Multiple Fracture following Non-Occupational Fall: A Case Report

Background and Purpose: Falls are prevalent in adults over the age of sixty-five due to lack of balance and decreased lower extremity strength. Non-occupational falls are reported to have an increasing prevalence with age and one-fifth of these types of falls results in hospitalization. The hospitalization of patients who sustain injuries following falls most often results in skeletal fractures. The cost to treat these patients is projected to reach $54.9 billion by the year 2020. The objective of this case report is to demonstrate the outcomes of a patient who sustained multiple fractures following a nonoccupational fall. Case Description: A sixty-five year old female presents to physical therapy within a rural Transitional Care Unit (TCU) following a twelve foot fall through her garage attic ceiling to the ground which resulted in fractures at three joints and a sprained right ankle. She received an external fixation of a left tibial fracture and open reduction internal fixation of the left thumb and right proximal humerus. An examination and evaluation revealed the patient in an immobilizer of the right upper extremity, left thumb splinted and a cast and splint on the left lower extremity. In addition to pain, the patient had weight bearing precautions which involved non-weight bearing on the left lower extremity, right upper extremity and left hand, and limitations in functional movement. A good prognosis was anticipated based on patient motivation. Intervention: Strength training of the lower extremity was targeted at the uninvolved joints to initially build strength that was lost over the preceding period of bed rest and then focused on endurance to return the patient to independence. Transfer training was also included. Education to the patient and spouse as well as a home exercise program were also provided. Outcomes: Following a twenty-three day stay in TCU with physical therapy intervention, the patient was able to complete all sliding board transfers independently and stand with contact guard assist. She was discharged home with her husband and the necessary adaptive equipment. Discussion: The combination of increased lower extremity strength and endurance allowed the patient to be discharged from the TCU to her home with her husband and modified independence. While the patient\u27s response to this intervention plan was positive, the need for further research to determine the long term effects specifically to gait training exists

Measures of Center of Pressure and Lower Leg Muscle Electromyography during Landing before and after Plantar flexor Stretch

Static stretching of the plantar flexor muscles is reported to modify neuromuscular responses to external stimuli. However, it is not known how these muscles respond to external loading in an applied task, such as single-leg drops. Further, if mechanical laxity in the plantar flexor muscles is present after stretching of it is unclear how this laxity will influence the muscle activation and movement patterns of the lower extremities. PURPOSE: This study is intended to further explore the response of the lower extremities to plantar flexor muscle stretch in an effort to understand its impact on potential injury. METHODS: Five participants (20.6 ± 1.1 yrs: 1.78 ± 0.1 m:, 80.6 ± 9.9 kg) performed drop landings from a 30 cm box onto a force platform before and immediately after 10 min of passive plantar flexor stretch. Surface electromyography (EMG) was collected from tibialis anterior (TA), medial gastrocnemius (MG), lateral gastrocnemius (LG), peroneus longus (PL), and soleus (SOL) muscles. Maximal isometric plantar and dorsi flexion efforts were performed before and after 10 minutes on passive plantar flexor stretch. EMG were normalized (NEMG) to maximum values during the maximal isometric efforts. Variables of interest were NEMG at landing and center of pressure (COP) measures. NEMG were assessed 300 ms prior to and after landing onto the force platform. An inertia measurement unit (IMU) was fixed to the tibia to record landing. Comparisons were performed at landing for NEMG and COP/COP velocity up to 5 sec after landing to measure COP/COP velocity variability. Alpha was set at 0.05. RESULTS: NEMG signals differed over time for all muscle from -300 to 300 ms (all p \u3c 0.01). Significant differences in NEMG amplitude were present in MG (0.44 ± 0.5 vs 0.36 ± 0.4), LG (0.28 ± 0.3 vs 0.24 ± 0.3), and SOL (0.40 ± 0.5 vs 0.32 ± 0.3) muscles (all p \u3c 0.05) before and after stretch. COPx (pre: -Δ29.8% post: -Δ56.4%) and COPy (pre: -Δ58.8%, post: -Δ 53.5%) variability measures were significant reduced over time (p \u3c 001). A significant time x condition interaction was present for COPx velocity variability (F6,308 = 2.135, p \u3c 0.049). CONCLUSION: Passive prolonged stretching of the plantarflexor muscles can modify a functional dynamic activity, such as single-leg drop landings. Although COP was not different between the landing before and after static stretch, the control of the balance at landing was different

Evaluation of beef top sirloin steaks of four quality grades cooked to three degrees of doneness

Master of ScienceDepartment of Animal Sciences and IndustryTravis O'QuinnThe objective of this study was to evaluate the impact of quality grade on beef eating quality of top sirloin steaks when cooked to multiple degrees of doneness (DOD). Beef top sirloin butts (N = 60; 15 / quality grade) were collected to equally represent 4 quality grades [Prime, Top Choice (modest⁰⁰ – moderate¹⁰⁰), Low Choice, and Select]. Top butts were cut into six consecutive steaks, and then divided laterally to get a total of twelve steaks per top butt. Steaks were assigned to one of three DOD: rare (60°C), medium (71°C), and well-done (77°C). Steaks within DOD were assigned to consumer sensory analysis, trained sensory analysis, fat and moisture analysis, and Warner-Bratzler shear force (WBSF). There were no interactions (P > 0.05) for all consumer ratings of palatability traits, indicating increases in DOD had the same impact across all quality grades. There was a difference (P > 0.05) within quality grade for consumer ratings of juiciness (P > 0.05). Prime steaks had greater (P medium > well-done). There was a quality grade × DOD interaction (P medium > well-done). Lastly, there were no quality grade by DOD interactions (P > 0.05) for Warner-Bratzler shear force. These results indicate that regardless of the DOD steaks were cooked to, quality grade had minimal impact on the palatability of beef top sirloin steaks. Therefore, unless cooked to a medium DOD, it is unnecessary for consumers, retailers, and foodservice to pay premium prices for higher quality top sirloin steaks, as the same eating experience will be given

Palatability Traits of Sirloin Cap Steaks From Four USDA Quality Grades

Sirloin cap steaks from 4 different USDA quality grades were evaluated to determine the effect of marbling on eating experience. Top sirloin cap steaks (N = 60) of 4 different quality grades (Prime, Top Choice, Low Choice, and Select) were evaluated in the current study. Top sirloin butts were collected, and the biceps femoris was removed, trimmed, and sliced into twelve 2.54-cm-thick steaks. The steaks from each subprimal were aged for 28 d and designated for either trained sensory panels, consumer sensory panels, Warner-Bratzler shear force, or moisture and fat determination. The Prime steaks were rated the highest (P < 0.05) for overall liking and were higher (P < 0.05) for flavor liking than Low Choice and Select steaks within the consumer panels. However, all quality treatments were similar (P > 0.05) in juiciness and tenderness for the consumer panels. Additionally, a similar (P > 0.05) percentage of samples from each treatment were rated acceptable for tenderness, juiciness, flavor liking, and overall liking, with each trait having greater than 70% of samples rated acceptable. Also, Prime steaks were rated the highest (P < 0.05) for sustained juiciness and overall tenderness within the trained sensory panels. Similarly, Prime steaks were rated higher (P <0.05) for initial juiciness than the Low Choice and Select treatments but were similar (P > 0.05) to Top Choice. These results indicate that USDA quality grades impact the eating quality of sirloin cap steaks, especially within the Prime grade, and could provide an opportunity for refined marketing and added economic value for the cut

Biochemical Factors Affecting East Asian Consumers’ Sensory Preferences of Six Beef Shank Cuts

The objective of this study was to evaluate biochemical factors affecting Warner-Bratzler shear force (WBSF) and East Asian consumers’ eating preferences of 6 different beef shank cuts cooked by moist heat. Six different beef shank muscles were collected from 12 USDA Choice beef carcasses (N = 72). Shank cuts from the left sides were cooked with moist heat and used for East Asian consumer sensory evaluation and WBSF, and shank cuts from the right sides were left uncooked and used for biochemical analysis and visual panels utilizing the same group of consumers. A correlation analysis was conducted to determine the driving factors that contributed to WBSF and East Asian consumers’ overall liking for beef shanks. Biceps brachii and flexor digitorum superficialis-pelvic received the greatest sensory overall liking, with deep digital flexor from the foreshank having the lowest scores (P < 0.01). Deep digital flexor from the foreshank had the greatest WBSF value, most cooked collagen content, and greatest insoluble collagen percentage as well as the greatest raw and cooked pyridinoline (PYD) densities among all the beef shank cuts (P < 0.05). For visual overall liking, shank cuts at approximately 700–750 g such as biceps brachii and extensor carpi radialis received the highest ratings (P < 0.01), and consumers indicated that there was no visual difference in surface color among the shank cuts (P > 0.10). Correlation analysis showed that cooked collagen content and insoluble collagen percentage as well as raw PYD densities had positive correlations with WBSF (P < 0.05) and negative correlations with consumer overall liking (P < 0.01). Surprisingly, collagen content from uncooked shank cuts did not have a direct relationship with consumers’ overall liking nor with WBSF. The results demonstrated that raw PYD density may be a great indicator for cooked beef tenderness in beef cuts with a high concentration of connective tissue prepared with moist heat cookery

Evaluation of Beef Top Sirloin Steaks of Four Quality Grades Cooked to Three Degrees of Doneness

The objective of this study was to evaluate the impact of USDA quality grade on beef eating quality of top sirloin steaks when cooked to multiple degrees of doneness (DOD). Beef top sirloin butts (N = 60; 15/quality grade) were collected to equally represent 4 quality grades [Prime, Top Choice (modest00 to moderate100), Low Choice, and Select]. Steaks were assigned to 1 of 3 DOD: rare (60°C), medium (71°C), and well-done (77°C). Steaks were allocated to either consumer sensory analysis, trained sensory analysis, fat and moisture analysis, or Warner-Bratzler shear force (WBSF). There were no interactions (P > 0.05) for all consumer ratings of palatability traits, indicating increases in DOD had the same impact across all quality grades. Prime steaks had greater (P medium > well-done). There was a quality grade × DOD interaction (P medium > well-done). Lastly, there was no quality grade by DOD interaction (P > 0.05) for Warner-Bratzler shear force. These results indicate that regardless of the DOD top sirloin steaks are cooked to, quality grade had minimal impact on palatability. Therefore, it is unnecessary for consumers, retailers, and foodservice to pay premium prices for higher quality top sirloin steaks, as the same eating experience will be provided

Pork Quality Attributes and Eating Characteristics Among Different Premium and Commodity Pork Loin Programs

Pork branding is a common tool used to differentiate products based on quality to assist consumers in making purchasing decisions. Most pork processers have premium pork programs with different parameters related to color, mar-bling, and other quality factors, though many differences in specific criteria exist among programs. The objective of this study was to assess differences in pork quality and the associated eating experience of different premium and commodity pork loin programs available in the retail market. Loins (n=30/brand) from 7 branded (PRE A, B, C, D, and E) and commodity (COM A and B) programs were acquired and fabricated at 14–15 d post-box date into 2.54-cm chops for visual color, marbling, pH, intramuscular fat, drip loss, purge loss, shear force, and trained sensory panels. Overall, few differences were found among products for most of the quality traits evaluated. One commodity brand, COM B, had higher (P<0.05) loin L* values and chop L* values and had lower chop a* values, visual color scores, pH, and drip loss than other treatments, but it did not differ (P>0.05) in initial juiciness, sustained juiciness, or any tenderness measurement. The only quality measurement that was associated with changes in eating experience was shear force value, with the PRE C product having the highest (P<0.05) Warner-Brazler shear force and slice shear force values and the associated lowest (P<0.05) myofibrillar tenderness and overall tenderness ratings in the sensory panels. There were no differences (P>0.05) among any treatment for initial juiciness, sustained juiciness, and pork flavor intensity. The results from this study indicate that the range of pork quality differences sold domestically among the evaluated premium and commodity programs is minimal and does not result in associated differences in eating experience

Do Published Cooking Temperatures Correspond with Consumer and Chef Perceptions of Steak Degrees of Doneness?

The objective of this study was to assess consumer and chef perceptions and knowledge of beef degrees of doneness (DOD) as well as to measure the changes in cooked color over time related to DOD. Steaks from strip loins (M. longissimus lumborum) from each of 5 quality treatments were used for this study. Steaks were cooked to an endpoint temperature of either very-rare (54°C), rare (60°C), medium-rare (63°C), medium (71°C), well-done (77°C), or very well-done (82°C). L*, a*, and b* were evaluated at 0, 1, 2, 3, 6, 9, and 12 min post-cutting and digital pictures were taken immediately on an internal surface of the steak. Digital surveys for the evaluation of the images of the cooked steaks were created for consumers and chefs. There were time × DOD interactions (P 0.05) for DOD responses for steak pictures evaluated by consumers or chefs. Consumers identified the DOD of cooked steaks as the DOD that corresponds to published end-point temperatures 27 to 35% of the time. Chefs typically identified the DOD as 1 DOD higher than which the steaks were cooked for steaks cooked to medium or less and 1 DOD lower for steaks cooked to well-done and higher. This indicates differences exist in the perceptions of DOD between culinary professionals and consumers, and may contribute to decreased consumer satisfaction when ordering steaks in a restaurant

Visual Degree of Doneness Impacts Beef Palatability for Consumers with Different Degree of Doneness Preferences

The objective of this study was to determine the impact on beef palatability perceptions when consumers with varying degree of doneness (DOD) preferences are served steaks cooked to multiple DOD. Paired Low Choice strip loin steaks were randomly assigned to a DOD of either rare (60°C), medium-rare (63°C), medium (71°C), medium-well (74°C), or well-done (77°C). Consumer panelists were prescreened for DOD preference (rare, medium, or well-done) prior to sensory panels and were assigned to panels based on their DOD preference. In the first round of testing, consumers were served 1 sample from each of the 5 DOD under low-intensity red incandescent light to mask any DOD differences among samples. In round 2 of testing, consumers were fed the paired samples cooked to the same DOD under white incandescent lights. There were no (P > 0.05) consumer DOD preference × steak DOD interactions or consumer DOD preference effects for tenderness, juiciness, and flavor ratings when steaks were evaluated under both lighting types. Within the white-lighting testing, there was a consumer DOD preference × steak DOD interaction (P 0.05) in overall palatability among DOD under white-lighting, whereas consumers who preferred steaks cooked to rare and medium rated steaks lower (P < 0.05) for overall palatability as DOD increased. Regardless of DOD preference, consumer sensory ratings decreased (P < 0.05) when steaks were cooked above the consumer’s preferred DOD; whereas sensory ratings improved (P < 0.05) when steaks were served below the consumers’ preferences. These results indicate that overcooking steaks has the greatest negative impact on beef palatability perception and thus, foodservice should err on the side of undercooking steaks to preserve, and potentially improve, eating satisfaction