Eccentric calf muscle exercise produces a greater acute reduction in Achilles tendon thickness than concentric exercise

Objective: To investigate the acute effects of isolated eccentric and concentric calf muscle exercise on Achilles tendon sagittal thickness. ---------- Design: Within-subject, counterbalanced, mixed design. ---------- Setting: Institutional. ---------- Participants: 11 healthy, recreationally active male adults. ---------- Interventions: Participants performed an exercise protocol, which involved isolated eccentric loading of the Achilles tendon of a single limb and isolated concentric loading of the contralateral, both with the addition of 20% bodyweight. ---------- Main outcome measurements: Sagittal sonograms were acquired prior to, immediately following and 3, 6, 12 and 24 h after exercise. Tendon thickness was measured 2 cm proximal to the superior aspect of the calcaneus. ---------- Results: Both loading conditions resulted in an immediate decrease in normalised Achilles tendon thickness. Eccentric loading induced a significantly greater decrease than concentric loading despite a similar impulse (−0.21 vs −0.05, p<0.05). Post-exercise, eccentrically loaded tendons recovered exponentially, with a recovery time constant of 2.5 h. The same exponential function did not adequately model changes in tendon thickness resulting from concentric loading. Even so, recovery pathways subsequent to the 3 h time point were comparable. Regardless of the exercise protocol, full tendon thickness recovery was not observed until 24 h. ---------- Conclusions: Eccentric loading invokes a greater reduction in Achilles tendon thickness immediately after exercise but appears to recover fully in a similar time frame to concentric loading.

The concentric all-polyethylene Exeter acetabular component in primary total hip replacement

We report the long term outcome of the flangeless, cemented all polyethylene Exeter cup at a mean of 14.6 years (range 10-17) after operation. Of the 263 hips in 243 patients, 122 hips are still in situ, 112 patients (119 hips) have died, eighteen hips were revised, and three patients (four hips) had moved abroad and were lost to follow-up (1.5%). Radiographs demonstrated two sockets had migrated and six more had radiolucent lines in all three zones. The Kaplan Meier survivorship at 15 years with endpoint revision for all causes is 89.9% (95% CI 84.6 to 95.2%) and for aseptic cup loosening or lysis 91.7% (CI 86.6 to 96.8%). In 210 hips with a diagnosis of primary osteoarthritis survivorship for all causes is 93.2% (95% CI 88.1 to 98.3%), and for aseptic cup loosening 95.0% (CI 90.3 to 99.7%). The cemented all polyethylene Exeter cup has an excellent long-term survivorship.

The acute adaptations of normal and pathological human Achilles tendons to eccentric and concentric exercise

Eccentric exercise is the conservative treatment of choice for mid-portion Achilles tendinopathy. While there is a growing body of evidence supporting the medium to long term efficacy of eccentric exercise in Achilles tendinopathy treatment, very few studies have investigated the short term response of the tendon to eccentric exercise. Moreover, the mechanisms through which tendinopathy symptom resolution occurs remain to be established. The primary purpose of this thesis was to investigate the acute adaptations of the Achilles tendon to, and the biomechanical characteristics of, the eccentric exercise protocol used for Achilles tendinopathy rehabilitation and a concentric equivalent. The research was conducted with an orientation towards exploring potential mechanisms through which eccentric exercise may bring about a resolution of tendinopathy symptoms. Specifically, the morphology of tendinopathic and normal Achilles tendons was monitored using high resolution sonography prior to and following eccentric and concentric exercise, to facilitate comparison between the treatment of choice and a similar alternative. To date, the only proposed mechanism through which eccentric exercise is thought to result in symptom resolution is the increased variability in motor output force observed during eccentric exercise. This thesis expanded upon prior work by investigating the variability in motor output force recorded during eccentric and concentric exercises, when performed at two different knee joint angles, by limbs with and without symptomatic tendinopathy. The methodological phase of the research focused on establishing the reliability of measures of tendon thickness, tendon echogenicity, electromyography (EMG) of the Triceps Surae and the standard deviation (SD) and power spectral density (PSD) of the vertical ground reaction force (VGRF). These analyses facilitated comparison between the error in the measurements and experimental differences identified as statistically significant, so that the importance and meaning of the experimental differences could be established. One potential limitation of monitoring the morphological response of the Achilles tendon to exercise loading is that the Achilles tendon is continually exposed to additional loading as participants complete the walking required to carry out their necessary daily tasks. The specific purpose of the last experiment in the methodological phase was to evaluate the effect of incidental walking activity on Achilles tendon morphology. The results of this study indicated that walking activity could decrease Achilles tendon thickness (negative diametral strain) and that the decrease in thickness was dependent on both the amount of walking completed and the proximity of walking activity to the sonographic examination. Thus, incidental walking activity was identified as a potentially confounding factor for future experiments which endeavoured to monitor changes in tendon thickness with exercise loading. In the experimental phase of this thesis the thickness of Achilles tendons was monitored prior to and following isolated eccentric and concentric exercise. The initial pilot study demonstrated that eccentric exercise resulted in a greater acute decrease in Achilles tendon thickness (greater diametral strain) compared to an equivalent concentric exercise, in participants with no history of Achilles tendon pain. This experiment was then expanded to incorporate participants with unilateral Achilles tendinopathy. The major finding of this experiment was that the acute decrease in Achilles tendon thickness observed following eccentric exercise was modified by the presence of tendinopathy, with a smaller decrease (less diametral strain) noted for tendinopathic compared to healthy control tendon. Based on in vitro evidence a decrease in tendon thickness is believed to reflect extrusion of fluid from the tendon with loading. This process would appear to be limited by the presence of pathology and is hypothesised to be a result of the changes in tendon structure associated with tendinopathy. Load induced fluid movement may be important to the maintenance of tendon homeostasis and structure as it has the potential to enhance molecular movement and stimulate tendon remodelling. On this basis eccentric exercise may be more beneficial to the tendon than concentric exercise. Finally, EMG and motor output force variability (SD and PSD of VGRF) were investigated while participants with and without tendinopathy performed the eccentric and concentric exercises. Although between condition differences were identified as statistically significant for a number of force variability parameters, the differences were not greater than the limits of agreement for repeated measures. Consequently the meaning and importance of these findings were questioned. Interestingly, the EMG amplitude of all three Triceps Surae muscles did not vary with knee joint angle during the performance of eccentric exercise. This raises questions pertaining to the functional importance of performing the eccentric exercise protocol at each of the two knee joint angles as it is currently prescribed. EMG amplitude was significantly greater during concentric compared to eccentric muscle actions. Differences in the muscle activation patterns may result in different stress distributions within the tendon and be related to the different diametral strain responses observed for eccentric and concentric muscle actions.

Architectural changes of the biceps femoris after concentric or eccentric training

Purpose To determine i) the architectural adaptations of the biceps femoris long head (BFlf) following concentric or eccentric strength training interventions; ii) the time course of adaptation during training and detraining. Methods Participants in this randomized controlled trial (control [n=28], concentric training group [n=14], eccentric training group [n=14], males) completed a 4-week control period, followed by 6 weeks of either concentric- or eccentric-only knee flexor training on an isokinetic dynamometer and finished with 28 days of detraining. Architectural characteristics of BFlf were assessed at rest and during graded isometric contractions utilizing two-dimensional ultrasonography at 28 days pre-baseline, baseline, days 14, 21 and 42 of the intervention and then again following 28 days of detraining. Results BFlf fascicle length was significantly longer in the eccentric training group (p<0.05, d range: 2.65 to 2.98) and shorter in the concentric training group (p<0.05, d range: -1.62 to -0.96) after 42 days of training compared to baseline at all isometric contraction intensities. Following the 28-day detraining period, BFlf fascicle length was significantly reduced in the eccentric training group at all contraction intensities compared to the end of the intervention (p<0.05, d range: -1.73 to -1.55). There was no significant change in fascicle length of the concentric training group following the detraining period. Conclusions These results provide evidence that short term resistance training can lead to architectural alterations in the BFlf. In addition, the eccentric training-induced lengthening of BFlf fascicle length was reversed and returned to baseline values following 28 days of detraining. The contraction mode specific adaptations in this study may have implications for injury prevention and rehabilitation.

A hybrid clustering procedure for concentric and chain-like clusters

K-means algorithm is a well known nonhierarchical method for clustering data. The most important limitations of this algorithm are that: (1) it gives final clusters on the basis of the cluster centroids or the seed points chosen initially, and (2) it is appropriate for data sets having fairly isotropic clusters. But this algorithm has the advantage of low computation and storage requirements. On the other hand, hierarchical agglomerative clustering algorithm, which can cluster nonisotropic (chain-like and concentric) clusters, requires high storage and computation requirements. This paper suggests a new method for selecting the initial seed points, so that theK-means algorithm gives the same results for any input data order. This paper also describes a hybrid clustering algorithm, based on the concepts of multilevel theory, which is nonhierarchical at the first level and hierarchical from second level onwards, to cluster data sets having (i) chain-like clusters and (ii) concentric clusters. It is observed that this hybrid clustering algorithm gives the same results as the hierarchical clustering algorithm, with less computation and storage requirements.

Secondary flow induced by the rotation of two concentric spheres about their common diameter in micropolar fluids

In this paper, we have studied the secondary flow induced in a micropolar fluid by the rotation of two concentric spheres about a fixed diameter. The secondary flow exhibits behaviour commonly observed in visco-elastic fluids. In particular we have obtained the expressions for microrotation vector. Numerical results have been obtained for a number of values of relative rotations of the two spheres for a chosen set of values of fluid parameters. The results are presented graphically and compared with the previous investigations.

Secondary flow of Rivlin-Ericksen fluids between two concentric spheres oscillating about a fixed diameter

The paper deals with the study of the nature of secondary flow of aRivlin-Ericksen fluid, contained between two concentric spheres, which perform oscillations about a fixed diameter. The steady part of the secondary flow is discussed in detail in the following three cases (i) the outer sphere at rest, the inner oscillating, (ii) the two spheres oscillating with the same angular velocity in the same sense and (iii) the spheres oscillating with the same angular velocity in opposite sense. In a previous paper, a similar problem was discussed for theOldroyd fluids. We find that the secondary flow is strongly dependent on the common frequency of oscillation of the two spheres and on the rotational nature of the motion for the present investigation also. Certain contrasting features of interest between the secondary flow field of the two fluids are also noted.

Experimental validation of the 1-D acoustical model for conical concentric tube resonators with moving medium

Variable cross-sectional area ducts are often used for attenuation at lower frequencies (of the order of firing frequency), whereas concentric tube resonators provide attenuation at relatively higher frequencies. In this paper, analysis of one dimensional control volume approach of conical concentric tube resonators is validated experimentally. The effects of mean flow and taper are investigated. The experimental setup is specially designed to measure the pressure transfer function in the form of Level Difference or Noise Reduction across the test muffler. It is shown that there is a reasonably good agreement between the predicted values of the Noise Reduction and the measured ones for incompressible mean flow as well as stationary medium. (C) 2011 Institute of Noise Control Engineering.

Tuning of the extended concentric tube resonators

It has been shown recently that the acoustic performance of the extended tube expansion chambers can be improved substantially by making the extended inlet and outlet equal to half and quarter chamber lengths, duly incorporating the end corrections due to the evanescent higher order modes that would be generated at the discontinuities. Such chambers however suffer from the disadvantages of high back pressure and generation of aerodynamic noise at the area discontinuities. These two disadvantages can be overcome by means of a perforated bridge between the extended inlet and extended outlet. This paper deals with design or tuning of these extended concentric tube resonators.

Improved tuning of the extended concentric tube resonator for wide-band transmission loss

Transmission loss (TL) of a simple expansion chamber (SEC) consists of periodic domes with sharp troughs. This limits practical application of the SEC in the variable-speed automobile exhaust systems. Three-fourths of the troughs of the SEC can be lifted by appropriate tuning of the extended inlet/outlet lengths. However, such mufflers suffer from high back pressure and generation of aerodynamic noise due to free shear layers at the area discontinuities. Therefore, a perforate bridge is made between the extended inlet and outlet. It is shown that the TL curve of a concentric tube resonator (CTR) can also be lifted in a similar way by proper tuning of the extended unperforated lengths. Differential lengths have to be used to correct the inlet/outlet lengths in order to account for the perforate inertance. The resonance peak frequencies calculated by means of the 1-D analysis are compared with those of the 3-D FEM, and appropriate differential lengths are calculated. It is shown how different geometric characteristics of the muffler and mean flow affect the differential lengths. A general correlation is obtained for the differential lengths by considering seven relevant geometric and environmental parameters in a comprehensive parametric study. The resulting expressions would help in design of extended-tube CTR for wide-band TL. (C) 2014 Institute of Noise Control Engineering.

A Voltage Space Vector Diagram Formed by Nineteen Concentric Dodecagons for Medium-Voltage Induction Motor Drive

In this paper, a multilevel dodecagonal voltage space vector structure with nineteen concentric dodecagons is proposed for the first time. This space vector structure is achieved by cascading two sets of asymmetric three-level inverters with isolated H-bridges on either side of an open-end winding induction motor. The dodecagonal structure is made possible by proper selection of dc link voltages and switching states of the inverters. The proposed scheme retains all the advantages of multilevel topologies as well as the advantages of dodecagonal voltage space vector structure. In addition to that, a generic and simple method for calculation of pulsewidth modulation timings using only sampled reference values (v(alpha) and v(beta)) is proposed. This enables the scheme to be used for any closed-loop application such as vector control. In addition, a new method of switching technique is proposed, which ensures minimum switching while eliminating the fifth-and seventh-order harmonics and suppressing the eleventh and thirteenth harmonics, eliminating the need for bulky filters. The motor phase voltage is a 24-stepped wave-form for the entire modulation range thereby reducing the number of switchings of the individual inverter modules. Experimental results for steady-state operation, transient operation, including start-up have been presented and the results of fast Fourier transform analysis is also presented for validating the proposed concept.

Reduced deep-tissue image degradation in three-dimensional multiphoton microscopy with concentric two-color two-photon fluorescence excitation

We theoretically demonstrate that enhanced penetration depth in three-dimensional multiphoton microscopy can be achieved using concentric two-color two-photon (C2C2P) fluorescence excitation in which the two excitation beams are separated in space before reaching their common focal spot. Monte Carlo simulation shows that, in comparison with the one-color two-photon excitation scheme, the C2C2P fluorescence microscopy provides a significantly greater penetration depth for imaging into a highly scattering medium. (C) 2008 Optical Society of America.