bluuebunny/crossref_metadata_2025_split huggingface dataset:
The differences in plantar loading between 3 positions related to the rugby scrum
Authors: Brown Sally , Twycross-Lewis R , Padhiar N 
Published: January 2011

ObjectiveFoot injuries cause a significant absence from training and playing in the English rugby premiership. Pressure analysis gives information on how load is distributed, to give clinically relevant information this must be carried out in sports specific tasks. The aim of this study was to identify peak areas of pressure in the foot during three different positions related to the rugby scrum and their association to lower limb kinematics or stud formation.MethodsTwenty-four male athletes were recruited from an English Premiership Rugby Club. An inner sole was inserted into the rugby boot to collect information on plantar pressure, the foot was divided into eight sections which were used to determine loading patterns. Three positions considered to be functionally relevant were studied, standing, engaged with a scrum machine and maximally pushing against the scrum machine. The Foot Posture Index, the weight bearing lunge test, first metatarsal extension and the number of studs were assessed.ResultsThe medial forefoot showed the greatest load in the engaged and push positions (p<0.05). Foot Posture Index was negatively correlated to forefoot pressures in standing (p<0.05). Increase range of weight bearing lunge allowed for greater posterior lateral plantar loading during pushing (p<0.05). Stud number was positively correlated to medial plantar pressure in standing and pushing (p<0.05).ConclusionThe substantial load on the medial forefoot in the rugby scrum suggests potential mechanisms for metatarsalphalangeal injury. Stud placement, foot posture index and range of weight bearing lunge can all influence plantar pressure. Future research should investigate mechanisms to reduce load in peak regions during the rugby scrum.
Are asymptomatic ultrasound abnormalities in the achilles tendon of elite soccer players risk factors for symptoms one year later? a longitudinal cohort study
Authors: Jhingan S , Perry M , O'Driscoll G , Ahmad M , Maffulli N , Morrissey D 
Published: January 2011

BackgroundAchilles tendinopathy is common and can bring a sports career to a premature end. Identifying players at an increased risk of this debilitating condition could lead to better prevention.ObjectivesThe primary aim was to compare asymptomatic elite soccer players with and without baseline ultrasound changes in terms of development of Achilles tendinopathy symptoms at one year follow-up. This study also investigated the effect that baseline tendon thickness had on development of symptoms.MethodUsing ultrasonography of the Achilles tendon, 18 initially asymptomatic elite soccer players in the top English league were examined in April 2009 and in May 2010. Symptom development during the 12 month follow-up period was assessed with an Achilles tendinopathy questionnaire on follow-up. Any Achilles pain during the follow-up period, of any duration or severity, was deemed to represent symptom development.ResultsNo association between the existence of baseline asymptomatic ultrasound signs and development of Achilles tendinopathy symptoms in the following year was observed (χ2, 1.180 p=0.277). Baseline calcaneal insertion thickness was greater in tendons that experienced symptoms (p=0.035) in the following year compared to those that remained asymptomatic.ConclusionBaseline calcaneal insertion thickness was identified as a risk factor in the development of Achilles tendinopathy in elite soccer players. However, follow-up studies should aim to establish whether abnormal ultrasound signs and thickness measures over a longer period of time are significant markers of a presymptomatic stage.
An evaluation of the relationship between vitamin d status and quadriceps strength in patients with copd: a cross sectional study
Authors: Fenn J , Martineau A , Yee J Wai , Islam K , Griffiths C , Maffulli N , Morrissey D 
Published: January 2011

BackgroundQuadriceps muscle weakness is a well-defined characteristic of chronic obstructive pulmonary disease (COPD). Vitamin D deficiency has been shown to be highly prevalent in COPD but its association with quadriceps strength in this group is unknown.ObjectivesTo investigate the effects of Vitamin D status on quadriceps strength. To validate measurements of quadriceps strength by handheld dynamometer (HHD) against the gold standard isokinetic dynamometer (IKD) in a sub-population.Methods30 patients with COPD Gold Stage II and above were recruited. Quadriceps muscle strength was tested using the HHD in all subjects. Eight of the subjects were also tested using the IKD for validation purposes. Vitamin D status and a range of potentially confounding measures were assessed. A multivariate analysis was performed to determine which variables were associated with quadriceps strength.ResultsA very strong and positive correlation (r=0.92, 95%, p<0.0001), existed between the HHD and IKD measurements. Serum 25-hydroxyvitaminD was not associated with quadriceps strength (r=0.17, p=0.20). The male gender (β 36.7, 95% CI 14.0 to 59.4, p=0.002) and pack year history (β −0.15 95% CI −0.2 to −0.05, p=0.003) were independently associated with quadriceps strength.ConclusionsThe portable and inexpensive HHD is a valid method of testing quadriceps strength in patients with COPD. Serum 25-hydroxyvitaminD is not associated with quadriceps strength in patients with COPD, although male gender and a decrease in pack year history are significantly associated.
Exercise, sports and musculoskeletal medicine in UK medical school curricula: a survey
Authors: Oluwajana F , Rufford C , Morrissey D 
Published: January 2011

IntroductionExercise and obesity (EO) and sports and exercise medicine (SEM) are important topics in today's society and musculoskeletal medicine (MSK) is already a well established subject in medical schools. Despite the importance of these subjects, little is known about their occurrence in medical school curricula. the study aimed to investigate the availability of EO, SEM and MSK teaching in UK medical schools, opinions regarding the importance and quality of the teaching and to compare SEM and EO with MSK teaching.MethodAn anonymous online survey was designed, piloted and distributed to the deans of undergraduate medical education at 33 UK medical schools. reminder emails were sent to participants every 4 weeks for 4 months.ResultsThe response rate was 76%. all medical schools have a direct focus on MSK in their curriculum. 68% have a direct focus on EO and 40% on SEM. There are more optional study opportunities in msk. 92% of medical schools assess MSK knowledge, while only 60% and 28% do so for EO and SEM respectively. MSK is perceived to be more important and have better quality teaching. The most common barrier to improving education was space in the curriculum.ConclusionsEO and SEM teaching are uncommon and considered less important in UK medical schools compared to MSK teaching. Increasing the perceived importance of these subjects and providing curricular guidance to medical schools will help improvements to be implemented. The optional curriculum is likely to be the most appropriate initial method of increasing and improving teaching in EO and SEM.
Physical therapy treatment for adhesive capsulitis: clinical evidence and clinical reasoning
Authors: Salam A , Hemmings S , Morrissey D 
Published: January 2011

BackgroundMany barriers exist impeding the translation of treatment evidence into practice for adhesive capsulitis (AC). The need for evidence-based practice is unquestionable, with reasoning skills needed to evaluate and apply the evidence. This study aims to combine published evidence and clinical reasoning to optimally guide clinical practice.ObjectivesThe first is to categorise and grade the evidence for each individual physical therapy treatment modality for AC, through a literature review. This informs the second; qualitative exploration of physiotherapists' perceptions of the evidence and its interaction with clinical reasoning.MethodsA systematic literature search was conducted for reviews and trials describing a physical therapy treatment for AC. Summaries of each individual modality were generated, and graded on the strength of supporting evidence. Semi-structured interviews were also conducted with experienced physiotherapists until data saturation.ResultsThe literature search yielded 26 studies, from which 19 physical therapy interventions were identified. Strong evidence exists to support the use of education, steroid injection, mobilisations, stretching, supervised exercise, home exercise, acupuncture, heat therapy, transcutaneous electrical nerve stimulation, non-steroidal anti-inflammatory drugs and interferential electrotherapy. Moderate evidence exists for six modalities, and limited evidence for two. Fourteen themes surrounding the assessment, treatment and evidence behind AC were identified from framework analysis of interview transcripts.ConclusionThere is relatively little high quality evidence in favour of one modality over another for AC. Until the quality and scope of evidence improves, clinicians will continue to rely heavily on their own expertise for treatment. These results are a meaningful guide to clinical practice, and reveal a number of research questions.
‘In it for the long run’: sources of self-efficacy in adolescent female athletes
Authors: Watson L , Binks E , Kawycz S 
Published: January 2011

IntroductionMost research in sport psychology investigating the sources of efficacious beliefs has been conducted within the parameters of Bandura's (1977) self-efficacy theory.1 Within the context of a situation six sources are believed to be cognitively appraised; mastery performances, vicarious experiences, verbal persuasion, imaginal experience, emotional states and physiological states, to develop one's efficacy expectations and goal directed behaviour.2 The aim of the study was to identify the sources of self-efficacy most salient to female adolescent long distant runners, why such sources are selected and whether they were interlinked.MethodSemi-structured interviews were conducted to allow athletes’ sources and types of efficacy to emerge inductively. Interviews were recorded, transcribed verbatim and analysed using the interpretative phenomenological approach. After obtaining ethical approval, six female adolescent athletes (mean age=15 years, national level) were recruited, using opportunistic sampling, from a single running club.ResultsNine sources emerged from this investigation with numerous variations within them being exclusive to sport and female adolescent athletes. The nine sources of self-efficacy identified were: performance accomplishments, vicarious experiences, verbal persuasion, physiological experiences, imaginal experiences, emotional states, situational favourableness, self-perception and athlete specific. Specifically, it was found that performance accomplishments provide a catalyst for the additional sources. In particular performance accomplishments inform the athlete efficacious beliefs, however this is only situational specific and is none transferable. Individual differences arose as an imperative factor in how one interprets the efficacious sources.ConclusionThe results extend previous conceptualisations related to personal efficacy beliefs within athletic settings and supported the contention that efficacious beliefs play a significant moderating effect on athlete functioning and athletic performance. Findings highlight the need to further examine the uses of multiple sources of self-efficacy and their weighting in individual's sports, as this may provide valuable insight for coaches and sports psychologists working with particular athlete groups and assist in developing interventions which augment or maintain efficacious beliefs in individual athletes.
The evaluation of the treatment of 10 cases of chronic compartmental syndrome of the upper arm
Authors: Gasol X , García M A , Turmo A , Valle X 
Published: January 2011

Chronic compartment syndrome (CCS) is a pathological situation in which there is an increase in the interstitial muscular pressure which produces a conflict of microcirculation and enervation. The main characteristic is pain and stiffness during activity with intense neurovascular symptoms.The initial presentation is clinical with diagnosis confirmed by an intracompartmental pressure measurement (ICP) to confirm the diagnosis. Other non-invasive diagnostic techniques like magnetic resonance imaging and near infrared spectroscopy produce less clear results.Conventional treatment reduces the symptoms but its application presents difficulties for sportspeople. Fasciotomy is still the treatment of choice followed by postsurgical rehabilitation, although the possibility of relapse cannot be discounted.Materials and methods10 sportspersons have been studied with CCS, diagnosed by ICP, and looked at in the medical department of CAR Sant Cugat during the period 2003–2009. Personal characteristics were: age: 31.5 years +12.07; weight: 72.4 kg + 6.55: height 171.4 cm+4.95; IMC 24.67+2.42; one woman and nine men. The Whitesides technique was used for administering the PIC and the Pedowitz criteria for confirming the diagnosis. The treatment was evaluated using a test based on Slimonet al(2002). The patients evaluated the results as bad, medium, good or excellent. The pain was evaluated on a subjective scale of 1–10 together with the presence or absence of weakness, muscular contractions or paresthesia.Results10 subjects diagnosed with CCS (8 flexors and 8 extensors). The latent diagnostic period was from 18,6 months±19,8.Over the total 16, 10 were treated with fasciotomy and 6 with conventional treatment.Total recovery: using fasciotomy 9 versus conservative 0. Using fasciotomy, the total recuperation period took more than a year in eight cases. Compartments with an unsatisfactory therapeutic result: fasciotomy 1, conservative 6. Two cases diagnosed as CCS without fulfilling the Pedowitz criteria due to an extended recovery time. These two cases were given conservative treatment but were not complete a good recovery.ConclusionThe latency diagnostic period are longFasciotomy comes out as the better treatment but with recovery times longer than a year in all cases except one.The recovery time of basal pressure during the test seems a variable worth taking into account independently of the Pedowitz criteria, so for that reason we think it deserve an analysis in greater depth.
An exploration of the hydration strategies of the runners of the 2010 london marathon by questionnaire
Authors: Williams Jonathan , Kipps Courtney , Tzorgiou Victoria 
Published: January 2011

BackgroundThere have been several recorded fatalities due to Exercise-associated hyponatraemia (EAH) attributed to excess fluid intake by marathon runners. A significant proportion of runners finishing marathons have been found to be hyponatraemic, mainly due to inappropriate fluid intake.ObjectiveTo explore the hydration strategies of marathon runners, their sources of information and knowledge about fluid intake on marathon day and their understanding of hyponatraemia.DesignAnonymised questionnaire.SettingThe London Marathon Registration.ParticipantsA random sample of 217 runners registering for the marathon.Results93% of the runners had read or been told about drinking fluids on marathon day. The majority of competitors had a plan regarding fluid intake prior to, during and after the marathon. 83.9% said that they knew enough about what and how much to drink on marathon day. However, 34% planned to drink a volume large enough to put themselves at higher risk of EAH. Only 21% knew the volumes of water and sports drink bottles from which they planned to drink during the marathon. 20.7% were planning to take a drink from all 24 water stations. Only 25% planned to drink according to their thirst as recommended by the international EAH conference consensus statement.68% of runners had heard of hyponatraemia or low sodium levels, but only 35% had a basic understanding of its cause and effects.ConclusionsRunners of the 2010 London Marathon lack knowledge about appropriate fluid intake on race day. A significant proportion of participants have drinking strategies that put them at risk of EAH. Runners need to be more effectively educated about safe fluid intake prior to future London Marathons.
Stresses and displacements for normal human knee menisci and for sectioned menisci using finite element method
Authors: Daniela Tarnita , Tarnita D N , Grecu D , Popa D , Rusu F I 
Published: January 2011

IntroductionThe paper has the following objectives: The obtaining of virtual 3D parameterised models of the menisci; the determination of the stresses, deformations and displacements of menisci for different cases and for different mechanical solicitations, using finite element method.MethodsTo obtain the bones cross sections we used a Aura Philips tomograph.–The obtained images were redrawn in AutoCad over the real tomographies and the drawings were imported in SolidWorks (a parametrical Computer Aided Design software), section by section, in parallel planes. The virtual models of the internal menisci and external menisci were obtained.–The initial parameters and kinematical and kinetostatical functions of the virtual biomechanical system of the knee joint were established.–This system was imported in VisualNastran software.–The virtual models of the internal menisci, external menisci were discretised and analysed using the finite element method.ResultsWe obtained the finite elements structure of both human knee menisci. Maps for the von Misses stresses, for the displacements, for the deformations and for the deformation energy in normal menisci. In the cases of 1/3 from the volume of the medial menisci is cut and 1/3 from the volume of the lateral menisci is cut, we simulated a virtual meniscetomy. The stresses and the displacements diagrams were also obtained.ConclusionsFor an indemn anatomical knee, the stress in menisci is un-uniform distributed, the zone of menisci body being the most loaded in both cases: extension and flexion.The deformations in menisci are unequal distributed, the maximum being obtained at the level of the menisci body.In the knee extension, the deformations are almost twice bigger than the deformations in the case of knee flexion.The increasing twice of the loading force in the knee joint determines an increasing of stresses with only 20% because of the amortiser role of the menisci.
Crisp-padhiar syndrome
Authors: Crisp TA , King JB , Chan O , Padhiar N 
Published: January 2011

IntroductionThe common cause of medial midfoot pain following acute trauma usually, either pronatory or inversion sprain is due to tibialis posterior tendon dysfunction, tibialis posterior tendinopathy, Os naviculare syndrome, stress fracture of the navicular and Lisfranc ligament injury. These are disabling conditions which are often treated in isolation.Crisp-Padhiar syndromeWe present a case history which highlights the complexity of the problem and discuss the findings of subsequent series of 42 patients who presented with post-traumatic medial midfoot pain. In Crisp-Padhiar syndrome patients present with combination of the following: (1) trauma, (2) presence of Os naviculare, (3) tibialis posterior tendinopathy, (4) tibialis posterior dysfunction, (5) acquired flatfoot, (6) Os naviculare synchondrosis and (7) anomalous tibialis posterior tendon attachment of Os naviculare.The treatment of choice in the initial stage is to stabilise the medial structures in Aircast Posterior Tibial Tendon Dysfunction brace for 6 weeks, followed by intensive physiotherapy and dependent on reduction of symptoms and degree of flat footedness, consider fluoroscopy guided tendon distension injection and introduction of customised carbon fibre foot orthoses. Surgery was performed only in two patients who did not respond to conservative management.
Chronic exertional compartment syndrome of the foot
Authors: Padhiar N , Tardioli A , Allen M , King J B 
Published: January 2011

In this paper the authors present a case history along with results of case series and a literature review to demonstrate the complexity of this condition.The main aim is to increase the awareness among clinicians and the scientist to research in the area of chronic exertional compartment syndrome (CECS).CECS usually refers to myoneural ischaemia due to a reversible increase in tissue pressure within a myofascial compartment.CECS of the leg is well documented in the literature since it was first described by Mavor in 1956.CECS of the foot remains underdiagnosed and has been reported in the literature only on an anecdotal basis. Wood Jones proposed that there were four compartments in the foot but Manoli and Weber suggest that there are nine separate muscle compartments.Clinical signs and symptoms of CECS of the foot remain diverse and lack the consistency of its counter part in the leg. The range of signs and symptoms include swelling, tension, cramps, tightness, paraesthesia, numbness, cyanosis and soft tissue indurations. As a result number of diagnosis is first considered and includes plantar fasciitis, tibialis posterior tendonitis, tarsal tunnel syndrome and medial Lisfranc injury.CECS of the foot remains a diagnosis of exclusion.The most effective treatment is a superficial fasciotomy.
The important role of the arthroscopic hip surgery in the athletes with hip injuries. our experience. a retrospective study
Authors: Tsikouris G , Tsolos I , Gosis Ch , Plessas S , Moschonas S , Tsikouris D 
Published: January 2011

Hip arthroscopy has gradually evolved over the past two decades.Recently hip arthroscopy has increase its role in diagnosis and treatment for specific intraarticular and extraarticular hip injuries and especially for soft tissue injuries.Material and methodsFebruary 2004–March 2010, 48 athletes, football players, basketball players, weight lifters, gymnasts, three water polo players. Mean age: 32 years. (19–39 year old)Instrumentation and equipment70°, 4.5 mm arthroscope, High flow rate mechanical pump, 15 gauge 6″ cardiac needle, Convex full radius chondroplasty blades, special electrocautery. Distraction apparatus, DVD unit, mechanical water pump unit, mage intensifierIndicationsUndiagnosed hip pain, early osteoarthritic signs, labral pathology, loose bodies, osteochondral defects, sepsis, ligamentum teres, trauma, synovitis, femoral acetabular impingment (FAI), ‘frozen hip’, chondrocalcinosis.SymptomsDeep dull ache pain during hip flexion and external or internal rotation, decrease range of motion, decreased hip flexion.Clinical findings30/48 Cam sign: positive, 12/48 Pincher sign: positive, impingement syndrome in hip flexion and internal and rotation and occasionally in external rotation, snapping hip, iliopsoas tendinitis.SurgeryStandard orthopaedic traction table, supine position, hip is extended and abducted 25°PortalsAnterolateral, posterolateral, modified anterolateralIntraoperative findingsDetachment of the labrum, 10/48 erosion of the articular cartilage of the acetabulum and drilling of the bare area, 30/48 Cam sign excision, 12/48 pincer sign excision, 8/48 superior medial and superior lateral labrum repair with anchors. (intra-articularly)ResultsThe modified Harris Hip Score was used for their classification of their symptoms. Two of the athletes had a residual pain due to an iliopsoas tendinitis. 45/48 had relief from their arm symptoms, 1/48 will need to be reoperated shortly (after he developed FAI), 2/48 are treated for the iliopsoas tendinitis.ConclusionThe athletes with symptoms of an internal hip pain and FAI signs after a detailed clinical exam of their hip and after failure of their conservative treatment, will certainly get a benefit from an arthroscopic procedure (which is technically demanding).