural changes and cognition in T2DM, the poor performance in memory, attention, and executive function tests associated with abnormal brain structure is consistent; (3) Diabetic microangiopathy or peripheral neuropathy may be associated with WMH, suggesting that the brain may be a target organ for T2DM microangiopathy; (4) Laboratory markers such as insulin resistance and fasting insulin levels were significantly associated with WMH. High HbA1c and high glucose variability were associated with WMH but not glycemic control.

Acute ankle sprain in athletes: Clinical aspects and algorithmic approach.

Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40% of all sports-related injuries. It is especially common in basketball, American football, and soccer. The majority of sprains affect the lateral ligaments, particularly the anterior talofibular ligament. Despite its high prevalence, a high proportion of patients experience persistent residual symptoms and injury recurrence. A detailed history and proper physical examination are diagnostic cornerstones. Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules. Several interventions have been recommended in the management of acute ankle sprains including rest, ice, compression, and elevation, analgesic and anti-inflammatory medications, bracing and immobilization, early weight-bearing and walking aids, foot orthoses, manual therapy, exercise therapy, electrophysical modalities and surgery (only in selected refractory cases). Among these interventions, exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process. An exercise program should be comprehensive and progressive including the range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises. Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables, manual tests for stability, and functional performance testing. There are some common myths and mistakes in the management of ankle sprains, which all clinicians should be aware of and avoid. These include excessive imaging, unwarranted non-weight-bearing, unjustified immobilization, delay in functional movements, and inadequate rehabilitation. The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.

Effect of a Multicomponent Exercise Program (VIVIFRAIL) on Functional Capacity in Elderly Ambulatory: A Non-Randomized Clinical Trial in Mexican Women with Dynapenia.

During aging, loss of muscle strength (dynapenia) combined with unhealthy lifestyles and sedentarism can lead to functional limitations and dependency; currently there is still limited evidence about multicomponent training as a treatment for dynapenia and dependence in ambulatory older women. To evaluate the effect of a multicomponent physical exercise program (VIVIFRAIL) on physical functionality in elderly ambulatory women with dynapenia. A non-randomized clinical trial was realized in 61 ambulatory older women (65-80 years old) with dynapenia that belonged from two Integral Gerontological Centers (IGC) of Hidalgo, Mexico, from June to December 2019. The control group (CG) received the physical daily training applied in the IGC (yoga, cardio-dance or tai chi) and the intervention group (IG) participated in a multicomponent program training (resistance, flexibility, balance and gait) called "VIVIFRAIL" for 12 weeks, minimum 3 weekly sessions of 45-60 minutes. All participants were evaluated at baseline (0 weeks), intermediate (6 weeks) and final (12 weeks), evaluations included glucose, blood pressure (SBP and DBP), anthropometric test, body composition evaluation and functional performance test with Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUGT), muscle strength and a falls risk short test. 52 older women completed the study, mean age was 71.9 ± 4.46. According to SPPB passport classification was 1 Type A, 1 Type B+, 9 Type C, 7 Type C+ and 9 Type D. After 12 weeks of intervention, statistical analysis showed that multicomponent exercise significantly improved strength (p=<0.001), gait speed (p<0.001), standing from a chair (p<0.001) and TUGT (p<0.001). About falls risk, intervention group went from 70% to 12.5% while control group went from 52.4% to 63.6% (p<0.05). Older women who completed the 12 weeks multicomponent exercise program significantly improved their functionality in muscle strength, gait speed (3mt and 6mt), standing from a chair and TUGT tests. Also, it showed a significantly decrease in falls risk, therefore, this type of intervention can reduce the risk of frailty in the elderly.

Estimativa do torque muscular de extensores do joelho de idosos baseado em testes de desempenho físico funcional

Objetivo: Verificar quais métodos de avaliação clínicos de força e potência muscular, e testes de desempenho físico funcionais estão correlacionados com o pico de torque isométrico e dinâmico dos extensores de joelho, e desenvolver equações preditivas que estimem o pico de torque isométrico e dinâmico em pessoas idosas. Métodos: Foram selecionados 49 sujeitos (≥ 60 anos) de ambos os sexos. O pico de torque muscular isométrico (PTISO) e dinâmico concêntrico (PTCON) dos extensores da articulação do joelho do membro preferido foi avaliado através de dinamômetro isocinético no primeiro dia de avaliação. Quarenta e oito horas depois o teste força máxima (1-RM) unilateral do membro preferido foi executado na cadeira extensora, seguindo do teste de potência do membro superior com uma medicine ball de 2 kg (ABM-2). No terceiro dia foram avaliados o teste de equilíbrio dinâmico (time up and go), a capacidade de subir e descer escadas (separadamente), com estes três testes foi construído um índice funcional (IFUNC). Resultados: Os principais resultados demonstraram que o IFUNC não prediz melhoria no pico de torque extensor do joelho (p0,05). Contrapondo a hipótese inicial que alterações no desempenho do pico de torque, tanto isométrico, como dinâmico, teria uma resposta direta com o desempenho funcional. Conclusão: As medidas de força máxima para membro inferior (cadeira extensora-1-RM) e potência de membro superior (arremesso da bola de medicine ball 2-kg) quando associadas explicam com mais de 60% (p0,05) uma mudança no desempenho na força isométrica e dinâmica dos extensores de joelho de idosos não treinados.

Network Performance Test and Analysis of LTE-V2X in Industrial Park Scenario

As one of the mainstream technologies of vehicle-to-everything (V2X) communication, Cellular-V2X (C-V2X) provides high reliability and low latency V2X communications. And with the development of mobile cellular systems, C-V2X is evolving from long-term evolution-V2X (LTE-V2X) to new radio-V2X (NR-V2X). However, C-V2X test specification has not been completely set in the industry. In order to promote the formulation of relevant standards and accelerate the implementation of industrialization, the field test and analysis based on LTE-V2X in the industrial park scenario is conducted in this paper. Firstly, key technologies of LTE-V2X are introduced. Then, the specific methods and contents of this test are proposed, which consists of functional and network performance tests to comprehensively evaluate the communication property of LTE-V2X. Static and dynamic tests are required in both line-of-sight (LOS) and non-line-of-sight (NLOS) scenarios to evaluate network performance. Next, the test results verify that all functions are normal, and the performance evaluation indexes are appraised and analyzed. Finally, it summarizes the whole paper and puts forward the future work.

Practicability of lower extremity functional performance tests and their measurement properties in elite athletes: protocol for a systematic review

IntroductionLower extremity injury (LEI) is highly prevalent and its occurrence increases the risk of future injury in athletic populations. Identifying athletes at risk of injury is the key to target...

Physical functional performance and prognosis in patients with heart failure: a systematic review and meta-analysis

BackgroundPatients with Heart Failure (HF) show impaired functional capacities which have been related to their prognosis. Moreover, physical functional performance in functional tests has also been related to the prognosis in patients with HF. Thus, it would be useful to investigate how physical functional performance in functional tests could determine the prognosis in patients with HF, because HF is the leading cause of hospital admissions for people older than 65 years old. This systematic review and meta-analysis aims to summarise and synthesise the evidence published about the relationship between physical functional performance and prognosis in patients with HF, as well as assess the risk of bias of included studies and the level of evidence per outcome.MethodsMajor electronic databases, such as PubMed, AMED, CINAHL, EMBASE, PEDro, Web of Science, were searched from inception to March 2020 for observational longitudinal cohort studies (prospective or retrospective) examining the relationship between physical functional performance and prognosis in patients with HF.Results44 observational longitudinal cohort studies with a total of 22,598 patients with HF were included. 26 included studies reported a low risk of bias, and 17 included studies showed a moderate risk of bias. Patients with poor physical functional performance in the Six Minute Walking Test (6MWT), in the Short Physical Performance Battery (SPPB) and in the Gait Speed Test showed worse prognosis in terms of larger risk of hospitalisation or mortality than patients with good physical functional performance. However, there was a lack of homogeneity regarding which cut-off points should be used to stratify patients with poor physical functional performance from patients with good physical functional performance.ConclusionThe review includes a large number of studies which show a strong relationship between physical functional performance and prognosis in patients with HF. Most of the included studies reported a low risk of bias, and GRADE criteria showed a low and a moderate level of evidence per outcome.

IN-SEASON REHABILITATION PROGRAM USING BLOOD FLOW RESTRICTION THERAPY FOR TWO DECATHLETES WITH PATELLAR TENDINOPATHY: A CASE REPORT.

Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from a rehabilitation program utilizing BFR for two collegiate decathletes with patellar tendinopathy. Case ReportCase Descriptions and Interventions: Two NCAA Division III freshmen collegiate decathletes with a history of left knee pain prior to college and who had been complaining of increasing pain during the initial month of track practices. Findings from the musculoskeletal examinations included left sided lower extremity weakness, pain during functional testing, pain when palpating the left patellar tendon, and VISA-P scores less than 80. Ultrasound imaging at baseline revealed thickened tendons on the left with hypoechoic regions. Both athletes participated in 20 therapy sessions consisting of therapeutic exercises performed with BFR. Both athletes experienced improvements in pain scores, increases in lower extremity strength, improved functional test performance, higher VISA-P scores, and improvements in tendon size and appearance as measured by diagnostic ultrasound. Both athletes experienced improvements with the BFR-based therapeutic exercise program and were able to compete throughout the track season. The use of BFR may allow patients who are unable to tolerate exercise due to pain an alternative approach during rehabilitation. Future research should compare therapeutic exercise programs for this condition with and without BFR. Level V.

Relationship Between Strength of Hip Muscles and Performance of Close Kinetic Chain Dynamic Lower Extremity Stability Test

Background: The hip muscle plays various roles. Several types of functional performance tests are used for the assessment of patients with various lower extremity injuries. Hip muscle functions are important to test the performance of maintaining the spine, pelvic, and leg during bridging exercise. We designed a novel functional performance test tool, which we named close kinetic chain dynamic lower extremity stability (CKCLE) test to assess hip muscle functions. Objects: The purpose of this study was to determine the relationship between CKCLE test and hip extensor, external rotator, and abductor strengths. Methods: Twenty-two subjects were recruited in the present study (13 males and 9 females). The hip extensor, external rotator, and abductor muscle strengths were measured using a Smart KEMA strength sensor. When the examiner said “Go”, the subject performed the CKCLE test by moving one leg from the floor and touching the opposite knee and then return to the floor while maintaining the bridging position. The subjects attempted as many “touches” as possible in the allotted time (20 seconds) during the maximal tests. The correlation between the hip muscle (extensor, external rotator, and abductor) strength of the supporting leg and the number of CKCLE tests performed in 20 seconds was determined using the Pearson correlation. Results: Hip extensor (r = 0.626, p < 0.05), hip external rotator (r = 0.616, p < 0.05), and hip abductor muscle strengths (r = 0.475, p < 0.05) positively correlated with the number of CKCLE tests performed. Conclusion: We designed a CKCLE test and found that performance in the test correlated with hip extensor, external rotator, and abductor muscle strengths. The result suggests that the CKCLE test can be applied as a performance test to assess the functions of the hip extensor, external rotator, and hip abductor muscles.

Strength training restores force-generating capacity in patients with schizophrenia.

Patients with schizophrenia spectrum disorders have impaired skeletal muscle force-generating capacity (FGC) of the lower extremities, that is, one repetition maximum (1RM) and rapid force development, and poor functional performance. We therefore investigated whether 12weeks of maximal strength training (MST) could (a) restore FGC and functional performance to the level of healthy references, (b) increase patient activation and quality of life, and (c) explore associations between symptom severity, defined daily dose of medication, illness duration, level of patient activation, and improvements in FGC and functional performance. Forty-eight outpatients were randomized to a training group (TG) or control group (CG). TG performed leg press MST 2day/week at~90% 1RM. The CG received two introductory training sessions and encouragement to train independently. Leg press 1RM, rapid force development, a battery of functional performance tests, Patient Activation Measure-13, and 36-Item Short Form Health Survey were tested. Healthy references performed baseline tests of FGC and functional performance. Thirty-six patients completed the study (TG: 17, CG: 19). TG improved 1RM (28%) and rapid force development (20%, both P<.01) to a level similar to healthy references, while no change was apparent in the CG. TG's improvement in rapid force development was negatively associated with defined daily dose of medication (r=-0.5, P=.05). Both TG and CG improved 30-second sit-to-stand test performance (P<.05) which was associated with improved rapid force development (r=0.6, P<.05). In conclusion, 12weeks of MST restored patients' lower extremity FGC to a level similar to healthy references and improved 30-second sit-to-stand test performance.

Direct comparison of gamma, electron beam and X-ray irradiation effects on single-use blood collection devices with plastic components

Effective sterilization methods for single-use devices are a growing need for the medical industry. Concerns with safety, throughput and source availability, however, prompt prudent contingency planning for gamma irradiation of devices suited for radiation sterilization. Electron beam (e-beam) and X-ray represent two alternatives to gamma radiation if they can be confirmed to be compatible with sterilization of the devices. To address this question, the effects of sterilization-relevant doses of e-beam and X-ray radiation are directly compared to the effects of gamma radiation using two prototypical commercial devices currently sterilized using cobalt-60 gamma radiation. These devices include components that comprise six distinct polymer materials commonly used in the medical device industry. The devices investigated are the Becton, Dickinson and Company (BD) VacutainerTMPlus tube, comprised of low-density polyethylene, chlorobutyl rubber, and polyethylene terephthalate components; and the BD VacutainerTMPush Button Blood Collection Set, containing polypropylene, polyolefin elastomer, and polyvinyl chloride components. Changes in functionality, discoloration and select mechanical properties of components of each device were measured following exposure to targeted doses of 15, 35, 50 and 80 kGy. A statistical analysis was performed to determine if the effects of e-beam or X-ray radiation differ from the effects of gamma radiation for the properties considered. No devices were found to fail the functional performance tests at any of the doses considered. Small, but statistically significant differences were observed in device discoloration from e-beam, X-ray and gamma radiation following processing for certain materials at certain dose levels. Both e-beam and X-ray irradiation appear as viable alternatives to gamma irradiation for sterilization of the medical devices and materials considered.