The effect of total knee arthroplasty on patients' balance and incidence of falls: a systematic review

Purpose: Despite the high incidence of falls in patients with OA, few studies have explored whether falls risk is affected after patients undergo total knee arthroplasty (TKA). Therefore, the aim of this systematic review was to identify the extent of the effects of TKA on balance and incidence of falls by critically reviewing the available literature. Methods: A systematic review of published literature sources was conducted up to March 2014. All studies assessing balance and incidence of falls after TKA (without physiotherapeutic intervention) were included. The methodological quality of each study was reviewed using the Critical Appraisal Skill Programme tool. Results: Thirteen studies were included, comprising of ten cohort studies (Level II) and three studies with Level of evidence III. Conclusions: Findings provide evidence that TKA improves significantly single-limb standing balance (~60%) and dynamic balance up to 1-year following surgery (Level of evidence II). Moreover, TKA influences positively fear of falling and incidence of falls by switching 54.2 % of pre-operative fallers to post-operative non-fallers (Level of evidence II-III). It is highlighted that knee extension strength, proprioception and symmetrization of postural strategies have not fully recovered post-TKA and influence balance performance. Clinically, these persistent deficits need to be mitigated by physiotherapy even before TKA takes place. 2016 The Author(s)sch_phypub4599pu

Association of low back pain on physical, sociodemographic and lifestyle factors across a general population sample within Greece

All rights reserved. BACKGROUND: Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. OBJECTIVE: To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors. METHOD: A sample of 3125 people of the Greek adult population was randomly selected by stratified sampling encompassing rural and urban representation within the Greek mainland. An extended survey form was developed entailing three sections; personal (sociodemographic) information, questions on symptomatology and physical factors (i.e. pain characteristics, recurrence, physical disability etc.) and 3 self-administered questionnaires (including mostly lifestyle factors); Hospital Anxiety and Depression (HAD) scale for anxiety and depression, SF-12 for quality of life (QoL) and Roland-Morris for disability. RESULTS: A total of 471 (15%) people reported LBP (210 males, mean age: 47.04 ' 15.03). Amongst them 60% reported sciatica, 76% suffered recurrent LBP and 70% received specialist care. Low disability levels, moderate to high pain intensity, gender differences and good self-reported QoL and psychosocial status were reported. Sociodemographic characteristics (income, smoking, marital status etc.) were not associated with LBP physical factors, apart from age which correlated with physical disability and wellness (r being 0.446 and 0.405, respectively, p < 0.001). Physical factors (particularly pain intensity and location) correlated with lifestyle factors (QoL) and disability (r ranging between 0.396 and 0.543, p < 0.001). Mental wellness, anxiety and depression (as lifestyle factors) were not associated with sociodemographic or physical factors. CONCLUSIONS: Physical parameters were amongst the most prevalent characteristics of the Greek sample, thus offering a direction towards a more targeted treatment and rehabilitation planning. Unlike previous literature, most sociodemographic characteristics were not correlated with any LBP physical or lifestyle factors, thus possibly indicating a different socioeconomic background and aetiology domain to that of the usual non-specific LBP spectrum

Frequency content asymmetry of the isokinetic curve between ACL deficient and healthy knee

The torque-time curve patterns of concentric isokinetic knee extension in anterior cruciate ligament (ACL) deficient patients usually present mid-range irregularities associated with the level of anterior tibial translation. The purpose of this study was to compare the smoothness in isokinetic torque production between the ACL deficient and the healthy knee. Thirty ACL deficient soccer players performed bilaterally five trials of maximum concentric knee extension-flexion at 60degrees/s on a Biodex dynamometer. The three middle trials (a total of six curves) were retained and submitted to further data processing. Maximum frequency values contained within the 90%, 95% and 99% level of the signal power were calculated for each extension and flexion curve. The frequency content of the ACL deficient side proved to be statistically higher compared to the intact side at all levels of the power spectrum. The percentage differences in the frequency content were 18.8%, 10.6% and 40.0% for knee extension, and 49.5%, 24.5% and 16.3% for knee flexion, for the respective power levels. This indicated higher oscillations and, therefore, more unstable mechanical output of the injured knee. An overall biological interpretation of the present results is based on the notion that disturbed motion is generally connected to poor level of joint functionality. (C) 2003 Elsevier Ltd. All rights reserved

Frequency content asymmetry of the isokinetic curve between ACL deficient and healthy knee

The torque-time curve patterns of concentric isokinetic knee extension in anterior cruciate ligament (ACL) deficient patients usually present mid-range irregularities associated with the level of anterior tibial translation. The purpose of this study was to compare the smoothness in isokinetic torque production between the ACL deficient and the healthy knee. Thirty ACL deficient soccer players performed bilaterally five trials of maximum concentric knee extension-flexion at 60°/s on a Biodex dynamometer. The three middle trials (a total of six curves) were retained and submitted to further data processing. Maximum frequency values contained within the 90%, 95% and 99% level of the signal power were calculated for each extension and flexion curve. The frequency content of the ACL deficient side proved to be statistically higher compared to the intact side at all levels of the power spectrum. The percentage differences in the frequency content were 18.8%, 10.6% and 40.0% for knee extension, and 49.5%, 24.5% and 16.3% for knee flexion, for the respective power levels. This indicated higher oscillations and, therefore, more unstable mechanical output of the injured knee. An overall biological interpretation of the present results is based on the notion that disturbed motion is generally connected to poor level of joint functionality. © 2003 Elsevier Ltd. All rights reserved

Acute effects of static self-stretching exercises and foam roller self-massaging on the trunk range of motions and strength of the trunk extensors

Although the effectiveness of static self-stretching exercises (SSSEs) and foam roller self-massaging (FRSM) in joint range of motion and muscle strength of the lower limbs has been exten-sively investigated, little is known about their effectiveness on the posterior trunk muscles. The present study aimed to investigate the acute effects of two 7-min SSSEs and FRSM intervention protocols on the range of trunk movements and the strength of the trunk extensors. Twenty-five healthy active males (n = 14) and females (n = 11) performed each intervention separately, one week apart. The range of motion (ROM) of the trunk-hip flexion (T-HF), the ROM of the trunk side-flexion (TSF) and rotation (TR) bilaterally, as well as the isometric maximum strength (TESmax) and endurance (TESend) of the trunk extensors were measured before and after each intervention. The ROMs of T-HF, TSF, and TR were significantly increased following both SSSEs and FRSM. The TESmax and TESend were also significantly increased after FRSM, but decreased following SSSEs. While both interventions were effective in increasing the range of motion of the trunk, a single 7-min session of FRSM presented more advantages over a similar duration SSSEs protocol due to the increase in the strength of the trunk extensors it induced. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Intrinsic risk factors of non-contact quadriceps and hamstring strains in soccer: A prospective study of 100 professional players

Objectives To identify the intrinsic risk factors of non-contact strains in the hamstrings and quadriceps muscles of professional soccer players via a cohort prospective design. Methods A total of 100 professional soccer players (aged 19.4-27.8 years) from four professional teams underwent a composite musculoskeletal assessment at preseason. Intrinsic risk factors included dichotomies of asymmetries in muscle strength, flexibility, proprioception, anthropometry and knee joint stability, and of previous injuries. Muscle strains were prospectively monitored during the subsequent season using questionnaires. The data were analysed via binary logistic regression. Results Thirty-eight percent of the players sustained one or more lower-extremity muscle strains. Sixteen (42.1 %) and seven (18.4 %) of them were clinically diagnosed as having non-contact muscle strains at their hamstrings and quadriceps, respectively. Players with eccentric hamstring strength asymmetries (OR=3.88; 95% CI 1.13 to 13.23), functional leg length asymmetries (OR=3.80; 95% CI 1.08 to 13.33) and no previous hamstrings injuries (OR=0.15; 95% CI 0.029 to 0.79) were at greater risk of sustaining a hamstring muscle strain. Players with eccentric strength (OR=5.01; 95% CI 0.92 to 27.14) and flexibility asymmetries (OR=4.98; 95% CI 0.78 to 31.80) in their quadriceps as well as heavier (OR=10.70; 95% CI 0.73 to 156.37) and shorter players (OR=0.08; 95% CI 0.00 to 1.35) were at greater risk of sustaining a strain in this muscle group. Conclusions Professional soccer players with functional asymmetries possess a higher risk of sustaining hamstring strains. Previous injury seems not to constitute a risk factor. The systematic isokinetic evaluation of the lower extremities during the preseason period can provide therapists and trainers with valuable data regarding the predictive elements of non-contact hamstring strains in professional soccer players

Cross cultural adaptation of the Greek sarcopenia quality of life (SarQoL) questionnaire

Purpose: To translate and validate into the Greek language and setting the Sarcopenia Quality of Life (SarQoL®) questionnaire. Methods: A convenience sample of 176 Greek elderly people (136 females, 40 males; aged 71.19 ± 7.95 years) was recruited, 50 of which (36 females, 14 males) were diagnosed sarcopenic. Questionnaire was back-translated and culturally adapted into Greek according to international guidelines. To validate the Greek SarQoL®, we assessed its validity (discriminative power, construct validity), reliability (internal consistency, test–retest reliability) and floor/ceiling effects. Participants were divided into sarcopenic and non-sarcopenic. Sarcopenic subjects apart from the Greek SarQoL (SarQoLGR) filled out the Greek versions of two generic questionnaires; Short Form-36 and EuroQoL 5-dimension. Results: The Greek SarQoL questionnaire was translated without major difficulties. SarQoLGR mean scores were 52.12 ± 11.04 (range: 24.74–71.81) for sarcopenic subjects and 68.23 ± 14.1 (range: 24.83–94.81) for non-sarcopenic ones. Results indicated good discriminative power across sarcopenic and non-sarcopenic subjects (p = 0.01), high internal consistency (Cronbach’s alpha of 0.96) and excellent test–retest reliability (ICC = 0.96, 95% CI = 0.95–0.97). Neither a floor nor a ceiling effect was observed. Conclusions: The Greek SarQoL was found to be a reliable and valid measure of quality of life for sarcopenic patients. It is therefore, available for use in future clinical research and practice.Implications for rehabilitation The Greek version of the SarQoL® questionnaire is a valid and reliable outcome measure for assessing patients with sarcopenia. The Greek SarQoL is recommended to be use in clinical settings and research. The Greek SarQoL® questionnaire is available online www.sarqol.org. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group