ResearchPad - elbow https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Early outcome after the use of the triceps fascia flap in interposition elbow arthroplasty: a novel method in the treatment of post-traumatic elbow stiffness]]> https://www.researchpad.co/article/Nb33f2873-3a22-4532-9241-b9c12fb883b4 Background: Post-traumatic elbow stiffness (PTES) results in severe interference with the activities of daily living (ADL), affecting mainly young people. Total elbow arthroplasty (TEA) is relatively contraindicated in the young patient and arthrodesis is poorly tolerated. Interposition elbow arthroplasty (IEA) improves the range of motion (ROM) buying time for future reconstructive surgery. While the fascia lata remains the most common material used in IEA, the triceps fascia is a native vascularized tissue, and it does not require a separate incision to harvest. To our knowledge, there are no published studies on the use of this technique of IEA. Method: Sixteen patients with post-traumatic elbow stiffness had IEA with the triceps fascia between January 2009 and January 2017. The ROM was assessed pre-operatively and post-operatively at the 6th and the 24th week. The researchers also evaluated the functional outcome with the Mayo Elbow Performance Score (MEPS) at the 24th week. The data were analysed with the software IBM SPSS Version 20. Results: Nine males and seven females had IEA with the triceps fascia. The mean age of the subjects was 22.8 years (SD = 6.39). The median duration of the stiffness was eight months (range: 2–168 months). Fall was the most frequent cause of post-traumatic elbow stiffness, and the non-dominant side was more frequently involved. Fourteen patients had an intervention at the native bone setters before presentation to the hospital. The mean elbow ROM increased from 16.4° pre-operatively to 97.2° at the 24th week (p < 0.001), while the mean MEPS improved from 42.5° pre-operatively to 81.2° post-operatively (p < 0.001). Conclusion: The triceps fascia flap provides an excellent alternative to the fascia lata for IEA without the complications of the donor site morbidity.

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<![CDATA[Why does radial head arthroplasty fail today? A systematic review of recent literature]]> https://www.researchpad.co/article/Ne0babf35-a698-4b18-9457-7a400e814025

  • Since the introduction of the radial head prosthesis (RHP) in 1941, many designs have been introduced. It is not clear whether prosthesis design parameters are related to early failure. The aim of this systematic review is to report on failure modes and to explore the association between implant design and early failure.

  • A search was conducted to identify studies reporting on failed primary RHP. The results are clustered per type of RHP based on: material, fixation technique, modularity, and polarity. Chi-square tests are used to compare reasons for failure between the groups.

  • Thirty-four articles are included involving 152 failed radial head arthroplasties (RHAs) in 152 patients. Eighteen different types of RHPs have been used.

  • The most frequent reasons for revision surgery after RHA are (aseptic) loosening (30%), elbow stiffness (20%) and/or persisting pain (17%). Failure occurs after an average of 34 months (range, 0–348 months; median, 14 months).

  • Press-fit prostheses fail at a higher ratio because of symptomatic loosening than intentionally loose-fit prostheses and prostheses that are fixed with an expandable stem (p < 0.01).

  • Because of the many different types of RHP used to date and the limited numbers and evidence on early failure of RHA, the current data provide no evidence for a specific RHP design.

Cite this article: EFORT Open Rev 2019;4:659-667. DOI: 10.1302/2058-5241.4.180099

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<![CDATA[Soft tissue tumours of the elbow: current concepts]]> https://www.researchpad.co/article/N428a074c-a445-4c2a-a3b6-3cab323d446e

  • Soft tissue tumours of the elbow are mostly benign. Malignant tumours in this area, although uncommon, often present unique clinical and histopathological characteristics that are helpful for diagnosis.

  • Management of soft tissue tumours around the elbow may be challenging because of their rarity and the proximity to neurovascular structures. Careful staging, histological diagnosis and treatment are essential to optimize clinical outcome. A missed or delayed diagnosis or an improperly executed biopsy may have devastating consequences for the patient.

  • This article reviews the most common benign and malignant soft tissue tumours of the elbow and discusses the clinicopathological findings, imaging features and current therapeutic concepts.

Cite this article: EFORT Open Rev 2019;4:668-677. DOI: 10.1302/2058-5241.4.190002

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<![CDATA[CHRONIC MONTEGGIA FRACTURE-DISLOCATION IN CHILDREN SURGICAL STRATEGY AND RESULTS]]> https://www.researchpad.co/article/Nefe64019-942f-4b20-baf5-0ef74fc53d5e

ABSTRACT

Objective:

To report surgical techniques and results in the treatment of chronic Monteggia fracture-dislocation in children.

Methods:

Six pediatric patients who had undergone a procedure involving the following 6 crucial surgical steps were retrospectively evaluated: 1- extended lateral approach, 2- fibrotic removal, 3-proximal ulnar osteotomy, 4- reduction of the radial head and transcapitellar temporary fixation, 5- ulnar fixation with a straight plate shaped according to the deformity generated by temporary fixation, and 6- transcapitellar Kirschner wire removal.

Results:

Four patients were women, and four showed the right-sided compromise. The mean age of patients was 8 years, and the minimum follow-up period was 12 months. The mean time from the onset of fracture to treatment was 6 months. Six patients underwent complete flexo/extension, and one patient had a complete prono-supination. In four patients, we observed loss of pronation (by 10° in two, 15° in one, and 20° in one), and one patient had a 15° decrease in supination. We did not observe any redislocation of the radial head in the follow-up evaluation. No complications were observed; the only complaint was salience of the ulnar plate.

Conclusions:

Our results demonstrated an effective option for the treatment of chronic Monteggia fracture-dislocation in children, even with a small study sample, following the presented technical and surgical strategies. Level of evidence IV, Therapeutic Studies.

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<![CDATA[Effects of realistic sheep elbow kinematics in inverse dynamic simulation]]> https://www.researchpad.co/article/5c8823cbd5eed0c48463901b

Looking for new opportunities in mechanical design, we are interested in studying the kinematic behaviour of biological joints. The real kinematic behaviour of the elbow of quadruped animals (which is submitted to high mechanical stresses in comparison with bipeds) remains unexplored. The sheep elbow joint was chosen because of its similarity with a revolute joint. The main objective of this study is to estimate the effects of elbow simplifications on the prediction of joint reaction forces in inverse dynamic simulations. Rigid motions between humerus and radius-ulna were registered during full flexion-extension gestures on five cadaveric specimens. The experiments were initially conducted with fresh specimens with ligaments and repeated after removal of all soft tissue, including cartilage. A digital image correlation system was used for tracking optical markers fixed on the bones. The geometry of the specimens was digitized using a 3D optical scanner. Then, the instantaneous helical axis of the joint was computed for each acquisition time. Finally, an OpenSim musculoskeletal model of the sheep forelimb was used to quantify effects of elbow joint approximations on the prediction of joint reaction forces. The motion analysis showed that only the medial-lateral translation is sufficiently large regarding the measuring uncertainty of the experiments. This translation assimilates the sheep elbow to a screw joint instead of a revolute joint. In comparison with fresh specimens, the experiments conducted with dry bone specimens (bones without soft tissue) provided different kinematic behaviour. From the results of our inverse dynamic simulations, it was noticed that the inclusion of the medial-lateral translation to the model made up with the mean flexion axis does not affect the predicted joint reaction forces. A geometrical difference between the axis of the best fitting cylinder and the mean flexion axis (derived from the motion analysis) of fresh specimens was highlighted. This geometrical difference impacts slightly the prediction of joint reactions.

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<![CDATA[A computational scheme for internal models not requiring precise system parameters]]> https://www.researchpad.co/article/5c803c6ed5eed0c484ad895a

Utilization by humans of a precise and adaptable internal model of the dynamics of the body in generating movements is a well-supported concept. The prevailing opinion is that such an internal model ceaselessly develops through long-term repetition and accumulation in the central nervous system (CNS). However, a long-term learning process would not be absolutely necessary for the formation of internal models. It is possible to estimate the dynamics of the system by using a motor command and its resulting output, instead of constructing a model of the dynamics with precise parameters. In this study, a computational model is proposed that uses a motor command and its corresponding output to estimate the dynamics of the system and it is examined whether the proposed model is capable of describing a series of empirical movements. The proposed model was found to be capable of describing humans’ fast movements which require compensation for system dynamics as well as sensory delays. In addition, the proposed model shows equifinality under inertial perturbations as seen in several experimental studies. This satisfactory reproducibility of the proposed computation raises the possibility that humans make a movement by estimating the system dynamics with a copy of motor command and sensory output on a momentary basis, without the need to identify precise system parameters.

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<![CDATA[Leg muscle strength is reduced and is associated with physical quality of life in Antineutrophil cytoplasmic antibody-associated vasculitis]]> https://www.researchpad.co/article/5c61e902d5eed0c48496f649

Objective

Physical quality of life is reduced in ANCA-associated vasculitis (AAV). This study aims to investigate whether this may be explained by reduced muscle strength and physical activity resulting from disease damage and steroid myopathy.

Methods

Forty-eight AAV patients were sequentially included from the outpatient clinic. Patients in different stages of disease and treatment underwent measurements of muscle strength and anthropometric parameters. Patients filled in physical activity (Baecke) and quality of life questionnaires (RAND-36) and carried an accelerometer for a week. Muscle strength and physical activity were compared to quality of life, prednisolone use and disease duration.

Results

Most AAV patients had lower knee extension (76%) and elbow flexion (67%) forces than expected based on healthy norms. Also, physical (P<0.001) and mental (P = 0.01) quality of life were significantly reduced compared to healthy norm values. Lower knee extension force (P = 0.009), younger age <70 (P<0.001) and relapse of vasculitis (P = 0.003) were associated with lower age-adjusted physical quality of life. Lower Baecke index (P = 0.006), higher prednisolone dose (P = 0.005) and ENT involvement (P = 0.006) were associated with lower age-adjusted mental quality of life. Leg muscle strength showed no association with current or cumulative prednisolone use. Disease duration was longer in patients with knee extension force below healthy norms (P = 0.006).

Conclusion

Knee extension force and physical activity are positively associated with quality of life in AAV. Knee extension force decreases with longer disease duration, suggesting that disease- and treatment-related damage have a cumulative negative effect on muscle strength.

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<![CDATA[Evidence-Based Review of Clinical Diagnostic Tests and Predictive Clinical Tests That Evaluate Response to Conservative Rehabilitation for Posterior Glenohumeral Instability: A Systematic Review]]> https://www.researchpad.co/article/5c50f2c2d5eed0c4846278a4

Context:

Posterior glenohumeral instability is poorly understood and can be challenging to recognize and evaluate. Using evidence-based clinical and predictive tests can assist clinicians in appropriate assessment and management.

Objective:

To review evidence-based clinical diagnostic tests for posterior glenohumeral instability and predictive tests that identify responders to conservative management.

Data Sources:

A comprehensive electronic bibliographic search was conducted using Embase, Ovid MEDLINE, PEDro, and CINAHL databases from their date of inception to February 2017.

Study Selection:

Studies were included for further review if they (1) reported on clinical diagnostic tests for posterior or posteroinferior instability of the glenohumeral joint, (2) assessed predictive clinical tests for posterior instability of the glenohumeral joint, and (3) were in English.

Study Design:

Systematic review.

Level of Evidence:

Level 4.

Data Extraction:

Data were extracted from the studies by 2 independent reviewers and included patient demographics and characteristics, index/reference test details (name and description of test), findings, and data available to calculate psychometric properties.

Results:

Five diagnostic and 2 predictive studies were selected for review. There was weak evidence for the use of the jerk test, Kim test, posterior impingement sign, and O’Brien test as stand-alone clinical tests for identifying posterior instability. Additionally, there was weak evidence to support the use of the painless jerk test and the hand squeeze sign as predictive tests for responders to conservative management. These findings are attributed to study design limitations, including small and/or nonrepresentative samples.

Conclusion:

Clustering of thorough history and physical examination findings, including the aforementioned tests, may identify those with posterior glenohumeral instability and assist in developing management strategies.

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<![CDATA[An Epidemiological Comparison of Elbow Injuries Among United States High School Baseball and Softball Players, 2005-2006 Through 2014-2015]]> https://www.researchpad.co/article/5c10f022d5eed0c4844b8bbb

Background:

Pitching is a common mechanism of injury in baseball, with known risk factors for elbow injuries among adolescent pitchers.

Hypothesis:

Elbow injury rates and mechanisms will differ between high school baseball and softball players.

Study Design:

Descriptive epidemiology study.

Level of Evidence:

Level 3.

Methods:

Baseball- and softball-related injury data from the 2005-2006 through 2014-2015 academic years were collected from the High School Reporting Information Online (RIO) Internet-based data collection tool. Athlete-exposure (AE) and injury data were collected by certified athletic trainers. Rate ratios (RRs) were calculated comparing injury rates in the 2 populations. Injury proportion ratios (IPRs) comparing elbow injuries in pitchers and nonpitchers were calculated as the proportion of all elbow injuries in pitchers divided by the proportion of all elbow injuries in nonpitchers.

Results:

A total of 214 elbow injuries in male baseball players occurred over 2,327,774 AEs, for an overall elbow injury rate of 0.92 per 10,000 AEs. A total of 75 elbow injuries were reported in female softball players over 1,731,644 AEs, for an overall rate of 0.43 per 10,000 AEs. The rate of elbow injury was significantly higher for baseball than softball (RR, 2.12; 95% CI, 1.64-2.77). A significantly greater proportion of elbow injuries in baseball were pitching-related compared with those from softball, with 50.2% occurring while pitching in baseball versus 11.0% in softball (IPR, 4.58; 95% CI, 2.35-8.93). If all injuries occurring during pitching were removed from both sports, the difference in elbow injury rate for baseball and softball would no longer be significant (RR, 1.19; 95% CI, 0.88-1.62).

Conclusion:

The rate of elbow injuries is significantly higher in baseball than softball. This is attributable to differences in rates of pitching-related injuries between these 2 groups.

Clinical Relevance:

These results demonstrate that overhand pitching increases risk of elbow injury in high school athletes.

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<![CDATA[Post-traumatic stiff elbow]]> https://www.researchpad.co/article/5b5b29a3463d7e186098e49d

  • Post-traumatic and post-operative stiffness of the elbow joint is relatively common and may in pronounced cases markedly interfere with normal upper extremity function.

  • Soft-tissue contractures and heterotopic bone formation are two major causes of limited movement.

  • Extensive recent research has elucidated many of the pathways contributing to these conditions, but the exact mechanisms are still unknown.

  • In the early phase of soft-tissue contractures conservative treatment may be valuable, but in longstanding cases operative treatment is often necessary.

  • Several different options are available depending on the severity of the condition and the underlying offending structures. Surgical treatment may allow significant gains in movement but rarely complete restoration, and complications are not uncommon.

  • The following presentation reviews the recent literature on pathomechanisms and treatment alternatives.

Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170062

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<![CDATA[Current concepts in the primary management of irreparable posterosuperior rotator cuff tears without arthritis]]> https://www.researchpad.co/article/5c042631d5eed0c48467dd5c

  • Various procedures exist for patients with irreparable posterosuperior rotator cuff tears (IRCT). At present, no single surgical option has demonstrated clinical superiority.

  • There is no panacea for treatment and patients must be aware, in cases of palliative or non-prosthetic options, of an alarming rate of structural failure (around 50%) in the short term.

  • The current review does not support the initial use of complex and expensive techniques in the management of posterosuperior IRCT.

  • Further prospective and comparative studies with large cohort populations and long-term follow-up are necessary to establish effectiveness of expensive or complicated procedures such as superior capsular reconstruction (SCR), subacromial spacers or biological augmentation as reliable and useful alternative treatments for IRCT.

Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180002

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<![CDATA[Push Force Analysis of Anchor Block of the Oil and Gas Pipeline in a Single-Slope Tunnel Based on the Energy Balance Method]]> https://www.researchpad.co/article/5989daadab0ee8fa60baa35b

In this paper, a single-slope tunnel pipeline was analysed considering the effects of vertical earth pressure, horizontal soil pressure, inner pressure, thermal expansion force and pipeline—soil friction. The concept of stagnation point for the pipeline was proposed. Considering the deformation compatibility condition of the pipeline elbow, the push force of anchor blocks of a single-slope tunnel pipeline was derived based on an energy method. Then, the theoretical formula for this force is thus generated. Using the analytical equation, the push force of the anchor block of an X80 large-diameter pipeline from the West—East Gas Transmission Project was determined. Meanwhile, to verify the results of the analytical method, and the finite element method, four categories of finite element codes were introduced to calculate the push force, including CAESARII, ANSYS, AutoPIPE and ALGOR. The results show that the analytical results agree well with the numerical results, and the maximum relative error is only 4.1%. Therefore, the results obtained with the analytical method can satisfy engineering requirements.

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<![CDATA[Subjects with Knee Osteoarthritis Exhibit Widespread Hyperalgesia to Pressure and Cold]]> https://www.researchpad.co/article/5989da7fab0ee8fa60b99f99

Hyperalgesia to mechanical and thermal stimuli are characteristics of a range of disorders such as tennis elbow, whiplash and fibromyalgia. This study evaluated the presence of local and widespread mechanical and thermal hyperalgesia in individuals with knee osteoarthritis, compared to healthy control subjects. Twenty-three subjects with knee osteoarthritis and 23 healthy controls, matched for age, gender and body mass index, were recruited for the study. Volunteers with any additional chronic pain conditions were excluded. Pain thresholds to pressure, cold and heat were tested at the knee, ipsilateral heel and ipsilateral elbow, in randomized order, using standardised methodology. Significant between-groups differences for pressure pain and cold pain thresholds were found with osteoarthritic subjects demonstrating significantly increased sensitivity to both pressure (p = .018) and cold (p = .003) stimuli, compared with controls. A similar pattern of results extended to the pain-free ipsilateral ankle and elbow indicating widespread pressure and cold hyperalgesia. No significant differences were found between groups for heat pain threshold, although correlations showed that subjects with greater sensitivity to pressure pain were also likely to be more sensitive to both cold pain and heat pain. This study found widespread elevated pain thresholds in subjects with painful knee osteoarthritis, suggesting that altered nociceptive system processing may play a role in ongoing arthritic pain for some patients.

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<![CDATA[Functional Ability Improved in Essential Tremor by IncobotulinumtoxinA Injections Using Kinematically Determined Biomechanical Patterns – A New Future]]> https://www.researchpad.co/article/5989da42ab0ee8fa60b8a5e2

Objective

Effective treatment for functional disability caused by essential tremor is a significant unmet need faced by many clinicians today. Current literature regarding focal therapy by botulinum toxin type A (BoNT-A) injections uses fixed dosing regimens, which cannot be individualized, provides only limited functional benefit and unacceptable muscle weakness commonly occurs. This 38-week open label study, the longest to-date, demonstrates how kinematic technology addressed all these issues by guiding muscle selection.

Method

Participants (n = 24) were assessed at weeks 0, 6, 16, 22, 32, and 38 and injected with incobotulinumtoxinA at weeks 0, 16, and 32. Clinical assessments including UPDRS tremor items, Fahn-Tolosa-Marin (FTM) tremor rating scale assessing tremor severity, writing and functional ability, quality of life questionnaire (QUEST) and objective kinematic assessments were completed at every visit. Participants performed two postural and two weight-bearing scripted tasks with motion sensors placed over the wrist, elbow and shoulder joints. These sensors captured angular tremor amplitude (RMS units) and acceleration joint motion that was segmented into directional components: flexion-extension (F/E), pronation-supination and radial-ulnar at the wrist, F/E at the elbow, and F/E and adduction-abduction at the shoulder. Injection parameters were determined using kinematics, followed by the clinician’s determination of which muscles would contribute to the specific upper limb tremor biomechanics and dosing per participant.

Results

Multi-joint biomechanical recordings allowed individualized muscle selection and showed significant improvement in whole-arm function, FTM parts A-C scores, at week 6 which continued throughout the study. By week 38, the total FTM score statistically significantly reduced from 16.2±4.6 at week 0 to 9.5±6.3 (p<0.0005). UPDRS item 21 score rating action tremor was significantly reduced from 2.6±0.5 at week 0 to 1.6±1.1 (p = 0.01) at week 32. Quality of life (QUEST) significantly improved from 40.3±15.8 at week 0 to 31.1±15.3 (p = 0.035) at week 32 and to 27.8±15.3 (p = 0.028) at week 38. Kinematics provided an objective, secondary outcome measure, which showed a significant decrease in tremor amplitude in the wrist and shoulder joints (p<0.05). Eight participants (40%) self-reported mild weakness in injected muscles but had no interference in arm function.

Conclusion

Kinematic tremor assessments provide the injector unique insight to objectively individualize and personalize injection parameters demonstrating BoNT-A effectively alleviates functional disability caused by essential tremor. Kinematic technology is a promising method for standardizing assessments and for focal upper limb tremor treatment.

Trial Registration

ClinicalTrials.gov NCT02427646

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<![CDATA[Magnetic resonance imaging of posterolateral plica of the elbow joint: Asymptomatic vs. symptomatic subjects]]> https://www.researchpad.co/article/5989db5fab0ee8fa60be1106

Background

Magnetic resonance imaging (MRI) may be useful to diagnose a posterolateral plica syndrome of the elbow joint because this syndrome has less clear clinical features. The purposes of this study were to document mediolateral and sagittal dimensions of a posterolateral synovial fold and to determine the proportion of subjects with the posterolateral plica in asymptomatic elbows. We also aimed to determine whether the dimensions of the posterolateral synovial fold and the prevalence of the plica differ between symptomatic and asymptomatic subjects.

Materials and methods

This retrospective review of prospectively collected data included 50 asymptomatic elbows (asymptomatic group) and 14 elbows with arthroscopically confirmed posterolateral plicae (plica group). The mediolateral and sagittal dimensions of the posterolateral synovial fold were measured. In addition, the criteria for the prevalence of posterolateral plica was determined with conventional MRI as synovial fold dimension ≥ 3 mm and coverage of radial head by synovial fold ≥ 30%.

Results

The plica group showed larger posterolateral synovial fold dimensions compared to the asymptomatic group. The median mediolateral and sagittal dimensions of the synovial fold in the asymptomatic group were 3.8 mm and 4.7 mm, respectively. Dimensions in the plica group were 7.0 mm and 7.4 mm, respectively. When the presence of posterolateral plica was determined using the dimension criteria, there was no difference in the prevalence of the plica between the asymptomatic and the plica group. However, using the coverage criteria, the prevalence of posterolateral elbow plica was significantly greater in the plica group than the asymptomatic group (64% vs. 18%; p < 0.001).

Conclusions

The patients who underwent arthroscopic surgery for posterolateral plica syndrome had larger dimensions of the posterolateral synovial fold and higher prevalence of the posterolateral plica on conventional MRI compared to the asymptomatic subjects.

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<![CDATA[Long-term genetic selection reduced prevalence of hip and elbow dysplasia in 60 dog breeds]]> https://www.researchpad.co/article/5989db50ab0ee8fa60bdbfe6

Canine hip dysplasia (CHD) and elbow dysplasia (ED) impact the health and welfare of all dogs. The first formally organized assessment scheme to improve canine health centered on reducing the prevalence of these orthopedic disorders. Phenotypic screening of joint conformation remains the currently available strategy for breeders to make selection decisions. The present study evaluated the efficacy of employing phenotypic selection on breed improvement of hips and elbows using the Orthopedic Foundation for Animals complete database spanning the 1970–2015 time period. Sixty breeds having more than 1000 unique hip evaluations and 500 elbow evaluations (1,056,852 and 275,129 hip and elbow records, respectively) were interrogated to derive phenotypic improvement, sex and age at time of assessment effects, correlation between the two joints, heritability estimates, estimated breeding values (EBV), and effectiveness of maternal/paternal selection. The data demonstrated that there has been overall improvement in hip and elbow conformation with a reduction in EBV for disease liability, although the breeds differed in the magnitude of the response to selection. Heritabilities also differed substantially across the breeds as did the correlation of the joints; in the absence of a universal association of these differences with breed size, popularity, or participation in screening, it appears that the breeds themselves vary in genetic control. There was subtle, though again breed specific, impact of sex and older ages on CHD and ED. There was greater paternal impact on a reduction of CHD. In the absence of direct genetic tests for either of these two diseases, phenotypic selection has proven to be effective. Furthermore, the data underscore that selection schemes must be breed specific and that it is likely the genetic profiles will be unique across the breeds for these two conditions. Despite the advances achieved with phenotypic selection, incorporation of EBVs into selection schemes should accelerate advances in hip and elbow improvement.

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<![CDATA[Pomegranate Supplementation Accelerates Recovery of Muscle Damage and Soreness and Inflammatory Markers after a Weightlifting Training Session]]> https://www.researchpad.co/article/5989da03ab0ee8fa60b74ecd

Purpose

The aim of this study was to investigate the effect of natural Pomegranate juice supplementation on performance and acute and delayed responses of muscle soreness and biomarkers of muscle damage after a weightlifting training session.

Methods

Nine elite weightlifters (21±0.5 years) performed two Olympic-Weightlifting-sessions after either placebo (PLA) or natural pomegranate juice (POMj) supplementations. Heart rate, blood pressure and blood samples (hematological parameters, muscle damage and C-reactive protein (CRP)) were collected at rest, 3min and 48h after each session. Weightlifting performance, RPE, and DOMS were also assessed after each training session.

Results

T-test showed higher performance (+8.30%) and lower RPE values (-4.37%) using POMj supplementation (p<0.05) in comparison with PLA. For the DOMS values, a significant improvement (13.4%) was shown only for the knee extensors (p<0.01) using the POMj. Compared to PLA condition, POMj attenuated the acute (i.e., 3min) increase of systolic blood pressure (SBP), HR, CK and LDH (p<0.05; -4.46%, -1.81%, -8.75%, -1.64%, respectively) and blunted the significant increase of ASAT, PAL and CRP (p>0.05). Additionally, during the 48h following the training session, POMj improved the recovery kinetic of SBP (p<0.01, 7.97%), CK (p<0.001, 11.34%), LDH (p<0.05, 7.30%) and ASAT (p<0.05, 6.77%). Indeed, the present study showed that 48h of recovery associated to natural POMj supplementation was sufficient to reach the resting values of the selected muscle damage markers after intensive training session.

Conclusion

Natural POMj seems to ameliorate the capacity to adhere to an intensive training program. Therefore, elite weightlifters are advised to use natural POMj during intensive training program and competition to accelerate muscle recovery.

Trial Registration

ClinicalTrials.gov NCT02697903

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<![CDATA[A systematic review of surface electromyography analyses of the bench press movement task]]> https://www.researchpad.co/article/5989db4fab0ee8fa60bdb87e

Background

The bench press exercise (BP) plays an important role in recreational and professional training, in which muscle activity is an important multifactorial phenomenon. The objective of this paper is to systematically review electromyography (EMG) studies performed on the barbell BP exercise to answer the following research questions: Which muscles show the greatest activity during the flat BP? Which changes in muscle activity are related to specific conditions under which the BP movement is performed?

Strategy

PubMed, Scopus, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library were searched through June 10, 2016. A combination of the following search terms was used: bench press, chest press, board press, test, measure, assessment, dynamometer, kinematics and biomechanics. Only original, full-text articles were considered.

Results

The search process resulted in 14 relevant studies that were included in the discussion. The triceps brachii (TB) and pectoralis major (PM) muscles were found to have similar activity during the BP, which was significantly higher than the activity of the anterior deltoid. During the BP movement, muscle activity changes with exercise intensity, velocity of movement, fatigue, mental focus, movement phase and stability conditions, such as bar vibration or unstable surfaces. Under these circumstances, TB is the most common object of activity change.

Conclusions

PM and TB EMG activity is more dominant and shows greater EMG amplitude than anterior deltoid during the BP. There are six factors that can influence muscle activity during the BP; however, the most important factor is exercise intensity, which interacts with all other factors. The research on muscle activity in the BP has several unresolved areas, such as clearly and strongly defined guidelines to perform EMG measurements (e.g., how to elaborate with surface EMG limits) or guidelines for the use of exact muscle models.

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<![CDATA[Feasibility of Using Microsoft Kinect to Assess Upper Limb Movement in Type III Spinal Muscular Atrophy Patients]]> https://www.researchpad.co/article/5989db53ab0ee8fa60bdc9be

Although functional rating scales are being used increasingly as primary outcome measures in spinal muscular atrophy (SMA), sensitive and objective assessment of early-stage disease progression and drug efficacy remains challenging. We have developed a game based on the Microsoft Kinect sensor, specifically designed to measure active upper limb movement. An explorative study was conducted to determine the feasibility of this new tool in 18 ambulant SMA type III patients and 19 age- and gender-matched healthy controls. Upper limb movement was analysed elaborately through derived features such as elbow flexion and extension angles, arm lifting angle, velocity and acceleration. No significant differences were found in the active range of motion between ambulant SMA type III patients and controls. Hand velocity was found to be different but further validation is necessary. This study presents an important step in the process of designing and handling digital biomarkers as complementary outcome measures for clinical trials.

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<![CDATA[Adaptation to random and systematic errors: Comparison of amputee and non-amputee control interfaces with varying levels of process noise]]> https://www.researchpad.co/article/5989db50ab0ee8fa60bdbecc

The objective of this study was to understand how people adapt to errors when using a myoelectric control interface. We compared adaptation across 1) non-amputee subjects using joint angle, joint torque, and myoelectric control interfaces, and 2) amputee subjects using myoelectric control interfaces with residual and intact limbs (five total control interface conditions). We measured trial-by-trial adaptation to self-generated errors and random perturbations during a virtual, single degree-of-freedom task with two levels of feedback uncertainty, and evaluated adaptation by fitting a hierarchical Kalman filter model. We have two main results. First, adaptation to random perturbations was similar across all control interfaces, whereas adaptation to self-generated errors differed. These patterns matched predictions of our model, which was fit to each control interface by changing the process noise parameter that represented system variability. Second, in amputee subjects, we found similar adaptation rates and error levels between residual and intact limbs. These results link prosthesis control to broader areas of motor learning and adaptation and provide a useful model of adaptation with myoelectric control. The model of adaptation will help us understand and solve prosthesis control challenges, such as providing additional sensory feedback.

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