3D Knee Kinematics and Kinetics With Visual Disruption in Subjects With ACL Reconstruction

BACKGROUND AND PURPOSE: The anterior cruciate ligament (ACL) is a commonly ruptured ligament among male and female athletes. Women are at a higher risk of ACL injuries compared to men. The leading cause of female ACL injuries has been identified as non-contact mechanisms. Several risk factors for injury among females that have been theorized include: quadriceps/hamstring activation pattern and force production, greater dynamic knee valgus, hormonal influenced laxity and anatomical gender variation. The purpose of this research was to analyze three dimensional (3D) kinetic and kinematic dynamic landing patterns at the knee between ACL reconstructed and healthy females and any interaction effects of visual disruption. METHODS: Seventeen healthy female subjects (25.3± 6 y) and 17 female subjects with an ACL reconstruction (26.5± 6.3 y) were studied. A 3D electromagnetic system measured knee position during a cutting maneuver from an athletic stance position. Anatomic boney landmarks on the occiput, sacrum, femur and tibia were digitized for capture. Subjects began on a force plate and were instructed to catch a ball and cut immediately left or right as indicated by a specific tone, which was randomized (40 trials). Vision was randomly disrupted via shutter glasses for either one second at the beginning of the cutting maneuver or was left intact for the duration of the movement. A two-way repeated measures ANOVA analyzed the differences between healthy and ACL reconstructed subjects and intact vision versus disrupted vision. RESULTS: The results indicate significant differences exist between subjects with ACL reconstruction and healthy subjects for flexion, adduction, and external rotation knee angles and extension, abduction, and internal rotation moments. Significant interactions of group and vision conditions also exist for flexion, adduction, and external rotation knee angles. Vision alone displayed no significant differences for all subjects. CONCLUSION: Years later, subjects with ACL reconstructions continue to display different knee kinematics and kinetics that could increase their risk for re-injury or injury of other leg. Furthermore, visual disturbances have significant effects on ACL reconstructed knee angles and moments when landing compared to healthy subjects. These results support continued movement related rehabilitation with visual disturbances for ACL reconstructed patients

The care of older cancer patients in the United Kingdom

The ageing population poses new challenges globally. Cancer care for older patients is one of these challenges, and it has a significant impact on societies. In the United Kingdom (UK), as the number of older cancer patients increases, the management of this group has become part of daily practice for most oncology teams in every geographical area. Older cancer patients are at a higher risk of both under- and over-treatment. Therefore, the assessment of a patient’s biological age and effective organ functional reserve becomes paramount. This may then guide treatment decisions by better estimating a prognosis and the risk-to-benefit ratio of a given therapy to anticipate and mitigate against potential toxicities/difficulties. Moreover, older cancer patients are often affected by geriatric syndromes and other issues that impact their overall health, function and quality of life. Comprehensive geriatric assessments offer an opportunity to identify and address health problems which may then optimise one’s fitness and well-being. Whilst it is widely accepted that older cancer patients may benefit from such an approach, resources are often scarce, and access to dedicated services and research remains limited to specific centres across the UK. The aim of this project is to map the current services and projects in the UK to learn from each other and shape the future direction of care of older patients with cancer

Earth Virtualization Engines (EVE)

To manage Earth in the Anthropocene, new tools, new institutions, and new forms of international cooperation will be required. Earth Virtualization Engines is proposed as an international federation of centers of excellence to empower all people to respond to the immense and urgent challenges posed by climate change