Four week program of intermittent fasting and high intensity interval training

Ohranjanje normalne telesne mase, brez pridobivanja odvečnih kilogramov, je v sodobni družbi izziv za več milijonov ljudi. Zaradi tega se veliko posameznikov loteva različnih diet. V tem diplomskem delu smo preučili program štiritedenskega občasnega posta v kombinaciji z visoko intenzivno intervalno vadbo. V raziskavi je sodelovalo 8 oseb, starih med 21 in 22 let, od katerih so bile 4 ženskega in 4 moškega spola. Moški udeleženci so imeli pred pričetkom izvajanja programa povprečen indeks telesne mase 28,6 kg/m2, ženske pa 21,0 kg/m2. V času izvajanja programa so se udeleženci prehranjevali po metodi občasnega posta. To pomeni, da so se moški vsak dan postili 16 ur, ženske pa 14 ur. Udeleženci so trikrat na teden izvajali tudi visoko intenzivno intervalno vadbo. Pred pričetkom in po končanem programu smo izvedli meritve telesne sestave z BIA-metodo. Za oceno počutja, prehranskih navad in nadzora vnosa količine ter kakovosti hrane smo uporabili anketni vprašalnik. Podatke smo analizirali s programom SPSS za Windows. Ugotovili smo, da je med začetnim in končnim stanjem prišlo do statistično značilnih razlik pri telesni masi (– 1,5 kg, p = 0,045), indeksu telesne mase (– 0,5, p = 0,029) in deležu telesne maščobe (– 2,1 %, p = 0,009). Pri količini mišične mase pa med začetnim in končnim stanjem nismo ugotovili statistično značilnih razlik (+ 0,2 kg, p = 0,768). Pri analizi anketnega vprašalnika smo med začetnim in končnim stanjem ugotovili statistično značilne razlike pri naslednjih spremenljivkah: količina spanja (– 1,15, p = 0,015), uživanje zelenjave (– 0,72, p = 0,008), uživanje sadja (– 0,71, p = 0,008), uživanje sladkarij (+ 1,0, p = 0,004) in pitje sokov (+ 1,0, p = 0,004). Statistično značilne razlike smo ugotovili tudi pri samonadzoru pri prehranjevanju (– 1,43, p = 0,000). Analiza rezultatov telesne sestave je pokazala, da je štiritedenski program občasnega posta in visoko intenzivne intervalne vadbe pri merjencih vplival na zmanjšanje telesne mase (– 1,5 kg, p = 0,045). Glede na to, da se delež mišične mase ni bistveno spremenil (+ 0,2 kg, p = 0,768), sklepamo, da se je telesna masa merjencev zmanjšala zaradi zmanjšanja deleža telesne maščobe (– 2,1 %, p = 0,009). Analiza programa z vidika prehranskih navad je pokazala, da so merjenci med postenjem občutili povišan nivo energije ter povečali samonadzor prehranjevanja z vidika vnosa količine in kakovosti hrane. Omejitve naše raziskave se kažejo v majhnem številu preizkušancev in nenadzorovani vadbi. Ugotovitve so uporabne kot izhodišče za nadaljnje natančnejše raziskave na tem področju.Maintaining normal body weight without gaining extra pounds is a challenge for millions of people in a modern society. For this, most people use different diets. In this thesis, we have studied the four-week program of intermittent fasting combined with high intensity interval training. The study involved eight people aged between 21 and 22 years, of which four were female and four males. Prior to the beginning of the program male participants had an average body mass index of 28,6women participants 21,0. Participants followed an intermittent fasting diet. This means, that the men fasted every day for 16 hours and women for 14 hours. Participants did high intensity interval training three times a week. Before starting and after the program we did measurements of body composition with BIA method. For the assessment of well-being, characteristics of eating habits and control of the quantity and quality of food, we used a questionnaire. We analysed the data using SPSS for Windows. During the starting and the final state, we found a statistically significant difference in body weight (- 1,5 kg, p = 0,045), body mass index (- 0,5, p = 0,029) and the percentage of body fat (- 2,1 %, p = 0,009). In the quantity of muscle mass during initial to final state, we have not found a statistically significant differences (+ 0,2, p = 0,768). In the analysis of the questionnaire, the statistically significant differences were found in the following variables: the quantity of sleep (- 1,15, p = 0,015), consumption of vegetables (- 0,72, p = 0,008), fruit (-0,71, p = 0,008), sugar (+ 1,0, p = 0,004) and juice (+ 1,0, p = 0,004). Statistically significant differences were also observed in the self-control in feeding (- 1,43, p = 0,000). An analysis of body composition results showed that the fourweek program of intermittent fasting and high intensity interval training had an impact on weight loss (- 1,5, p = 0,045). Considering that the percentage of muscle mass didn’t change significantly (+ 0,2, p = 0,768), we assume that the body weight decreased due to a decrease in the proportion of body fat (- 2,1 %, p = 0,009). The analysis of the dietary habits showed that during intermittent fasting participants experienced increased levels of energy and increased self-control over eating in terms of quantity and quality of food. The limitations of our research are reflected in a small number of test subjects and uncontrolled exercise. The findings are useful as a starting point for further more detailed research in this field

Use of Acellular Dermal Matrix to Prevent Recurrence of Radioulnar Heterotopic Ossification.

Radioulnar heterotopic ossification is a rare occurrence found in approximately 2% of all forearm injuries. Treatment is complicated by relatively high recurrence rates. Strategies to decrease recurrence have included the range of motion exercises and the interposition of inert or autogenous barriers. We report on the interposition of human acellular dermal matrix (ADM) for the treatment of distal radioulnar synostosis. We report a novel technique for the treatment of distal radioulnar heterotopic ossification. After resection, ADM in a cigar-shaped construct is interposed between the radius and ulna. Patients are followed clinically and radiographically. Two female patients were treated. Both patients had significant improvement in the range of motion in supination and pronation of the affected wrist postoperatively with an average follow-up of 36 months. There were no postoperative complications. Neither patient had recurrent disease. We describe the successful treatment of 2 patients with distal radioulnar heterotopic ossification with the use of human ADM. The ADM provides a barrier between the radius and ulna to prevent the recurrent formation of heterotopic ossification. ADM usage results in no donor site morbidity and is theoretically more resistant to infection when compared with nonbiologic barriers such as silicone and Integra. This technique is a simple, safe, and effective way to treat and prevent the recurrence of radioulnar heterotopic ossification

The safety and efficacy of mesenchymal stem cells for prevention or regeneration of intervertebral disc degeneration: a systematic review

General Posters: abstract no. GP86INTRODUCTION: Mesenchymal stem cells (MSCs) have been used to halt the progression or regenerate the disc with hopes to prevent or treat discogenic back pain. However, the safety and efficacy of the use of MSCs for such treatment in animal and human models at short and long term assessment (i.e. greater than 48 weeks) have not been systematically addressed. This study addressed a systematic review of comparative controlled studies addressing the use of MSCs to that of no treatment/saline for the treatment of disc degeneration. METHODS: Online databases were extensively searched. Controlled trials in animal models and humans were eligible for inclusion. Trial design, MSC characteristics, injection method, disc assessment, outcome intervals, and complication events were assessed. Validity of each study was assessed addressing trial design. Two individuals independently addressed the aforementioned. RESULTS: Twenty-two animal studies were included. No human comparative controlled trials were reported. All three types of MSCs (i.e. derived from bone marrow, synovial and adipose tissue) showed successful inhibition of disc degeneration progression. From three included studies, bone marrow derived MSC showed superior quality of disc repair when compared to other treatments, including TGF-β1, NP bilaminar co-culture and axial distraction regimen. However, osteophyte development was reported in two studies as potential complication of MSC transplantation. CONCLUSIONS: Based on animal models, the current evidence suggests that in the short-term MSC transplantation is safe and effective in halting disc degeneration; however, additional and larger studies are needed to assess the long-term regenerative effects and potential complications. Inconsistency in methodological design and outcome parameters prevent any robust conclusions. In addition, randomized controlled trials in humans are needed to assess the safety and efficacy of such therapy.published_or_final_versio

Focused Extracorporeal Shock Wave Therapy in Calcifying Tendinitis of the Shoulder

Background:: The objective of this study is to assess the effectiveness of extracorporeal shock wave therapy in the management of calcifying tendinitis of the shoulder. Furthermore, a dose-response relationship was sought as a secondary confirmation of effectiveness. Hypothesis: Focused extracorporeal shock wave therapy has a high, dose-responsive effectiveness in the management of calcifying tendinitis of the shoulder. Study Design: Meta-analysis. Methods: Studies were identified from online databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Register), manual searches, and personal communication with experts in the field. After assessment of heterogeneity, a random effects model was generated. The primary end points were identified as pain and function by using the visual analog scale and the Constant-Murley Score, respectively. These end points were pooled and the weighted mean differences and 95% confidence intervals were estimated. Odds ratios of the secondary end point deposit resorption were pooled. Results:: In 14 studies, shock wave therapy led to a significantly higher reduction of pain (weighted mean difference, −2.8 points; 95% confidence interval, −4.2 to −1.5 points) and improvement of function (weighted mean difference, 19.8 points; 95% confidence interval, 13.4-26.3 points), compared to other treatments and placebo. High-energy treatment produced significantly better results than low-energy treatment for pain reduction (weighted mean difference, 1.7 points; 95% confidence interval, 0.7-2.6 points) and improvement of function (weighted mean difference, 10.7 points; 95% confidence interval, 7.2-14.1 points). These results are consistent with a dose-response relationship supporting the effectiveness of shock wave therapy. Conclusion:: Shock wave therapy for calcifying tendinitis of the shoulder is effective in pain relief, function restoration, and deposit resorption; however, these conclusions are susceptible to bias arising from the limitations of the included studies

Verhilft die Integrationsvereinbarung MigrantInnen in Österreich zu "Chancengleichheit" und "Beteiligungsgerechtigkeit"

Die Forschungsfrage, die dieser Master Thesis zu Grunde liegt, heißt: Verhilft die Integrationsvereinbarung MigrantInnen aus Drittländern in Österreich zu „Chancengleichheit“ und zu „Beteiligungsgerechtigkeit“ mit der Vorbedingung distributiver Gleichheit und Autonomie, und ist mit der Erfüllung der gesetzlichen Auflage auch die Voraussetzung für einen eigenen Lebensplan gegeben. Integration, als zweiseitiges Bemühen um die Wiederherstellung eines ganzheitlich wirksamen sozialen und gesellschaftlichen Systems durch Prozesse, die das Verhalten und Bewusstsein nachhaltig verändern, ist ein gesamtgesellschaftlicher Prozess, der von allen Beteiligten getragen werden muss, um erfolgreich sein zu können. Der Zwangscharakter der „Integrationsvereinbarung“, die durch den Nachweis rudimentärer Deutschkenntnisse auf Niveau A2, des Europäischen Referenzrahmens erfüllt werden muss, betont jedoch die einseitig durch die MigrantInnen zu erbringende Leistung. Der empirische Teil dieser Arbeit untersucht, ob und inwieweit der Einbezug von MigrantInnen nach erfüllter Integrationsvereinbarung in Bildung, Ökonomie, Recht, Erziehung und Gesundheit innerhalb der Österreichischen Gesellschaft gewährleistet sein kann. 300 DeutschlernerInnen mit dem Ziel einer ÖSD-Prüfung Niveau A2 oder B1, wurden nach den individuellen Vorstellungen von einem guten Leben, in dem ihre vorhandenen Ressourcen in ihren Zukunftsperspektiven mitzudenken und mit einzubeziehen waren, befragt. Der Capabilities –Ansatz (Fähigkeitenansatz) von Martha C. Nussbaum (1999) diente dabei als Basiskonzept der Fähigkeiten, die ein gutes menschliches Leben ermöglichen oder durch ihre Absenz verhindern. Die Konzeption lässt Raum für Entscheidungsfreiheit, Aufgabe der Regierung ist es sicherzustellen, dass alle Menschen die notwendigen Ressourcen und Bedingungen vorfinden, um in dieser Weise zu handeln. Maßgeblich entscheidend für den Progress im Sprachlern- und Bildungsprozess erwiesen sich die bereits vorhandene Fähigkeiten und Lernerfahrungen des untersuchten Personenfeldes. Jedoch war die angestrebte Erwerbstätigkeit am Österreichischen Arbeitsmarkt, trotz guter Qualifikationen, nur für wenige der erfolgreichen AbsolventInnen von Niveau A2, tatsächlich erreichbar

Effectiveness of the addition of Lidocaine to a hemostatic, bioresorbable putty in the treatment of iliac crest donor site pain

Background: The harvest of iliac crest bone grafts (ICBG) is associated with relevant donor site pain, but may be lowered by the application of lidocaine loaded on biodegradable, hemostatic putty for sustained local analgesic release. The goal of this double-blind controlled trial was to assess the efficacy of adding lidocaine to a hemostatic putty (Orthostat ™) to treat donor site pain following harvest of ICBG in foot and ankle procedures. Methods: After ICBG harvest during a foot and ankle procedure, the resulting bone defect was either filled with Orthostat™ (n = 7) or with the same hemostatic putty loaded with lidocaine (Orthostat-L™, n = 7). During the first 72 postoperative hours, donor site and surgical site pain were managed by patient controlled morphine delivery and a peripheral nerve block. Donor site pain was periodically quantified on a Visual Analog (VAS) and a Wong Baker FACES scale. Pain scores were plotted over time to calculate the area under the curve (AUC) to quantify the overall pain experienced in specific time intervals. Results: Orthostat-L™ significantly reduced donor site pain over the first 12 hours postoperatively as evidenced by a significant decrease of the AUC in both VAS (p = 0.0366) and Wong Baker FACES pain score plots (p = 0.0024). Cumulated morphine uses were not significantly decreased with Orthostat-L™. Conclusion: The addition of lidocaine to a hemostatic putty offers a significant ICBG donor site pain reduction over the first 12 postoperative hours. Trial registration ClinicalTrials.gov NCT01504035. Registered January 2nd 2012

Substitutes of Structural and Non-Structural Autologous Bone Grafts in Hindfoot Arthrodeses and Osteotomies: A Systematic Review

Background: Structural and non-structural substitutes of autologous bone grafts are frequently used in hindfoot arthrodeses and osteotomies. However, their efficacy is unclear. The primary goal of this systematic review was to compare autologous bone grafts with structural and non-structural substitutes regarding the odds of union in hindfoot arthrodeses and osteotomies. Methods: The Medline and EMBASE and Cochrane databases were searched for relevant randomized and non-randomized prospective studies as well as retrospective comparative chart reviews. Results: 10 studies which comprised 928 hindfoot arthrodeses and osteotomies met the inclusion criteria for this systematic review. The quality of the retrieved studies was low due to small samples sizes and confounding variables. The pooled random effect odds for union were 12.8 (95% CI 12.7 to 12.9) for structural allografts, 5.7 (95% CI 5.5 to 6.0) for cortical autologous grafts, 7.3 (95% CI 6.0 to 8.6) for cancellous allografts and 6.0 (95% CI 5.7 to 6.4) for cancellous autologous grafts. In individual studies, the odds of union in hindfoot arthrodeses achieved with cancellous autologous grafts was similar to those achieved with demineralised bone matrix or platelet derived growth factor augmented ceramic granules. Conclusion: Our results suggest an equivalent incorporation of structural allografts as compared to autologous grafts in hindfoot arthrodeses and osteotomies. There is a need for prospective randomized trials to further clarify the role of substitutes of autologous bone grafts in hindfoot surgery

Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

Purpose: The best treatment for Achilles tendon (AT) ruptures remains controversial. Long-term follow-up with radiological and clinical measurements is needed. Methods: In this retrospective multicentre cohort study, patients (n=52) were assessed at a mean of 91months follow-up after unilateral AT rupture treated by open, percutaneous or conservative (non-surgical) treatment. Demographic parameters, time off work, maximum calf circumference and clinical scores (ATRS, Hannover, AOFAS) were evaluated. Muscle volume and cross-sectional area of the calf and AT length were measured on MR images and were compared between groups and to each patient's healthy contralateral leg. Results: Reduced muscle volume was found across all groups with a higher muscle volume in the conservative (729.9±130.3cm3) compared to the percutaneous group (675.9±207.4cm3, p=0.04). AT length was longer in the affected leg (198.4±24.1 vs. 180.6±25.0mm, p<0.0001) without difference in subgroup analysis. Clinically measured ankle dorsiflexion showed poor correlation with AT length (R 2=0.07, p=0.008). Muscle volume strongly correlated with the cross-sectional area (R 2=0.6, p<0.0001) but showed a weak correlation with the Hannover score (R 2=0.08, p=0.048). Maximum calf circumference correlated with muscle volume (R 2=0.42, p<0.0001). Conclusions: No significant difference between the treatment groups was found in muscle volume, AT length, clinical measures or days off work. Cross-sectional area and maximum calf circumference are cost-effective measurements and a good approximation of muscle volume and can thus be used in a clinical setting while clinical dorsiflexion should not be used. Level of evidence: II

Does cervical disc arthroplasty reduce adjacent segment disease and other complications in comparison to anterior cervical discectomy and fusion? A meta-analysis of randomized controlled trials

Concurrent Session 5A - Cervical Spine: paper no. 72SUMMARY: A meta-analysis of the literature was performed to assess the development of adjacent segment degeneration/disease between cervical disc arthroplasty (CDA) to that of anterior cervical discectomy and fusion (ACDF) at 2 and 4 year follow-up periods. Due to weaknesses in study design, heterogeneity in management, and relatively high withdrawal/drop-out rates, robust conclusions supporting the advocacy of CDA over ACDF cannot be made at this ...postprin

Erratum to: Poor outcome at 7.5years after Stanisavljevic quadriceps transposition for patello-femoral instability

Introduction: Congenital dislocation of the patella and recurrent symptomatic dislocation in adolescents are difficult pathologies to treat. Stanisavljevic described an extensive release procedure essentially involving medializing the entire lateral quadriceps and medial soft tissue stabilization. There are no significant series reporting the success of this method. This procedure has been performed in our institution over several years and we report our results. Method: Retrospective case series. Between 1990 and 2007, 20 knees in 13 children and adolescents (mean age 12.8years; 4-17, 7 female) with recurrent or congenital dislocation of the patella (8 knees) underwent this procedure after failed conservative treatment (mean follow-up 7.5years; 4-16). All were immobilized in a long leg cast for 6weeks. Results: Five knees in five patients (20%, 1 congenital dislocation) reported their knees as improved without further dislocations. Out of the 15 knees with failures (80%) 12 in six patients (60%) were revised due to redislocation. Three knees in two patients (15%) still had dislocations or subluxations, but any revision was refused. Three knees in three patients caused pain and discomfort during daily activity. Redislocation first developed after a mean of 21.3months (4-72) postoperatively. Only one patient had returned to sport at the 12-month follow-up. Discussion: The Stanisavljevic procedure produces a mediocre success rate with our long-term follow-up series showing a failure rate up to 80%. We therefore recommend more specific procedures dealing with the anatomical deformity such as trochleaplasty to produce superior success rates