Anthropometry, physical performance, and ultrasound patellar tendon abnormality in elite junior basketball players: a cross-sectional study

Objective: Patellar tendinopathy has been reported to be associated with many intrinsic risk factors. Few have been fully investigated. This cross-sectional study examined the anthropometric and physical performance results of elite junior basketball players with normal or abnormal patellar tendons to see if any measures were associated with changes in tendon morphology.

Methods: Agility, leg strength, endurance, and flexibility were measured in 71 male and 64 female players. A blinded radiologist ultrasonographically examined their patellar tendons and athletes were grouped as having normal or abnormal tendons. One-way ANOVA was used to test for differences in anthropometric and physical performance data for athletes whose tendons were normal or abnormal (unilateral or bilateral tendinopathy) on ultrasound.

Results: Results show that females with abnormalities in their tendons had a significantly better vertical jump (50.9±6.8 cm) than those with normal tendons (46.1±5.4 cm) (p = 0.02). This was not found in males. In males, the mean sit and reach in those with normal tendons (13.2±6.7 cm) was greater (p<0.03) than in unilateral tendinopathy (10.3±6.2 cm) or in bilateral tendinopathy (7.8±8.3 cm). In females, those with normal tendons (13.3±4.8 cm) and bilateral tendinopathy (15.8±6.2 cm) were distinctly different from those with unilateral tendinopathy (7.9±6.6 cm).

Conclusion: Flexibility and vertical jump ability are associated with patellar tendinopathy and the findings warrant consideration when managing young, jumping athletes.

Asymptomatic hypoechoic regions on patellar tendon ultrasound : a 4-year clinical and ultrasound followup of 46 tendons

Patellar tendon ultrasound appearance is commonly used in clinical practice to diagnose patellar tendinopathy and guide management. Using a longitudinal study design we examined whether or not the presence of a hypoechoic ultrasonographic lesion in an asymptomatic patellar tendon conferred a risk for developing jumper's knee compared with a tendon that was ultrasonographically normal. Ultrasonographic, symptomatic and anthropometric assessment was completed at baseline and followup. Magnetic resonance imaging was performed on four tendons that resolved ultrasonographically in the study period. Forty-six patellar tendons were followed over 47±11.8 months. Eighteen tendons were hypoechoic at baseline and 28 were ultrasonographically normal. Five tendons resolved ultrasonographically in the study period. Magnetic resonance imaging in four of these tendons was normal. Seven normal patellar tendons at baseline developed a hypoechoic area but only two became symptomatic. Analysis of ultrasonography at baseline and clinical outcome with Fisher's exact test shows there is no association between baseline ultrasound changes and symptoms at followup. In this study there is no statistically significant relationship between ultrasonographic patellar tendon abnormalities and clinical outcome in elite male athletes. Management of jumper's knee should not be solely based on ultrasonographic appearance; clinical assessment remains the cornerstone of appropriate management.

The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage

This cross-sectional study investigated the imaging appearance of the previous termpatellarnext term tendon attachment to the tibia in young male and female tennis players of different ages and pubertal status. Forty-four competitive young players, who had been playing tennis at least for 2 years, were recruited from a tennis school and local tennis clubs. All subjects had bilateral ultrasound imaging of the previous termpatellarnext term tendon attachment to the tibia. Standard anthropometric measurements, pubertal status and injury history were recorded. Ultrasound appearance of the previous termpatellarnext term tendon attachment was categorised into three stages: cartilage attachment, insertional cartilage and mature attachment. Cartilage attachment was more prevalent in boys (32%) and extended further into puberty (until Tanner stage 4) compared to girls (6% and Tanner stage 1). Tendons with Osgood–Schlatter Disease symptoms (n = 3) did not have a cartilage attachment. Imaging appearance commonly seen in young active athletes, consistent with a clinical diagnosis of OSD, was more common in boys and in the pre- and peri-pubertal stages.

Low-intensity pulsed ultrasound for chronic patellar tendinopathy : a randomized, double-blind, placebo-controlled trial

Objective. Patellar tendinopathy (PT) is a common and significant clinical condition for which there are few established interventions. One intervention that is currently being used clinically to manage PT symptoms is the introduction of low-intensity pulsed ultrasound (LIPUS). The aim of this study was to investigate the clinical efficacy of LIPUS in the management of PT symptoms.

Methods. A randomized, double-blind, placebo-controlled study was conducted. Volunteers with clinically and radiologically confirmed PT were randomly allocated to either an active-LIPUS (treatment) or inactive-LIPUS (placebo) group. LIPUS was self-administered by participants for 20 min/day, 7 days/week for 12 weeks. All participants also completed a daily, standardized eccentric exercise programme based on best practice. Primary outcomes were change in pain during the participant's most aggravating activity in the preceding week, measured on 10 cm visual analogue scales for both usual (VAS-U) and worst (VAS-W) tendon pain.

Results. Out of 156 individuals who volunteered, 37 met the eligibility criteria and were randomized to either active-LIPUS (n = 17) or inactive-LIPUS (n = 20). Using an intention-to-treat analysis, VAS-U and VAS-W for the entire cohort decreased by 1.6 ± 1.9 cm (P < 0.01) and 2.5 ± 2.4 cm (P < 0.01), respectively. There were no differences between the active- and inactive-LIPUS groups for change in VAS-U (–0.2 cm; 95% CI, –1.5, 1.1 cm) (P = 0.74) or VAS-W (–0.5 cm; 95% CI, –2.1, 1.1 cm) (P = 0.57). A per-protocol analysis provided similar results.

Conclusions. These findings suggest that LIPUS does not provide any additional benefit over and above placebo in the management of symptoms associated with PT.

Potential uses of ultrasound in the dairy ultrafiltration processes

There has been a growing interest in the industrial application of ultrasound, especially in the food industry. Power ultrasound can have a number of physical effects; it can increase turbulence through both the introduction of vibrational energy and through acoustic streaming, it can cause both particle agglomeration and particle dispersion and clean surfaces with a scouring action. Our work in this area has focused on the use of ultrasound to enhance membrane processing. Low frequency ultrasound has been used to facilitate cross flow ultrafiltration of dairy whey solutions for both during the ultrafiltration production cycle and the cleaning cycle. During the production cycle, the use of ultrasound reduces both pore blockage and the specific resistance of the fouling cake layer. This leads to higher flux rates and the potential for longer production cycles. During the cleaning cycle, ultrasound systematically increases cleaning efficiency, thus has the potential to reduce both total chemical consumption and system downtime. There was no deterioration in cleaning effectiveness or membrane condition which imples that sonication , has not damaged the membrane itself. Similarly, there was no change in the chemical nature of soluble proteins following sonication.

The application of ultrasound to dairy ultrafiltration : the influence of operating conditions

Work previously presented has shown that ultrasound can be effective in enhancing both the production and cleaning cycles of dairy membrane  processes. In this present work we extend these previous results to consider the effect of ultrasonic frequency and the use of intermittent ultrasound. These results show that the use of continuous low frequency (50 kHz) ultrasound is most effective in both the fouling and cleaning cycles. The application of intermittent high frequency (1 MHz) ultrasound is less effective. At higher transmembrane pressure, high frequency pulsed sonication can indeed lead to a reduction in steady state membrane flux. The benefits of ultrasound arise from a reduction in both concentration polarization and in the resistance provided by the more labile protein deposits that are removed during a water wash. Conversely, the loss of membrane flux when high frequency pulsed sonication is used arises from a significant increase in the more tenacious ‘irreversible’ fouling deposit.

Power ultrasound offers an environmentally friendly approach to cleaning dairy UF membranes

Flat sheet polymeric UF membranes of 30000 MWCO were obtained from Millipore Inc. Polypropylene spacers of a 50 mil (1.3 mm) thickness were obtained from KOCH membrane systems. A single 30 cm^sup 2^ membrane sheet was sandwiched with a spacer on the feed side of a cross flow Minitan S unit (Millipore Inc). The unit was immersed in a 50 kHz ultrasonic bath that was switched on as required. All experiments used re-constituted spray-dried whey powder to foul the membrane.

Engineering molecular self-assembled fibrillar networks by ultrasound

The architecture of self-organized three-dimensionally interconnected nanocrystal fibrillar networks has been achieved by ultrasound from a solution consisting of separate spherulites. The ultrasound stimulated structural transformation is correlated to the striking ultrasonic effects on turning nongelled solutions or weak gels into strong gels instantly, with enhancement of the storage modulus up to 3 magnitudes and up to 4 times more gelling capability. The basic principle involved in the ultrasound-induced structural transformation is established on the basis of the nucleation-and-growth model of a fiber network formation, and the mechanism of seeding multiplication, aggregation suppressing, and fiber distribution and growth promotion is proposed. This novel technique enables us to produce self-supporting gel functional materials possessing significantly modified macroscopic properties, from materials previously thus far considered to be “useless”, without the use of chemical stimuli. Moreover, it provides a general strategy for the engineering of self-organized fiber network architectures, and we are consequently able to achieve the supramolecular functional materials with controllable macroscopic properties.

What has transcranial magnetic stimulation taught us about neural adaptations to strength training? A brief review

The evidence for neural mechanisms underpinning rapid strength increases has been investigated and discussed for over 30 years using indirect methods, such as surface electromyography, with inferences made toward the nervous system. Alternatively, electrical stimulation techniques such as the Hoffman reflex, volitional wave, and maximal wave have provided evidence of central nervous system changes at the spinal level. For 25 years, the technique of transcranial magnetic stimulation (TMS) has allowed for noninvasive supraspinal measurement of the human nervous system in a number of areas such as fatigue, skill acquisition, clinical neurophysiology, and neurology. However, it has only been within the last decade that this technique has been used to assess neural changes after strength training. The aim of this brief review is to provide an overview of TMS, discuss specific strength training studies that have investigated changes, after short-term strength training in healthy populations in upper and lower limbs, and conclude with further research suggestions and the application of this knowledge for the strength and conditioning coach.