A NEW METHOD FOR ASSESSMENT OF FUNCTIONAL STABILITY AT THE KNEE JOINT

INTRODUCTION: Muscle forces are transmitted by the joints to the movement of the body. Sometimes high muscle forces are used, especially in sports practice. To stabilize the arthron, it is necessary to train the musculature in a functional way. Knowledge of the stability of the arthron during its function in athletic use is helpful to prevent the arthron from overuse or injury. The knee joint frequently becomes unstable due to disruption of the cruciate ligaments. Several methods and devices were developed to test the amount of the tibial translation. Among other things, tibial translation depends on the status of the cruciate ligaments. When the cruciate ligaments are examined, the patient usually sits down or lies on the back with the leg unloaded and the knee joint muscles relaxed (DANIEL et al. 1985, ANDERSON/LIBSCOMP 1989). The examination focuses on the passive stability of the knee joint. Measurement of the passive stability of the ankle joint cannot give an exact description of the active stability of the ankle joint during functional situations (GOLLHOFER et al. 1993, LOHRER et al. 1993, SCHEUFFELEN et al. 1993). Measurement of the functional stability of the knee joint gets more and more a subject of interest (LYSHOLM et al. 1994, PFEIFFER et al. 1996). At the same time the examination methods that are used remain the same as those used during examination of passive stability. We have developed a device to measure the tibial translation of the knee joint. The purpose of the study was to test our new device and the corresponding method in a simple functional situation like standing and to measure the functional stability of the knee joint. We measured the size of the tibial translation and the reflex activities of the knee joint muscles in dependence on aclstatus, load of the leg and size and dynamic of the applied mechanical stimulus

The repertoire of equine intestinal α-defensins

<p>Abstract</p> <p>Background</p> <p>Defensins represent an important class of antimicrobial peptides. These effector molecules of the innate immune system act as endogenous antibiotics to protect the organism against infections with pathogenic microorganisms. Mammalian defensins are classified into three distinct sub-families (α-, β- and θ-defensins) according to their specific intramolecular disulfide-bond pattern. The peptides exhibit an antimicrobial activity against a broad spectrum of microorganisms including bacteria and fungi. Alpha-Defensins are primarily synthesised in neutrophils and intestinal Paneth cells. They play a role in the pathogenesis of intestinal diseases and may regulate the flora of the intestinal tract. An equine intestinal α-defensin (DEFA1), the first characterised in the <it>Laurasiatheria</it>, shows a broad antimicrobial spectrum against human and equine pathogens. Here we report a first investigation of the repertoire of equine intestinal α-defensins. The equine genome was screened for putative α-defensin genes by using known α-defensin sequences as matrices. Based on the obtained sequence information, a set of oligonucleotides specific to the α-defensin gene-family was designed. The products generated by reverse-transcriptase PCR with cDNA from the small intestine as template were sub-cloned and numerous clones were sequenced.</p> <p>Results</p> <p>Thirty-eight equine intestinal α-defensin transcripts were determined. After translation it became evident that at least 20 of them may code for functional peptides. Ten transcripts lacked matching genomic sequences and for 14 α-defensin genes apparently present in the genome no appropriate transcript could be verified. In other cases the same genomic exons were found in different transcripts.</p> <p>Conclusions</p> <p>The large repertoire of equine α-defensins found in this study points to a particular importance of these peptides regarding animal health and protection from infectious diseases. Moreover, these findings make the horse an excellent species to study biological properties of α-defensins. Interestingly, the peptides were not found in other species of the <it>Laurasiatheria </it>to date. Comparison of the obtained transcripts with the genomic sequences in the current assembly of the horse (EquCab2.0) indicates that it is yet not complete and/or to some extent falsely assembled.</p

Neuromuscular Control During Stair Descent and Artificial Tibial Translation After Acute ACL Rupture.

Background Anterior cruciate ligament (ACL) rupture has direct effect on passive and active knee stability and, specifically, stretch-reflex excitability. Purpose/Hypothesis The purpose of this study was to investigate neuromuscular activity in patients with an acute ACL deficit (ACL-D group) compared with a matched control group with an intact ACL (ACL-I group) during stair descent and artificially induced anterior tibial translation. It was hypothesized that neuromuscular control would be impaired in the ACL-D group. Study Design Cross-sectional study; Level of evidence, 3. Methods Surface electromyographic (EMG) activity of the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) muscles was recorded bilaterally in 15 patients with ACL-D (mean, 13.8 days [range, 7-21 days] since injury) and 15 controls with ACL-I during stair descent and artificially induced anterior tibial translation. The movements of stair descent were divided into preactivity, weight acceptance, and push-off phases. Reflex activity during anterior tibial translation was split into preactivity and short, medium, and late latency responses. Walking on a treadmill was used for submaximal EMG normalization. Kruskal-Wallis test and post hoc analyses with Dunn-Bonferroni correction were used to compare normalized root mean square values for each muscle, limb, movement, and reflex phase between the ACL-D and ACL-I groups. Results During the preactivity phase of stair descent, the hamstrings of the involved leg of the ACL-D group showed 33% to 51% less activity compared with the matched leg and contralateral leg of the ACL-I group (P < .05). During the weight acceptance and push-off phases, the VL revealed a significant reduction (approximately 40%) in the involved leg of the ACL-D group compared with the ACL-I group. At short latency, the BF and ST of the involved leg of the ACL-D group showed a significant increase in EMG activity compared with the uninvolved leg of the ACL-I group, by a factor of 2.2 to 4.6. Conclusion In the acute phase after an ACL rupture, neuromuscular alterations were found mainly in the hamstrings of both limbs during stair descent and reflex activity. The potential role of prehabilitation needs to be further studied

The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study

BACKGROUND: The parallel-group randomized active-controlled clinical study was conducted to compare the effectiveness of two in-hospital range of motion (ROM) exercise programs following total knee arthroplasty (TKA). Continuous passive motion (CPM) is frequently used to increase ROM and improve postoperative recovery despite little conclusive scientific evidence. In contrast, a new active sling-based ROM therapy requires the activation of the knee joint muscles and dynamic joint stabilization. It was hypothesized that higher demands on muscle strength and muscle coordination during sling exercise training (ST) might be advantageous for early recovery following TKA. METHODS: A total of 125 patients undergoing primary TKA were assessed for eligibility. Thirty-eight patients were randomly assigned to receive ST or CPM (control intervention) during hospital stay. Patients were assessed before TKA for baseline measurement (pretest), 1 day before discharge (posttest) and 3 months after TKA (follow-up). The passive knee flexion range of motion (pFL) was the primary outcome measure. Secondary outcome measures included active knee flexion range of motion, active and passive knee extension ROM, static postural control, physical activity, pain, length of hospital stay as well as clinical, functional and quality-of-life outcomes (SF-36, HSS and WOMAC scores). Data were analyzed according to the intention-to-treat principle. Differences between the groups were tested for significance by the unpaired Student’s t test or an analysis of covariance (ANCOVA) adjusted for baseline, weight, sex, age, pain and physical activity. RESULTS: A between-group difference could be determined at posttest. The pFL was significantly higher by 6.0° (95% CI 0.9 to 11.2°; P = 0.022) in the ST group. No difference between groups in pFL was documented at follow-up. Furthermore, no significant differences could be observed for any secondary outcome measure at posttest and follow-up. CONCLUSIONS: ST seems to have a clinically relevant beneficial short-term effect on pFL compared to CPM. The results support the implementation of ST in rehabilitation programs following TKA. LEVEL OF EVIDENCE: Therapy, level 2

Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance

Dietary Nitrate Supplementation Improves Exercise Tolerance by Reducing Muscle Fatigue and Perceptual Responses

The present study was designed to provide further insight into the mechanistic basis for the improved exercise tolerance following dietary nitrate supplementation. In a randomized, double-blind, crossover design, twelve recreationally active males completed a dynamic time-to-exhaustion test of the knee extensors after 5 days of consuming both nitrate-rich (NITRATE) and nitrate-depleted beetroot juice (PLACEBO). Participants who improved their time-to-exhaustion following NITRATE performed a time-matched trial corresponding to the PLACEBO exercise duration with another 5 days of dietary nitrate supplementation. This procedure was performed to obtain time-matched exercise trials with (NITRATEtm) and without dietary nitrate supplementation (PLACEBO). Neuromuscular tests were performed before and after each time-matched condition. Muscle fatigue was quantified as percentage change in maximal voluntary torque from pre- to post-exercise (ΔMVT). Changes in voluntary activation (ΔVA) and quadriceps twitch torque (ΔPS100) were used to quantify central and peripheral factors of muscle fatigue, respectively. Muscle oxygen saturation, quadriceps muscle activity as well as perceptual data (i.e., perception of effort and leg muscle pain) were recorded during exercise. Time-to-exhaustion was improved with NITRATE (12:41 ± 07:18 min) compared to PLACEBO (09:03 ± 04:18 min; P = 0.010). NITRATEtm resulted in both lower ΔMVT and ΔPS100 compared to PLACEBO (P = 0.002; P = 0.001, respectively). ΔVA was not different between conditions (P = 0.308). NITRATEtm resulted in reduced perception of effort and leg muscle pain. Our findings extend the mechanistic basis for the improved exercise tolerance by showing that dietary nitrate supplementation (i) attenuated the development of muscle fatigue by reducing the exercise-induced impairments in contractile muscle function; and (ii) lowered the perception of both effort and leg muscle pain during exercise

Effects on Bone and Muscle upon Treadmill Interval Training in Hypogonadal Male Rats

Testosterone deficiency in males is linked to various pathological conditions, including muscle and bone loss. This study evaluated the potential of different training modalities to counteract these losses in hypogonadal male rats. A total of 54 male Wistar rats underwent either castration (ORX, n = 18) or sham castration (n = 18), with 18 castrated rats engaging in uphill, level, or downhill interval treadmill training. Analyses were conducted at 4, 8, and 12 weeks postsurgery. Muscle force of the soleus muscle, muscle tissue samples, and bone characteristics were analyzed. No significant differences were observed in cortical bone characteristics. Castrated rats experienced decreased trabecular bone mineral density compared to sham-operated rats. However, 12 weeks of training increased trabecular bone mineral density, with no significant differences among groups. Muscle force measurements revealed decreased tetanic force in castrated rats at week 12, while uphill and downhill interval training restored force to sham group levels and led to muscle hypertrophy compared to ORX animals. Linear regression analyses showed a positive correlation between bone biomechanical characteristics and muscle force. The findings suggest that running exercise can prevent bone loss in osteoporosis, with similar bone restoration effects observed across different training modalities

Prediction of disorientation by accelerometric and gait features in young and older adults navigating in a virtually enriched environment

OBJECTIVE: To determine whether gait and accelerometric features can predict disorientation events in young and older adults. METHODS: Cognitively healthy younger (18–40 years, n = 25) and older (60–85 years, n = 28) participants navigated on a treadmill through a virtual representation of the city of Rostock featured within the Gait Real-Time Analysis Interactive Lab (GRAIL) system. We conducted Bayesian Poisson regression to determine the association of navigation performance with domain-specific cognitive functions. We determined associations of gait and accelerometric features with disorientation events in real-time data using Bayesian generalized mixed effect models. The accuracy of gait and accelerometric features to predict disorientation events was determined using cross-validated support vector machines (SVM) and Hidden Markov models (HMM). RESULTS: Bayesian analysis revealed strong evidence for the effect of gait and accelerometric features on disorientation. The evidence supported a relationship between executive functions but not visuospatial abilities and perspective taking with navigation performance. Despite these effects, the cross-validated percentage of correctly assigned instances of disorientation was only 72% in the SVM and 63% in the HMM analysis using gait and accelerometric features as predictors. CONCLUSION: Disorientation is reflected in spatiotemporal gait features and the accelerometric signal as a potentially more easily accessible surrogate for gait features. At the same time, such measurements probably need to be enriched with other parameters to be sufficiently accurate for individual prediction of disorientation events

It's Harder to Push, When I Have to Push Hard—Physical Exertion and Fatigue Changes Reasoning and Decision-Making on Hypothetical Moral Dilemmas in Males

Despite the prevalence of physical exertion and fatigue during military, firefighting and disaster medicine operations, sports or even daily life, their acute effects on moral reasoning and moral decision-making have never been systematically investigated. To test the effects of physical exertion on moral reasoning and moral decision-making, we administered a moral dilemma task to 32 male participants during a moderate or high intensity cycling intervention. Participants in the high intensity cycling group tended to show more non-utilitarian reasoning and more non-utilitarian decision-making on impersonal but not on personal dilemmas than participants in the moderate intensity cycling group. Exercise-induced exertion and fatigue, thus, shifted moral reasoning and moral decision-making in a non-utilitarian rather than utilitarian direction, presumably due to an exercise-induced limitation of prefrontally mediated executive resources that are more relevant for utilitarian than non-utilitarian reasoning and decision-making

Violation of Bell inequality by photon scattering on a two-level emitter

Entanglement, the non-local correlations present in multipartite quantum systems, is a curious feature of quantum mechanics and the fuel of quantum technology. It is therefore a major priority to develop energy-conserving and simple methods for generating high-fidelity entangled states. In the case of light, entanglement can be realized by interactions with matter, although the required nonlinear interaction is typically weak, thereby limiting its applicability. Here, we show how a single two-level emitter deterministically coupled to light in a nanophotonic waveguide is used to realize genuine photonic quantum entanglement for excitation at the single photon level. By virtue of the efficient optical coupling, two-photon interactions are strongly mediated by the emitter realizing a giant nonlinearity that leads to entanglement. We experimentally generate and verify energy-time entanglement by violating a Bell inequality (Clauder-Horne-Shimony-Holt Bell parameter of $S=2.67(16)>2$) in an interferometric measurement of the two-photon scattering response. As an attractive feature of this approach, the two-level emitter acts as a passive scatterer initially prepared in the ground state, i.e., no advanced spin control is required. This experiment is a fundamental advancement that may pave a new route for ultra-low energy-consuming synthesis of photonic entangled states for quantum simulators or metrology.Comment: the manuscript of 6 pages with 3 figures and a Supplementary Material file of 12 pages with 7 figure