Case report: medial gastrocnemius strain rehabilitation

Background and Purpose: Gastrocnemius tears are relatively rare, especially when in comparison to the more common Achilles tendon injury. This case study set out to provide insight on setting up a successful rehabilitation program for patients with a medial gastrocnemius strain. Case Description: The patient was a 37-year-old male who presented with a grade II medial gastrocnemius strain that was sustained while dancing on vacation. The patient’s only comorbidity was a BMI of 37 (despite somewhat muscular frame) & the evaluation revealed no red flags. The patient was motivated to heal to walk his kid to school and begin a new exercise journey. Outcomes: Over the 9-week span, the patient improved from 21/80 to 63/80 (55% increase) on the Lower Extremity Functional Scale. The patient’s passive dorsiflexion (leg extended) improved from 5 degrees and painful to 15 degrees and non-painful. Additionally, the patient reported “high satisfaction” with care. Discussion: This study has shown that fostering patient buy-in/compliance, setting expectations for tissue healing times, and a graded exercise program can lead to positive outcomes in patients with a medial gastrocnemius strain

Financial Relationships With Industry Among National Comprehensive Cancer Network Guideline Authors

Financial conflicts of interest (FCOIs) among authors of clinical practice guidelines have the potential to influence treatment recommendations. To quantify FCOIs with industry among authors of the National Comprehensive Cancer Network (NCCN) guidelines. We assessed FCOIs occurring during 2014 among NCCN guideline authors in the United States. All were physician members of the NCCN guideline committees for lung, breast, prostate, and colorectal cancer as of the end of 2014. The data source for FCOIs was Open Payments, which is publically reported by the Centers for Medicare and Medicaid Services. This study was cross-sectional. The proportion of NCCN authors having FCOIs with industry; the average amount received from industry sources per author. Of 125 guideline authors, 108 (86%) had at least 1 reported FCOI. Authors received an average of $10 011 (range,$0-$106 859) in general payments (GPs), which include consulting, meals, lodging, and similar transfers of value, and$236 066 (range $0-$2 756 713) in industry research payments (RPs), including funding associated with clinical trials. Approximately 84% of authors received GPs, while 47% received RPs. Eight (6%) had FCOIs in excess of the $50 000 net and/or$20 000 single-company maximums stipulated by NCCN. Among NCCN guideline authors, FCOIs involving RPs were of greater value, while those involving GPs were more prevalent. Although FCOIs may result from engaging in important scholarship, FCOIs may still influence guideline authors in counterproductive ways. Research is needed to understand how best to manage author FCOIs during guideline creation

Spatio-Velocity CSF as a Function of Retinal Velocity Using Unstabilized Stimuli

LCD televisions have LC response times and hold-type data cycles that contribute to the appearance of blur when objects are in motion on the screen. New algorithms based on studies of the human visual system\u27s sensitivity to motion are being developed to compensate for these artifacts. This paper describes a series of experiments that incorporate eyetracking in the psychophysical determination of spatio-velocity contrast sensitivity in order to build on the 2D spatiovelocity contrast sensitivity function (CSF) model first described by Kelly and later refined by Daly. We explore whether the velocity of the eye has an additional effect on sensitivity and whether the model can be used to predict sensitivity to more complex stimuli. There were a total of five experiments performed in this research. The first four experiments utilized Gabor patterns with three different spatial and temporal frequencies and were used to investigate and/or populate the 2D spatio-velocity CSF. The fifth experiment utilized a disembodied edge and was used to validate the model. All experiments used a two interval forced choice (2IFC) method of constant stimuli guided by a QUEST routine to determine thresholds. The results showed that sensitivity to motion was determined by the retinal velocity produced by the Gabor patterns regardless of the type of motion of the eye. Based on the results of these experiments the parameters for the spatio-velocity CSF model were optimized to our experimental conditions

Longitudinal Study of Water Quality in Jennings Creek, Bowling Green, Kentucky: Urbanization Impacts on Karst Groundwater

Karst groundwater systems, which occur in areas where caves, sinkholes, and underground rivers dominate the landscape, are vulnerable to pollution from surface contaminants. In urban areas, like Bowling Green, Kentucky, which is home to extensive caves and groundwater supplies, the immediate transport of heavy metals, organic waste, chemicals, and other pollutants from surface activities into groundwater poses a serious threat. This research project was done to examine the water quality of urban karst sites in Bowling Green, Kentucky at Jennings Creek, which is a local river primarily fed from springs; the water quality of Jennings Creek was never tested before this project, although it is an input to the Barren River, the area’s primary drinking water source. Weekly water samples were taken at five sites for six weeks over the summer. Each sample site was selected based on its proximity downstream from a primary spring input with a known drainage area and land use. The samples were tested each week for forty-three different parameters related to water quality, which included alkalinity, total organic carbon (TOC), cations, anions, metal concentrations, dissolved oxygen, total chlorine, and E. coli, among others. The results of the data collected indicate different pollutant concentrations based on land use in the area surrounding the spring inputs, with major detrimental changes occurring at the largest spring inputs. The sites in mixed land use areas (agricultural and residential) had more nitrates and phosphate, while urban areas suffered from more industrial waste and metal contamination. Overall, nearly every site exceeded the EPA drinking water quality standard for several parameters, including nitrates, E. coli bacteria, and several metals, indicating that more research is needed to address the primary causes of these contaminants and better practices to mitigate their input into the groundwater system

Age-related Differences in Forearm Muscle Size and Handgrip Maximal and Rapid Force Characteristics

With handgrip strength being an important predictor of future disability and mortality, it is essential to expand our understanding of the age-related changes in handgrip strength characteristics and their underlying mechanisms. Previous studies have reported that decreases in muscle size of the forearm may contribute to age-related deficits in wrist flexion strength. However, we are aware of no previous studies that have examined the contribution of forearm muscle size to age-related differences in handgrip strength, and more specifically, the age-related differences in handgrip maximal and rapid force characteristics. PURPOSE: To determine the effects of age on forearm muscle size [muscle thickness (MT)] and handgrip maximal and rapid force characteristics in young and old females. METHODS: Ten young (age = 22 ± 3 years; height = 162 ± 8 cm; mass = 62 ± 9 kg) and 10 old (age = 68 ± 4 years; height = 160 ± 5 cm; mass = 68 ± 5 kg) females underwent two diagnostic ultrasound assessments followed by three isometric handgrip maximal voluntary contractions (MVCs) using an electronic handgrip dynamometer. Forearm MT (cm) was measured on the right arm using a portable B-mode ultrasound imaging device and linear-array probe. For each MVC, participants sat in an upright position and were instructed to squeeze the handgrip dynamometer with their right hand “as hard and fast as possible” for 3-4 seconds. Handgrip MVC peak force (PF; N) was calculated as the highest mean 500 ms epoch during the entire 3-4 second MVC plateau. Rate of force development (RFD; N·s-1) was calculated as the linear slope of the force-time curve over the time interval of 0-100 ms. Independent samples t-tests were used to compare demographic characteristics, MT, PF, and RFD between age groups. Pearson product-moment correlation coefficients (r) were used to examine the relationships between MT and PF and RFD. RESULTS: There were no differences between the young and old females for height (P = 0.521) or body mass (P = 0.090). The old females exhibited lower MT (old = 1.53 ± 0.22 cm; young = 1.76 ± 0.21 cm; P = 0.026), PF (old = 152.53 ± 28.37 N; young = 209.67 ± 39.08 N; P = 0.001), and RFD (old = 606.96 ± 248.41 N·s-1; young = 1154.04 ± 390.55 N·s-1; P = 0.002) than the young females. Significant positive relationships were observed between MT and PF (r = 0.470; P = 0.036) and RFD (r = 0.485; P = 0.030). CONCLUSION: These findings demonstrated that forearm muscle size and handgrip PF and RFD decrease in old age. The significant relationships observed between MT and PF and RFD in the young and old females perhaps suggest that these age-related declines in forearm muscle size may play an important role in the lower handgrip maximal and rapid force values observed in older adults. As a result, practitioners may consider implementing training programs aimed at increasing MT of the forearm in the elderly which may be beneficial for improving muscle size as well as handgrip maximal and rapid force production

Reliability and Relationship between Ballistic Push-Up and Vertical Jump Peak Ground Reaction Force

Ballistic push-up (BPU) assessments are commonly used to evaluate athletic ability in young adults. It has been hypothesized that the peak ground reaction force (GRF) produced during a BPU may be an important predictor of upper-body strength and explosive performance capacities. However, limited data exist regarding the reliability of BPU GRF and how it relates to peak force values during a countermovement vertical jump (CMJ) test. PURPOSE: The purpose of this study was to examine the reliability of BPU GRF and its relationship with vertical jump GRF values. METHODS: Seventeen young, healthy females (age = 22 ± 3 years; mass = 61 ± 8 kg; height = 163 ± 7 cm) volunteered for this study. Participants visited the laboratory 2 times, separated by 2-7 days at approximately the same time of day (±2 hours). During each visit, participants performed 3 CMJs followed by 3 BPU assessments using a portable force plate. For the CMJs, participants were instructed to jump up as high as possible and explode off the force plate with maximal effort. For each BPU, participants adopted a prone position with hands positioned shoulder-width apart on the force plate. A wooden box of equal height to the force plate supported the participants’ knees. Participants descended from the “up” position by flexing their elbows until they were at an angle of 90°. After reaching this position, participants performed an explosive push-up action to full arm extension with their hands leaving the force plate. Peak GRF was determined during the CMJ and BPU assessments as the highest value from the force-time curve. The intraclass correlation coefficient (ICC) and standard error of measurement expressed as a percentage of the mean (SEM%) were calculated across visits to assess the reliability for BPU and CMJ peak GRF. The relationship between BPU and CMJ peak GRF values was determined by a Pearson product-moment correlation coefficient (r). RESULTS: Means ± SDs (averaged across both visits) were 266.89 ± 49.36 and 1325.78 ± 215.20 N, ICCs were 0.91 and 0.93, and SEM% values were 5.78 and 4.20% for the BPU and CMJ peak GRF data, respectively. A significant positive relationship was observed between BPU and CMJ peak GRF values (r = 0.832, P \u3c 0.001). CONCLUSION: These findings demonstrated that BPU and CMJ peak GRFs may be reliable measures for assessing dynamic upper- and lower-body force production in young, healthy adults. The significant relationship observed between the two tests indicated that those who produced greater forces in the BPU also produced greater forces in the CMJ. Therefore, in addition to upper-body performance, BPU GRF measurements may also be used to predict lower-body explosive performance capacities as assessed during a vertical jump test