The effect of an exercise program in conjunction with short-period patellar taping on pain, electromyogram activity, and muscle strength in patellofemoral pain syndrome

Background: McConnell recommended that patellar tape be kept on all day, until patients learn how to activate their vastus medialis obliquus (VMO) during an exercise program. This application may pose problems because prolonged taping may be inadvisable for some patients or even contraindicated owing to skin discomfort, irritation, or allergic reaction. Hypothesis: Wearing patellofemoral tape for a shorter duration during an exercise program would be just as beneficial as a prolonged taping application. Study Design: Prospective cohort. Methods: Twelve patients and 16 healthy people participated. Patients underwent short-period patellar taping plus an exercise program for 3 months. Numeric pain rating, muscle strength of the knee extensors, and electromyogram activity of the vastus lateralis and VMO were evaluated. Results: There were significant differences in electromyogram activity (P=.04) and knee extensor muscle strength (P=.03) between involved and uninvolved sides before treatment. After treatment, pain scores decreased, and there were no significant differences between involved and uninvolved sides in electromyogram activity (P=.68) and knee extensor strength (P=.62). Before treatment, mean VMO activation started significantly later than that of vastus lateralis, as compared with the matched healthy control group (P=.01). After treatment, these differences were nonsignificant (P=.08). Conclusion: Short-period patellar taping plus an exercise program improves VMO and vastus lateralis activation. Clinical Relevance: A shorter period of taping for the exercise program may be as beneficial as a prolonged taping application. © 2009 The Author(s)

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

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

The Effects of Additional Kinesio Taping Over Exercise in the Treatment of Patellofemoral Pain Syndrome

Objective: The purpose of this prospective, randomized, controlled study was to determine the effects of kinesio taping in the treatment of patients with patellofemoral pain syndrome (PFPS). Methods: Thirty-one women with PFPS (mean age: 44.88 years; range: 17 to 50 years) were randomly assigned to either a kinesio taping (KT) (n=15) or control (n=16) group. Both groups received the same muscle strengthening and soft tissue stretching exercises for six weeks and the KT group additionally received kinesio taping at four day intervals for six weeks. Visual analog scale was used to measure pain intensity. Tension of the iliotibial band/tensor fascia lata and hamstring muscles and the mediolateral location of the patella were measured before the treatment and at the end of the third and sixth week. The Anterior Knee Pain Scale / Kujala Scale was used for the analysis of functional performance. Results: Comparing pretreatment and 6th week values, significant improvements were found in pain, soft tissue flexibility and functional performance of both groups (p0.05). The KT group had significantly better hamstring flexibility than the control group at the end of three weeks (p<0.05). Conclusion: The addition of kinesio taping to the conventional exercise program does not improve the results in patients with PFPS, other than a faster improvement in hamstring muscle flexibility

Force Sense Evaluation Of The Knee Joint Following Meniscectomy Related With Degenerative Meniscal Tear

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Which One Enhances Muscular Performance In Acl Reconstructed Subjects: Brace Or Tape?

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THE CLINICAL AND SONOGRAPHIC EFFECTS OF KINESIOTAPING AND EXERCISE IN COMPARISON WITH MANUAL THERAPY AND EXERCISE FOR PATIENTS WITH SUBACROMIAL IMPINGEMENT SYNDROME: A PRELIMINARY TRIAL

WOS: 000341190200008PubMed ID: 25108752Objective: The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. Methods: Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. Results: At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P < .05). Conclusion: For the group of subjects studied, no differences were found between kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks

Anterior Cruciate Ligament Quality Of Life Questionnaire

Objectives: Despite a number of questionnaires in the area of ACL injuries there is a need for cross-cultural adaptation for patients with ACL reconstruction (ACL-R). To test the measurement properties of the Turkish version of the Anterior Cruciate Ligament Quality of Life Questionnaire (ACL-QOL). Methods: One-hundred nineteen patients with ACL-R completed internal consistency, agreement, construct validity, floor and ceiling effect analyses. Eighty out of 119 patients with ACL-R completed the Turkish adapted version of the ACL-QOL questionnaire twice for the test-retest reliability. A subgroup of thirty-nine patients undergoing physiotherapy were also asked to answer the ACL-QOL questionnaire, the Lysholm knee scale (LKS), Knee Outcome Survey – Activities of Daily Living Scale (KOS-ADLS) and the Short Form-36 (SF-36) at preoperative, 16th week and 2 years post-operatively to assess responsiveness. Results: The questionnaire had high internal consistency (Cronbach α=.95). The paired t-test showed no significant difference between the test-retest means. The intraclass correlation was excellent for reliability and agreement in five domains and overall score (ICC: 0.95, 0.95, 0.97, 0.95, 0.96, and 0.95; p<0.001). The standard error of measurement (SEM) and the minumum detectable change (MDC95) were found to be 3.14 points and 8.70 points, respectively. The questionnaire showed a fair correlation (r=0.23) with (LKS) and a poor correlation (r=0.14) with (KOS-ADLS); good and very good construct validity (r=0.51, r=0.62) with SF-36 physical component score and mental component score, respectively. We observed no ceiling and floor effects overall on the ACL-QOL questionnaire except the subdomain of “work-related concerns” (22.9%). The responsiveness demonstrated a dramatic effect size of 2.12 at the 16th week and large effect size of 0.97 at 2 years follow-up. Conclusion: The Turkish version of the ACL-QOL questionnaire is a reproducible and responsive instrument that can be used in clinical studies.PubMe