bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of loading speed on the force frequency spectrum during eccentric & concentric calf exercise
Authors: Chaudhry S , Screen H R C , Woledge R C , Bader D , Morrissey D 
Published: January 2011

IntroductionHeavy load eccentric training (ET) has been shown to be more effective than concentric training (CT) in treating Achilles tendinopathy.1 2 It is unclear at what speed ET should be performed to treat the condition with greatest efficacy. Recent studies have indicated that high frequency tendon force fluctuations may underpin therapeutic mechanotransduction, but the effect of training speed on resulting tendon vibration remains unexplored. The aim of this study was to compare tendon vibration during ET and CT at three speeds commonly employed during conservative treatment.Methods24 healthy volunteers (12 male and 12 female, age=27.8±1.9 years) performed ET and CT exercises for the Achilles tendon either at a fast (loading phase=1.5 s), medium (loading phase=3 s) or slow pace (loading phase=6 s). Tendon vibration was measured by analysing the power spectra of the ground reaction force vector using a fast Fourier transform with 1Hz windows, and compared using ANOVA.ResultsHigh frequency vibrations (8–13 Hz range) were greatest during fast and medium speed ET, with a mean of 15.8 N2/Hz (sd=8.8). This was significantly greater than all other combinations of conditions and speeds (p value range across these frequencies=0.03–0.001). No significant differences between any combinations of speed and loading condition were found in the 1–7 Hz low frequency range (p value range=0.11–0.98).ConclusionThe observed high frequency Achilles tendon force fluctuations during fast and medium speed ET were mostly in the higher frequency range, reflecting where physiological tremor particularly occurs. This may reflect inefficient recruitment of large motor units at high speeds, creating oscillation frequencies that are known to stimulate mechanotransduction in tenocytes. These findings were made in normal subjects and pave the way for exploration in patients with tendinopathic disease.
A modelling approach to aid the understanding of high volume image guided injection in recalcitrant achilles tendinopathy
Authors: Twycross-Lewis Richard , Lu Yiling , Malliaras Peter , Mueller Jens-Dominik , Maffulli Nicola 
Published: January 2011

BackgroundHigh volume image guided injections (HVIGI) have recently been shown to significantly reduce pain and improve function in patients with resistant Achilles tendinopathy. However, the mechanism by which HVIGI treatment works has yet to be identified.MethodsSubjects will be recruited from the London Independent Hospital for either open surgery for Achilles tendinopathy or for intervention by HVIGI. Tissue from the Kager's fad pad will be removed during open surgery for Achilles tendinopathy and paratendinopathy. Mechanical loading of the Kager's sample will be performed using an MTS Biomex 100 at varying applied loads in order to plot the Young's Modulus. Concurrent to this, patients undergoing HVIGI treatment will be recruited to undergo imaging by MRI scan during high volume injection to measure fluid distribution during and immediately after injection. Geometries of the tendon and Kager's fat pad will be reconstructed from images using Mimics software, which constitutes the computational domain of numerical modelling. Poroelastic theory will be adopted to model both Achilles tendon and Kager's fat pad with their distinctive parameters. Mechanical responses of the whole system will be compared before and after the injection. The fluid pressurisation and resultant stress/strain distribution are crucial to understanding the working mechanisms for HVIGI.ResultsParametric studies of the injection treatment will be conducted numerically by adjusting different loading speeds and loading time intervals between injections and volumes. This is for the first time Kager's fat tissue has been mechanically characterised. In combination with poroelastic modeling, we will be able to obtain the detailed strain and stress information and injected fluid movement, which are important to understand the mechanism underlying the high volume image guided injection.DiscussionIt is expected that results from this study will elucidate the unknown mechanism by which HVIGI works, particularly the effect on neovasculature associated with Achilles tendinopathy
Collagen v expression in skin, tendons and capsules of athletic population after shoulder dislocation and acl injuries
Authors: Akhtar M A , Ingman T G , Robinson C M , Keating J F , Muir A Y , Simpson H , Salter D 
Published: January 2011

IntroductionCruciate ligament ruptures and shoulder dislocations are often caused by trauma, but predisposing intrinsic factors might also influence the risk. Collagen type V is widely distributed in tissues and helps regulate the diameters of fibrils of the abundant collagen type I. Mutations in its genes have been identified which can result in connective tissue fragility, particularly in skin and joints.The aim of this study was to localise collagen V in skin, hamstring tendons and shoulder capsules of patients following sports injuries.Patients and methodsLocalisation of collagen V was studied by immunohistochemical staining of paraffin embedded sections of skin, tendons and capsules of patients attending for shoulder stabilisation for recurrent instability or primary anterior cruciate ligament (ACL) reconstruction between November 2008 and July 2009.Results40 patients were studied, 25 undergoing primary ACL reconstruction and 15 undergoing shoulder stabilisation. The mean age of patients was 26 years. 34 patients (85%) were male and 6 female (15%). Most common sport played was football in 13 patients (32%) followed by rugby in 10 (25%) and skiing in 5 (12%).Skin epidermis stained negative but dermal papilla, papillary and reticular dermis, blood vessels, sweat glands, sebaceous glands and arrector pilli stained positive to varying degrees for collagen V. Synovial surface of the capsule, blood vessels and extracellular matrix stained positive to varying degrees. Tendon sheath, collagen fibres, blood vessels and interfascicular connective tissue stained positive to varying degrees, but skeletal muscle was negative for collagen V.DiscussionWe looked at the expression and distribution of collagen V in skin, tendons and capsules of patients undergoing shoulder stabilisation or ACL reconstruction following sports injuries. There may be a link in the distribution of collagen V and strength of tissues, which can predispose individuals to injuries while playing sports and can also affect healing process. Further studies are needed to study this link.
Profound diathermy uhf in sport traumatological pathology
Authors: Jordi Suros Romagos , Joaquim Suros Frigola , Iris Parrilla Forcada 
Published: January 2011

IntroductionProfound diathermy ultra high frequency (UHF), are electromagnetically waves which create a profound therapeutic thermal increase, at a muscle, tendon, or intra joint level depending pathology or therapeutically demand.Those are non-ion sated waves that through the therapeutic profoundness achieve to enter till 8–10 cm acting on the focal point of the lesion/injury. The deepness and these results can not be reached with any microwave or short wave.The working of the therapeutically frequency is 433.9 mHz with the potential of 150 w. Applicable in every acute inflammatory joint and chronicle dystrophy, fibrosis post surgical, tendinosis, condropathy, bursitis, hematomas, joint dislocation. With very high results from the first application through the profound thermal vasodilatation application in the tissue, creating a wide tissue oxygenation and stimulation of the segregation of collagen.This type of technology al by herself is very resolute and doesn’t have any side effects.You can take the benefit of the application of other therapies to potency the therapeutically effect.The application of the profound diathermy UHF, accelerates the recovery process, reduces the time of pain and reduces the rest time (of not paying sport), accelerating the reincorporation of the sport activity. Decrease the risk of consequences.The application of the therapy is 10 min it is possible to do it twice a day to accelerate the efficiency therapeutically, but then it would be enough to do it twice a week.The healing of the pathological described above last between 10 and 20 sessions.
The role of active knee rom for posterior thigh muscle injuries prevention
Authors: Siozos A , Malliaropoulos N , Tsiftsogloy D , Xristodoulou D 
Published: January 2011

Athletes' physiological characteristics are fundamental both in terms of performance and injuries prevention. One of those is flexibility. Using an easy and cheap method, goniometry, estimating active knee range of motion (ROM) through the whole training and competing season, we can possibly lower the incidence of posterior thigh muscle injuries.PurposeThe aim of our study was to assess the effects of repeated, on a regular basis, active knee ROM measurements in order to prevent posterior thigh muscles injuries (POTMI).MethodsDuring 2006–2008 we followed up 100 Greek athletes (elite and non-elite) whose active knee ROM was measured in both sides. We estimated the active knee ROM related to their sport (runners-jumpers/sprinters-throwers), their performance (elite and non-elite ones) and their posterior thigh muscle injury rate.ResultsJumpers/sprinters were found to have a statistically significant higher active knee ROM (>71°) in comparison with the runners (69.3°) and throwers (69.4°) group.Elite athletes' active knee ROM was higher than non-elite ones' and the difference reached statistical difference. Finally elite athletes were found to have fewer and less severe injuries than the non-elite ones.ConclusionOur results suggest thatJumpers/sprinters have generally higher active knee ROM than other track and field athletes.Elite athletes were found to have higher active knee ROM than non-elite ones. That seems to protect them from injuries of the hamstring muscles.Active knee ROM measurement can be an easy and practical method of follow-up and a useful tool for injury prevention.
The role of patellar entesophyte in jumper's knee. ultrasound findings in 18 athletes' knees
Authors: Silván D Martínez , Pazos F Baró , Valero A Roldán , Justo X Díaz , Jaén T Fernández 
Published: January 2011

IntroductionPatellar tendinopathy (jumper's knee) is a common injury in those sports causing high-torque forces on the patella. Several investigations have tried to elucidate its aetiology, being structural changes in the tendon insertion at the inferior patellar pole the most studied finding. Although the overload at the pole seems to be the cause of the formation of the entesophyte, its role in jumper's knee remains unclear.MethodsStudy design retrospective cohort study with two groups:–Jumper's knee group (JKG): 12 elite athletes (18 pathologic knees, mean age 29.6±7.09) from different sport specialities, with a clinical diagnosis of patellar tendinopathy from 2007 to 2010.–Control group (CG): 18 elite athletes (mean age 28.1±5.4) without any previous clinical history of patellar tendon injury.Anthropometrical measurements, evolution time of symptoms, and grade of tendinopathy (Blazina scale 1–4) were determined, and by means of color Doppler ultrasound examination (Voluson 730 General Electric SP6-12. Multi-frequency linear transducer) structural changes and neovascularisation (Hoksrud criteria) were classified, and tendon thickness (6 mm from the apex) and entesophyte length (if present) were measured.ResultsThe average evolution time of symptoms was 22.9 months, and the average Blazina scale grade for JKG was 2.7±1. No statistically significative data were found between anthropometry and symptoms. Ultrasound examination revealed that the entesophyte was present in 16 of 18 pathological tendons (JKG=89%, CG=27%), with a medium length of 6.1±3.6 mm (CG=2.1±0.4mm). Neovascularisation was present in 13 of 18 pathological tendons (JKG=72%, CG=5%), and the average tendon thickness was 69.8% higher in JKG than in CG (JK=8.68 mm/CG=5.11 mm). A direct relationship among entesophyte length, tendon thickness and evolution time of symptoms was found.ConclusionsPresence and size of a distal enthesophyte in the inferior patellar pole influence the perpetuation of symptoms, and determine tendon degeneration and chronicity.
Platelet-rich plasma (prp) and tendon healing: animal model
Authors: Kaux J F , Drion P , Renouf J , Pascon F , Libertiaux V , Colige A , Le Goff C , Lambert C , Nusgens B , Gothot A , Cescotto S , Defraigne J O , Rickert M , Crielaard J M 
Published: January 2011

IntroductionThe tendon is a tissue which does not heal easily. Recently, several studies have demonstrated the positive effects of platelets on the healing process of tendons. A local injection of platelet-rich plasma (PRP), which releases in situ many growth factors, has the potentiality to enhance the tendon healing process. The aim of our experiment was to ascertain by an original mechanical measure whether the use of PRP was of interest for accelerating the healing process of rats' Achilles tendons after surgical induced lesion.MethodsA 5 mm defect was surgically induced in 90 rats' Achilles tendon. Rats were divided into two groups of 45: (A) control (no treatment) and (B) PRP treatment. Rats of group B received a PRP injection in situ after the surgery. Afterwards, rats of both groups were placed in their cages without immobilisation. After 5, 15 and 30 days, 10 traumatised Achilles tendons of each group were dissected and removed. Immediately after sampling, tendons were submitted to a biomechanical tensile test up to rupture, using a ‘Cryo-jaw’. After that, transcriptomic analyses were made on the tendon samples, to study the expression of type III collagen, matrix metalloproteases and tenomodulin. A hydroxyproline dosage was done to quantify the collagen in the tendon during its healing process. Tendons of the 15 remaining rats of each group were subjected to a histological study, respectively at day 5, 15 and 30 (five rats for each time).ResultsWe demonstrated that the force necessary to induce tendon rupture during biomechanical tensile test study was greater for tendons which had been submitted to an injection of PRP compared to the control group: +19% (day 5), +30% (day 15) and +43% (day 30). Histological study showed that PRP could enhance cells proliferation, angiogenesis and collagen organisation. Our biochemical analyses did not explain beneficial effects of PRP. Indeed, there was no significant difference neither between the expression of different studied genes, nor in the quantity of hydroxyproline between both groups.ConclusionThis experimentation has shown that a PRP injection could accelerate the tendons healing process and improve its quality.
Pitch side combined assessment for suspected ankle fractures
Authors: Pechlivanidis H , Malliaropoulos N , Christodoulou D 
Published: January 2011

ObjectiveTo assess the sensitivity of two musculoskeletal tests as primary examination for on site use.MethodsI searched through electronic search engines for articles ranging from 2000 to 2010. I used the key words: ankle injuries, ankle examination, ankle assessment and tuning fork.Data synthesisAnkle injuries are a common injury in sport accounting for 15–45% of all sport injuries. 85% of all ankle injuries concern the lateral ankle complex. However differential diagnosis suggests the examination of fractures such as at the malleolus, fifth metatarsal, navicular, anterior calcaneus process and at the midtarsal bones. During sport events in the misfortune incidence of an ankle injury physicians are required to assess their athletes. However according to each games rules and situation they are required to assess in shortest time possible.Ottawa ankle rules (OAR) have been suggested to have a high sensitivity to detect to assess fractures (Northrup et al 2005; Papacostas et al 2001). Papacostaset al(2001) examined 122 patients and found 100% sensitivity for maleolar and midfoot fractures when applied the OAR. Leddyet al(2002) found 100% sensitivity in 217 patients applying the OAR-Buffalo modification. Moore (2009) found high sensitivity (n=10) using a tuning fork for the detection of transverse fractures. Further is suggested that the use of a tuning fork is an fast and reliable method to assess possible fractures (Moore 2009).ConclusionWe believe that the combination of those two tools can provide a clear and fast initial evaluation during an event. Nevertheless in a clinical or on site setting can further increase reliability for assessing fractures where x-ray is not available. However, further investigation is required regarding the reliability of the tuning fork in assessing fractures, reliability of the examiner and time required to complete the progressive examination.
Re-injury following acute posterior thigh injuries in elite track and field athletes
Authors: Isinkaye T , Malliaropoulos N , Tsitas K , Maffulli N 
Published: January 2011

IntroductionHamstring muscle strains can lead to an increased risk of reinjury. We recently proposed a clinical classification system for acute hamstring strains. We studied the effect of the grade of the initial injury on the subsequent risk of reinjury. We hypothesised that there would be no difference in reinjury rate between acute low grade (grade I and II) and high grade (III and IV) hamstring muscle strains.MethodsBetween 1994 and 2007, we managed 165 elite Greek track and field athletes with acute, first-time unilateral hamstring muscle strains. Using a validated classification system, strains were classified into four grades (I, II, III and IV) based on objective clinical criteria (knee active range of motion deficit at 48 h). The same rehabilitation protocol was prescribed to all athletes and the rate of reinjury was recorded during the following 24 months.ResultsAt follow-up, 23 of the 165 athletes (13.9%) had experienced a second hamstring muscle strain. Of the 75 athletes presenting with a grade I injury, 7 (9.3%) had experienced a recurrence after 24 months. Of the 58 athletes presenting a grade II injury, 14 (24.1%) experienced a recurrence. Of the 26 athletes presenting a grade III injury, 2 (7.7%) experienced a recurrence and of the 6 athletes presenting a grade IV injury, none had experienced a recurrence after 24 months.ConclusionsAccording to our classification, athletes with acute grade II hamstring muscle strains experience a higher risk of reinjury than athletes with grade I or grade III strains. Low grade hamstring muscle sprains lead to a higher risk of reinjury than high grade hamstring muscle sprains. Objective clinical findings can accurately predict the risk of reinjury following acute hamstring muscle strains.
Treatment of talar osteochondral lesions using local osteochondral talar autograft mid term results
Authors: Evangelou Evangelos , Badekas Thanos 
Published: January 2011

BackgroundOsteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. A variety of treatment methods exist for OLT. The use of local Osteochondral talar autograft is an established treatment method for such articular cartilage defects. We present a series of patients treated this way for osteochondral defects of the ankle, and assess the functional and clinical long-term results.Materials and methodsFrom March 2005 to December 2008, 11 patients underwent implantation of local osteochondral talar autograft for OLT, 6 male and 5 female. The graft was harvested from the medial or lateral talar articular facet on the same side of the lesion. Graft sizes ranged from 4 to 8 mm in diameter. Age ranged from 19 to 53 (mean 38) years. Sports related injury concerned eight patients and the duration of symptoms was mean 65 months (range 6–98). Mean follow-up was 41 months (range 16–61). Preoperative and postoperative results evaluated used the American Orthopaedic Foot & Ankle Society (AOFAS) score. Special diagnostics studies performed preoperative, MRI (11 patients), computed axial tomography (11 patients), bone scan 2 patients and weight-bearing radiographs to all of them to evaluate the injury.ResultsAll osteotomies healed. The AOFAS average score improved from mean 65 pre- to 89 postop. The AOFAS score was slightly higher in patients under 40 years of age and in those without pre-existing joint arthritis. Concerned satisfaction all the patients would have the procedure again. The most common post op complaint was a mold ache at anteromedial joint line of the ankle. There were no complications in the study group. Most returned to pre injury level of activity. Two patients had a second look arthroscopy one 6 and one 12 months post because of impingement of lateral malleolus the first and debridement of anterior tibial margin the second. Both of them had incorporation of the graft into the surrounding talar dome cartilage.ConclusionWe believe treatment of talar osteochondral lesions using local osteochondral talar autograft is a reliable treatment method. The long-term results confirm that it is a well-accepted procedure from the patients with no high risk of complications compared to other procedures.
Is soy milk a better recovery aid compared to semi-skimmed milk after exercise? does it increase time to exhaustion in trained cyclists?
Authors: Ravalia Shimal 
Published: January 2011

IntroductionMilk has been proven to be a popular recovery drink for trained cyclists to achieve high profile results because milk contains carbohydrates and protein. On the other hand, research has now shown that Soy milk can be just as effective as semi skimmed milk as it contains the same high quality protein.MethodFor the first visit, eight male trained cyclists took part in a maximum oxygen consumption test (VO2max) to determine each participant's VO2 max and maximum power output (Pmax).The second visit consisted of the glycogen depletion trial where each participant had to cycle at 90% of their Pmax for 2 min and then cycle for 2 min at 50% of their Pmax. This was in a form of intervals and continued until participants could no longer maintain their pedal rate. The percentage was then decreased to 80%, 70% and 60%.This was followed by a 4 h recovery period. Participants were given 355 ml of soy milk or semi-skimmed milk in a double blind, randomised design at the start and then 2 h into the recovery process. Both drinks were masked with 10 g of cocoa powder.The Endurance trial followed which required participants to cycle at 70% of their Pmax until exhaustion. Heart rate, body hydration, blood lactate, food diaries and gastrointestinal distress questionnaire were variables that were also measured throughout.ResultsTime to exhaustion at the end of the endurance trial showed six out of eight participants cycled for longer with semi-skimmed milk (11.9±3.6 min). Only two participants cycled longer with soy milk (9.9±3.2 min). There were no significant differences in the results or any of the variables measured.ConclusionThe present study did not reveal significant results when testing for the relevance of the ingestion of soy milk over semi-skimmed milk.