Jala koormusjaotuse mõõtmine ning selle kasutusvõimalused taastusravis

Jala koormusjaotuse mõõtmine võimaldab saada informatsiooni pöia ja hüppeliigese morfofunktsionaalse seisundi kohta kõndimise, jooksmise ja muude funktsionaalsete tegevuste ajal. Jala koormusjaotuse mõõtmine on uus objektiivne meetod tugi liikumissüsteemi ning neuroloogiliste patsientide uurimisel, samuti diabeetilise või perifeerse neuropaatia korral. Artiklis on antud lühiülevaade uue diagnostikameetodi põhimõtetest ja kasutusvaldkondadest. Eesti Arst 2003; 82 (3): 161–16

Infrapunakiirguse mõjust kehakaalule tugiliikumissüsteemi kaebustega naispatsientidel

Eestis esineb jätkuv suur haigestumus ja suremus vereringehaigustesse, mille üheks riskiteguriks on ülekaalulisus. Kehakaalu langetamisel on oluline organismi viidud energiaallikate hulga ja energia kulutamise õige vahekord. Käesoleva uuringu eesmärgiks oli selgitada infrapunakiirguse ainevahetust kiirendavat ja kehakaalu langetavat toimet ülekaalulistel naispatsientidel, kes pöördusid taastusarsti vastuvõtule tugiliikumissüsteemi kaebustega. Uuringus kasutati üldist infrapunakiirgusprotseduuri, mille järel esines kehakaalu langust 45%-l osalenutest, kuigi muutused ei saavutanud keskmise kehakaalu, KMI, rasvaprotsendi ja rasvamassi osas statistilist usaldus väärsust. Samas täheldati patsientidel märgatavat meeleolu paranemist ja väsimustunde vähenemist, ka valusid liigestes esines neil pärast ravikuuri tunduvalt vähem. Eesti Arst 2006; 85 (4): 285–28

Põlveliigese funktsionaalne võimekus ja subjektiivne seisund 20 aastat pärast eesmise ristatisideme rekonstruktsiooni põlvekerdakõõluse autotransplantaadiga endistel tippsportlastel

Eesmise ristatisideme (ERS) vigastust peetakse üheks põlveliigese sidemete enam levinud vigastuseks. ERSi rekonstruktsiooni järgseid kaugtulemusi on patsientide subjektiivse hinnangu ning objektiivsete näitajate põhjal Eestis vähe uuritud. Töö eesmärk oli hinnata retrospektiivselt subjektiivseid ja objektiivseid kaugtulemusi 20 aastat pärast ERSi taastamist. Uuriti 15 meessoost patsienti, kellel taastati ERS, kasutades põlvekedra kõõluse autosiirikut. Kaugtulemustes esines kõikides KOOSi alakategooriates opereeritud ja terve jala võrdluses statistiliselt oluline erinevus, neist suurim elukvaliteedi alakategoorias (p ≤ 0,005). Sääre sirutajalihaste (reie nelipealihase) isokineetilise jõumomendi näitajates esines statistiliselt oluline erinevus opereeritud ja opereerimata jala võrdluses nurkkiirusel 60°/s (p ≤ 0,008) ja nurkkiirusel 180°/s (p ≤ 0,005). Sääre painutajalihaste (nn hamstring-lihaste) jõumomendi näitajate tulemustes statistiliselt olulised erinevused puudusid. 20 aastat pärast ERSi taastamist on opereeritud jalal reie nelipealihase jõunäitajad väiksemad ning kaebusi on rohkem võrreldes opereerimata jalaga. &nbsp

Men have higher risk of kinesiophobia after anterior cruciate ligament reconstruction in long term follow up.

Background Psychological and physiological factors could negatively affect patients' recovery and increase re-injury rate after anterior cruciate ligament reconstruction (ACLR). In daily practice surgeons and physiotherapists see athletes struggling to improve muscle strength and complaining of lack of self-confidence during the progress of return to sport. The Tampa Scale for Kinesiophobia is a valid questionnaire to measure a patient's psychological status and isokinetic test is widely used to measure muscle recovery. Hypothesis Patients with kinesiophobia have inferior self reported and functional outcomes after ACLR. Methods 140 patients, 100 (71%) men and 40 (29%) women, mean age 32.5 (±8.3), were included in the study 5.5 (±1.25) years after ACLR. All patients were operated by two senior surgeons. Preoperative and postoperative assessments were performed by two sports specialized physical therapists. Patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee score and Tampa Scale of Kinesiophobia (TSK-17). Quadriceps and hamstring muscle isokinetic strength was assessed at 60°/sec and 180°/sec using the HumacNorm dynamometer. Functional performance was tested with the single-leg-hop test for distance and the Y-balance test for anterior reach. Variables of the study were described by means and standard deviations. Shapiro-Wilk test was conducted to test for normality of the variables and unpaired t-tests were used to test for differences between subgroups. After tests were conducted, simple Bonferroni adjustment was applied to account for the number of tests made. Results 68/140 patients (48.6%) reported a Tampa kinesiophobia score equal or higher than 37 points, above which is the cut off score for kinesiophobia. Patients with kinesiophobia had statistically significant lower scores in the KOOS Symptoms (p=0.001) and Quality of Life subscores (p=0.001), Total score (p=0.001) and the Oxford Knee Score (p=0.024). Isokinetic peak torque muscle strength mean deficits at 60°/sec and 180°/sec for knee flexion and extension were between 6% and 7% for patients with kinesiophobia and between 2% to 4% for patients without kinesiophobia compared with the contralateral side, with no significant differences between groups. There was no statistically significant difference in the Single-leg-hop test for distance leg ratio (0.98 (±0.19) and 1.00 (±0.26)) and the Y-balance test for anterior reach leg ratio (0.99 (±0.08) and 1.01 (±0.07)) respectively between the groups. Conclusion At 5 years after ACLR operated leg functional performance is equal to nonoperated leg. However kinesiophobia is present in nearly half of patients. Strength and functional tests alone are not good enough instruments for assessing complete recovery, on the other hand self-reported questionnaires have high correlation to kinesiophobia after ALCR. Further studies are needed to avoid development of kinesiophobia as well how to recognize phobia at early stages of rehabilitation

Seven-month wintertime supplementation of 1200 IU vitamin D has no effect on hand grip strength in young, physically active males: A randomized, controlled study

Background There has been a growing interest in the role of vitamin D for the well-being and physical performance of humans under heavy training such as conscripts in military service; however, there is a lack of long-term supplementation studies performed on members of this type of young, physically active, male population. The hypothesis of the study was that vitamin D supplementation during wintertime will decrease the prevalence of critically low vitamin D blood serum levels and increase hand grip strength during the winter season among young male conscripts. Study Design Longitudinal, triple-blinded, randomized, placebo-controlled trial. Methods Fifty-three male conscripts from the Estonian Army were randomized into two groups: 27 to an intervention group and 26 to a placebo group. The groups were comparable in terms of their demographics. The intervention group received 1200 IU (30 µg) capsules of vitamin D3, and the control group received placebo oil capsules once per day. The length of the follow-up was 7 months, from October 2016 until April 2017. Blood serum vitamin D (25(OH)D), parathyroid hormone (PTH), calcium (Ca), ionized calcium (Ca-i), testosterone and cortisol values, and hand grip strength were measured four times during the study period. Results The mean 25(OH)D level decreased significantly in the control group to a critically low level during the study, with the lowest mean value of 22 nmol/l found in March 2017. At that time point, 65% in the control group vs 15% in the intervention group had 25(OH)D values of less than 25 nmol/l (p < 0.001). In the intervention group, the levels of 25(OH)D did not change significantly during the study period. All other blood tests revealed no significant differences at any time point. The corresponding result was found for hand grip strength at all time points. Conclusion Long-term vitamin D supplementation during wintertime results in fewer conscripts in the Estonian Army with critically low serum vitamin D (25(OH)D) levels during the winter season. However, this did not influence their physical performance in the form of the hand grip strength test