Self-reported outcomes are associated with knee strength and functional symmetry in individuals who have undergone anterior cruciate ligament reconstruction with hamstring tendon autograft

Background: The aim of this study was to investigate the relationship between self-reported knee outcomes and limb symmetry indices (LSIs) for hip and knee strength, postural control and single leg hop distance in individuals who had undergone an ACL reconstruction with hamstring tendon autograft (HTG). Methods: A total of 72 participants with a history of unilateral ACL reconstruction with HTG (Mean ± SD age, 28.0 ± 7.6 years; height, 178.4 ± 6.7 cm; mass, 76.9 ± 14.9 kg) were included. IKDC, Lysholm, KOOS and TAMPA scores were used to evaluate self-reported outcomes. Concentric and eccentric knee extensor and flexor strength, and hip abductor strength were measured with an isokinetic dynamometer. Postural control was assessed using the modified star excursion balance test and hop performance using the single leg hop test. The relationships between the LSI scores and the performance measures were explored using the Pearson correlation coefficient. Results: The IKDC, Lysholm and KOOS scores were positively correlated with knee extensor and flexor strength LSIs (p0.05). Conclusions: Self-reported scores were correlated with knee extensor and flexor strength, postural control and hop performance in individuals who have undergone ACLR with HTG. Compared to Lysholm and TAMPA scores, KOOS and IKDC scores were more likely to be correlated with performance-based outcomes. Therefore, KOOS and IKDC scores may help clinicians in RTS decision making when there is a limited time to perform extensive evaluations or access equipment

External Supports Improve Knee Performance In Anterior Cruciate Ligament Reconstructed Individuals With Higher Kinesiophobia Levels

Background: The objectives of this studywere to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals sixmonths post-ACLRwho desired to return to their pre-injury activity levels but felt unable to do so due to kinesiophobia. Methods: This was a cross-sectional study involving 30 individuals six months post-ACLR with Tampa Kinesiophobia Scores N37. Individuals were tested under three conditions: no intervention, KB and KT in a randomized order. Isokinetic concentric quadriceps and hamstring strength tests, one leg hop test, star excursion balance test and global rating scale were assessed under the three conditions. Results: The involved side showed that KT and KB significantly increased the hop distance (P=0.01, P = 0.04) and improved balance (P = 0.01, P = 0.04), respectively, but only KB was found to increase the quadriceps and hamstring peak torques compared to no intervention (P b 0.05). Individuals reported having better knee function with KB when compared to no intervention (P b 0.001) and KT (P=0.03). Conclusions: Both KB and KT have positive effects in individuals post-ACLR which may assist in reducing kinesiophobia when returning to their pre-injury activity levels, with the KB appearing to offer the participants better knee function compared to KT

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

EFFECT OF KINESIO TAPING AND SOFT ORTHOSIS APPLICATION ON THE PAIN AND FUNCTIONAL DISABILITY IN LUMBAR REGION PATHOLOGIES WITHOUT NEUROLOGICAL DEFICITS: A RANDOMIZED CONTROLLED EXPERIMENTAL STUDY

Background: Back pain caused by lumbar region pathologies is a condition that leads to loss of productivity and physical disability, with high costs of diagnosis and treatment. This study was planned to investigate the effect of taping and soft orthosis application on the pain and functional disability in the pathology of lumbar region without neurological deficit. Methods: This study is randomized controlled trial. Sixty-three volunteer patients were randomly divided into three groups of 21 people. Group I, soft orthotics and stabilization exercise program; Group II, Kinesio taping and stabilization exercise program; Group III, stabilization exercise program was applied. After obtaining demographic data of the participants; patients were evaluated in terms of range of motion and muscle strength. We used visual analog scale for pain level assessment, sit and reach test for flexibility assessment, timed up and go test (TUG) for functional ambulation and balance, modified Schober test for lumbar spine flexibility, Oswestry Disability Index in the assessment of functional disability. They were assessed at the pretreatment, third (post treatment) and six week (home programs and follow-up). Results: The results showed that significant differences (p<0.05) occurred over time in the study parameters such as functional ambulation, flexibility, lumbar flexibility, functional disability, pain, strength, range of motion in all groups. In comparisons between groups, there was a difference mainly in favor of Group II (p<0.05). Conclusions: We have concluded that in lumbar region pathologies without neurological deficits, stabilization exercises combined with orthotics and Kinesio taping applications reduces pain and functional disability

The Outcomes Of Anterior Cruciate Ligament Reconstructed And Rehabilitated Knees Versus Healthy Knees: A Functional Comparison

Objective: In this study, we aimed to evaluate and compare the functional performance and muscle strength of cases of ACL reconstruction using bone-patellar tendon-bone graft followed by rehabilitation with those of healthy subjects. Methods: This study included fifteen patients (range: 20 to 35 years) who underwent ACL reconstruction 18 to 24 months previously and a control group of 15 healthy volunteers with similar characteristics. Cases were evaluated with physical examinations, functional tests, subjective scales (Lysholm, Hospital for Special Surgery Knee Score (HSSS), and Tegner activity scale) and isokinetic test. Differences between the reconstruction group and control group were analyzed. Results: Significant differences were found in the activity level of the reconstruction group (p<0.05) and in the clinical findings of the subjects with involved and uninvolved legs (p<0.05). When the reconstructed and control groups were compared according to the limb symmetry index, there were significant differences in single-leg hop test, timed hop test, shuttle run and stair hop test (p<0.05). The study also revealed a significant correlation between the vertical hop and quadriceps strength in the isokinetic test (r=0.56). When the operated knees were compared to the healthy side, mean limb symmetry index was over 92% (with two cases at 88%). When the dominant leg was compared to the non-dominant leg in the control group, the mean limb symmetry index was over 95%. Conclusion: Functional outcomes similar to those of healthy legs can be achieved following ACL reconstruction with bone-patellar tendon-bone grafting and rehabilitation. The similar functional test results of the operated and healthy subjects prove the effectiveness of the rehabilitation program.WoSScopu

Hospital-Based Versus Home-Based Proprioceptive And Strengthening Exercise Programs In Knee Osteoarthritis

Objectives: This study aimed to establish the effects of hospital- and home-based proprioceptive and strengthening exercise programs on proprioception, pain, and functional status in patients with knee osteoarthritis (OA). Methods: Sixty patients with bilateral knee OA were randomly allocated into either a home-based or hospital-based exercise program. Hospital-based exercise group (n=30, mean age 50.23 +/- 9.07 years) received functional training program with proprioceptive ability, ice, and home exercises. Home-based exercise group (n=30, mean age 54.4 +/- 7.9 years) had a program of ice and home exercises. Treatment programs was conducted 5 days per week for 6 weeks (30 sessions). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Monitorized Functional Squat System-Proprioceptive Test (MFSS), timed performance test (TUG), and visual analogue scale (VAS) for the intensity of pain were used to quantify the variables. Results: Both groups demonstrated significant improvement when pre- and post-treatment results were compared for pain intensity, WOMAC, and TUG test scores (p0.05). Hospital-based group demonstrated significantly greater improvement in MFSS, TUG test, and VAS in activity when compared with the home-based group (p<0.05). Conclusion: Both hospital- and home-based exercise programs decreased joint symptoms and improved function in patients with knee OA.WoSScopu

The Effectiveness of Manual Therapy in Supraspinatus Tendinopathy

Objectives: The aim of this randomized controlled study was to assess the efficacy of manual therapy in the treatment of patients with symptomatic supraspinatus tendinopathy. Methods: Seventy-seven patients (age range, 30 to 55 years) with supraspinatus tendinopathy, were randomly assigned to one of the three treatment groups: a supervised exercise program (Group 1), a supervised exercise program combined with joint and soft tissue mobilization (Group 2), or a home-based rehabilitation program (Group 3). All patients had rehabilitation for 12 weeks. Pain level was evaluated with a visual analogue scale (VAS) and the range of motion (ROM) was measured with a goniometer. The Modified American Shoulder and Elbow Surgery (MASES) score was used in functional assessment. Flexion, abduction, internal and external rotation strengths were measured with a manual muscle test. All patients were evaluated before, and at the 4th and 12th week of the rehabilitation. Results: All groups experienced significant decrease in pain and an increase in shoulder muscle strength and function by both the 4th and 12th weeks of treatment (p0.05). However, the greatest improvement in functionality was found in Group 2. Conclusion: Supervised exercise, supervised and manual therapy, and home-based exercise are all effective and promising methods in the rehabilitation of the patients with subacromial impingement syndrome. The addition of an initial manual therapy may improve the results of the rehabilitation with exercise

Comparison Of Slow And Accelerated Rehabilitation Protocol After Arthroscopic Rotator Cuff Repair: Pain And Functional Activity

Objectives: In this study, we sought to compare the effects of the slow and accelerated protocols on pain and functional activity level after arthroscopic rotator cuff repair. Methods: The study included 29 patients (3 men, 26 women) who underwent arthroscopic repair of stage 2 and 3 rotator cuff tears. Patients were randomized in two groups: the accelerated protocol group (n=13) and slow protocol group (n=16). Patients in the accelerated protocol group participated in a preoperative rehabilitation program for 4-6 weeks. Patients were evaluated pre-operatively and for 24 weeks postoperatively. Pain was assessed by visual analog scale, and functional activity level was assessed by The Disabilities of The Arm Shoulder and Hand (DASH) questionnaire. The active range of motion was initiated at week 3 after surgery for the accelerated rehabilitation protocol and at week 6 for the slow protocol. The rehabilitation program was completed by the 8th week with the accelerated protocol and by the 22nd week with the slow protocol. Results: There was no significant difference between the slow and accelerated protocols with regard to pain at rest (p>0.05). However, the accelerated protocol was associated with less pain during activity at weeks 5 and 16, and with less pain at night during week 5 (p<0.05). The accelerated protocol was superior to the slow protocol in terms of functional activity level, as determined by DASH at weeks 8, 12, and 16 after surgery (p<0.05). Conclusion: The accelerated protocol is recommended to physical therapists during rehabilitation after arthroscopic rotator cuff repair to prevent the negative effects of immobilization and to support rapid reintegration to daily living activities.WoSScopu

The Effect of Kinesiotape Application on Functional Performance in Surgeons Who Have Musculo-Skeletal Pain After Performing Surgery

AIM: Surgeons make up a unique group that is at risk for developing work-related musculoskeletal symptoms. The purpose of this study was to evaluate the effect of Kinesiotape technique on pain and functional performance in surgeons who have musculoskeletal system pain after performing surgery. MATERIAL and METHODS: 32 surgeons between the ages of 27 and 44 yrs working in a university hospital were included. The Visual Analog Scale (VAS) was used to evaluate the surgeons' neck and low back pain and the Oswestry Low Back and Neck Disability Indexes were used to determine the impact of pain on daily living activities. First, surgeons were evaluated without Kinesiotape application, then evaluated again on the first day and fourth day of Kinesiotape application. RESULTS: The results showed that surgeons had a significant reduction in neck and low back pain (p<0.05). There were improvements in both Oswestry Low Back Disability Index and Neck Disability Index scores when compared with their initial status (p<0.05). After Kinesiotape application, neck and low back range of motions' scores showed an increase (p<0.05). CONCLUSION: Findings demonstrated that Kinesio taping would be an effective method for reducing neck and low back pain and improving functional performance.WoSScopu

The Physical Characteristics and Performance Profiles of Female Handball Players: Influence of Playing Position

The purpose of the study was to compare physical characteristics and performance values between different playing positions in professional female team handball. Twenty-nine female handball players were categorized as centers (n=6), pivots (n=9), wings (n=8) or goalkeepers (n=16). Measurement of physical characteristics including body height and mass, body mass index; knee muscle strength, scores on the lower limb vertical power (vPower), lower and upper limb performance and trunk extension endurance were determined and compared across playing positions. The goalkeepers had higher knee strength as compared to pivots, wings, and centers (p.20). Pivot players achieved higher vPower than wings, centers, and goalkeepers (p=.011, ηp2=.759). In addition, goalkeepers and wings achieved higher vPower than centers (p.05, ηp2<.20). The pivots and wings had better lower limb performance than goalkeepers and centers (p<.001, ηp2=.682-.701). The present study concludes that depending on their play positions, there are differences in terms of physical characteristics, knee muscle strength, vertical power, and lower extremity performance in elite female handball players. These results could help improve coaches' knowledge of elite female teams in the particular in the country where the study was conducted and in others of similar characteristics