821 resultados para knee arthroplasty


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Objective: To assess sensory deficits and their effects on proprioceptive and motor function in patients who had undergone unilateral anterior cruciate ligament (ACL) reconstruction.Design: Four evaluations were conducted: (1) joint position perception of the knee for predetermined angles (0degrees, 15degrees, 30degrees, 45degrees, 60degrees); (2) threshold for detection of passive knee motion at 0degrees, 15degrees, 30degrees, 45degrees, and 60degrees moving into flexion and at 15degrees, 30degrees, 45degrees, and 60degrees moving into extension; (3) latency onset of hamstring muscles; and (4) postural control during upright double- and single-leg stance.Setting: Movement laboratory in Brazil.Participants: Ten participants who had surgical reconstruction of the ACL (reconstructed group) and 10 participants without knee injury (control group).Interventions: Not applicable.Main Outcome Measures: Absolute error, angular displacement, hamstring muscles latency, and mean sway amplitude.Results: Individuals with a reconstructed knee showed decreased joint position perception, a higher threshold for detection of passive knee motion, longer latency of hamstring muscles, and decreased performance in postural control.Conclusions: After lesion and ACL reconstruction, sensory and motor behavior changes were still observed. This may be because of the lack of proprioceptive information resulting from the ACL lesion and/or substitution of ACL by the graft. (C) 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

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Objective. - In a pioneer way, we investigated the morbidity of sports injuries referred by judo athletes from São Paulo State Championship.Material and methods. - Data collection from 93 senior judokas in State of São Paulo Judo Championship, through Referred Morbidity Inquiry about last year.Results. - One hundred and ten events were registered with a distribution frequency gradient of sprain > contusion > strain > ligament injury > partial and total dislocation. The most injured body areas were: knee (26.3%), shoulder (21.8%), fingers (17.3%), and ankle (10.0%). The most risky situation was when the athlete was training (standing, applying a blow) and it can be explained by the frequent and unprepared exposition of the athletes. Yearly lesion rate was 1.18 injuries per athlete/year.Conclusion. - Sprains constitute the most common judo injury, and athletes are more susceptible when they apply blows; discussion about the direction that the prevention should be applied remains opened. (c) 2006 Elsevier Masson SAS. All rights reserved.

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Pereira, GR, Leporace, G, Chagas, DV, Furtado, LFL, Praxedes, J, and Batista, LA. Influence of hip external rotation on hip adductor and rectus femoris myoelectric activity during a dynamic parallel squat. J Strength Cond Res 24(10): 27492754, 2010-This study sought to compare the myoelectric activity of the hip adductors (HAs) and rectus femoris (RF) when the hip was in a neutral position or externally rotated by 30 degrees or 50 degrees (H0, H30, and H50, respectively) during a parallel squat. Ten healthy subjects performed 10 repetitions of squats in each of the 3 hip positions and the myoelectric activities of the HAs and RF were recorded. The signal was then divided into categories representing concentric (C) and eccentric (E) contractions in the following ranges of motion: 0-30 degrees (C1 and E1), 30-60 degrees (C2 and E2), and 60-90 degrees (C3 and E3) of knee flexion. From those signals, an root mean square (RMS) value for each range of motion in each hip position was obtained. All values were normalized to those obtained during maximum voluntary isometric contraction. We found that HAs showed a significant increase in myoelectric activity during C3 and E3 in the H30 and H50 positions, as compared with H0. Meanwhile, RF activity did not significantly differ between hip positions. Both muscles showed higher activation during 60-90 degrees (C3 and E3) of knee flexion, as compared with 0-30 degrees (C1 and E1) and 30-60 degrees (C2 and E2). The results suggest that if the aim is to increase HA activity despite the low percentage of muscle activation, squats should be performed with 30 degrees of external rotation and at least 90 degrees of knee flexion.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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OBJETIVO: Comparar a atividade muscular antes e após o contato com o solo entre as aterrissagens unilateral (AU) e bilateral (AB) em atletas do sexo masculino. PARTICIPANTES: Quinze atletas masculinos de voleibol sem sinais e sintomas de lesões nas extremidades inferiores (13 ± 1 ano, 1,70 ± 0,12m, 60 ± 12kg). MENSURAÇÕES:Os participantes realizaram dois saltos verticais, aterrissando unilateralmente e bilateralmente. A atividade mioelétrica do reto femoral (RF), bíceps femoral (BF), adutores de quadril (AQ) e a relação BF/RF foram comparados entre as duas aterrissagens e entre as fases caracterizadas por 100ms antes (PRE) e 100ms após (POS) o contato com o solo. RESULTADOS: Em ambas as aterrissagens, a ativação do RF foi maior na fase POS em relação à PRE. Na comparação entre as aterrissagens dentro da mesma fase não encontramos diferenças estatísticas. Apesar de o BF não ter apresentado diferenças entre as fases PRE e POS em cada aterrissagem, sua ativação foi maior na AU. Os AQ apresentaram maior ativação na fase POS durante a AU, no entanto não houve diferenças quando comparadas as duas aterrissagens. A relação BF/RF apresentou valores maiores em ambas as aterrissagens na fase PRE. No entanto, não encontramos diferenças entre as aterrissagens. CONCLUSÃO: Os resultados sugerem que cada músculo apresenta um papel diferente durante a fase de aterrissagem em homens. Enquanto que o RF possui como principal função a frenagem da articulação do joelho e do movimento descendente, caracterizada pelo aumento da ativação na fase pós-contato, o BF parece atenuar a tensão articular do joelho em atividades de maior impacto, mantendo-se mais ativo durante todo o ciclo da AU. Já a maior ativação dos AQ após o contato com solo na AU evidencia a importância da região lombo-pélvica na estabilização pélvica em situações de grande instabilidade. Estudos futuros são necessários para determinar os efeitos da ativação muscular apresentada na imposição de cargas mecânicas potencialmente lesivas no joelho em atletas do sexo masculino.

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Queiroz BC, Cagliari MF, Amorim CF, Sacco IC. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil 2010;91: 86-92.Objective: To compare the activity of stabilizing trunk and hip muscles in 4 variations of Pilates stabilizing exercises in the quadruped position.Design: Repeated-measures descriptive study.Setting: A biomechanics laboratory at a university school of medicine.Participants: Healthy subjects (N=19; mean age +/- SD, 31 +/- 5y; mean weight +/- SD, 60 +/- 11 kg; mean height +/- SD, 166 +/- 9cm) experienced in Pilates routines.Interventions: Surface electromyographic signals of iliocostalis, multifidus, gluteus maximus, rectus abdominis, and external and internal oblique muscles were recorded in 4 knee stretch exercises: retroverted pelvis with flexed trunk; anteverted pelvis with extended trunk; neutral pelvis with inclined trunk; and neutral pelvis with trunk parallel to the ground.Main Outcome Measures: Root mean square values of each muscle and exercise in both phases of hip extension and flexion, normalized by the maximal voluntary isometric contraction.Results: The retroverted pelvis with flexed trunk position led to significantly increased external oblique and gluteus maximus muscle activation. The anteverted pelvis with trunk extension significantly increased multifidus muscle activity. The neutral pelvis position led to significantly lower activity of all muscles. Rectus abdominis muscle activation to maintain body posture was similar in all exercises and was not influenced by position of the pelvis and trunk.Conclusions: Variations in the pelvic and trunk positions in the knee stretch exercises change the activation pattern of the multifidus, gluteus maximus, rectus abdominis, and oblique muscles. The lower level of activation of the rectus abdominis muscle suggests that pelvic stability is maintained in the 4 exercise positions.

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The rectus femoris was analysed in 10 volunteers during knee flexion and extension with the feet in normal, plantar flexion and dorsal flexion positions. Hewlett-Packard surface electrodes, an electromyographic signal amplifier, a computer equipped with an A/D conversion plaque (Model CAD 10/26), software specially designed to record and analyse the signals, Horizontal Leg Press, and electrogoniometers were used. The rectus femoris muscle showed strong potentials at the beginning of knee extension. In the simultaneous bendings of the knee and hip the activity was strong toward the end of the movement. The rectus femoris showed a similar activity both in the upper and lower platforms. As for foot positions, the rectus femoris showed the smallest potentials with the foot in plantar flexion and the largest ones with the foot in dorsal flexion.

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The double pulley equipment was tested on ten male volunteers during contraction of the semitendinosus and biceps femoris (caput longum) muscles in the following movements of the lower limbs: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. The myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. The semitendinosus and biceps femoris muscles presented the highest potentials in movements 1; 2; 7, 8 and 9, whereas the potentials in the remaining movements were negligible. The pattern of activity of the semitendinosus and the biceps femoris was similar in exercises 1, 2, 3, 4 and 8. The potentials of the semitendinosus prevailed in movements 5, 6 and 7, and the strongest potentials observed in movement 9 were those of the biceps femoris.

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This study investigated the oblique ligament mechanical contribution to the medial collateral ligament of the canine elbow joint. Fifteen dogs were used for the study of the failure load, displacement, and energy absorption of the medial collateral and oblique ligaments of the canine elbow joint, associate and separately in the joint. Medial collateral ligament failure load and energy absorption were significantly higher in relation to the isolated oblique ligament. When the ligaments were associated in the joint, they presented an increment in failure load, displacement and energy absorption in relation to the ligaments analyzed separately. It was concluded, therefore, that the oblique ligament could have an important paper in the stability of the canine elbow joint, as it favors the medial collateral ligament resistance to the tensile load, one of the main stabilizer of the elbow joint.

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Ultrastructural evaluation of the collagen of the mongrel dog medial collateral ligament associated to the oblique ligament after strain. The present work aimed to observe the disposition of the collagen fibres of the medial collateral ligament of the elbow joint of the dog, when associated to the oblique ligament. Thus, 18 articulations were used, divided in three groups. A group had the medial collateral ligament collected and not stretched, other group had the collateral medial ligament stretched separately and the other group had both ligaments (medial collateral and oblique) stretched associately. The medial collateral ligament examined by scanning electron microscopy presented a wavy and reticular pattern of the collagen fibres when not submitted to strain, which was not totally destroyed when it was associated to the oblique ligament. When stretched separately, the medial collateral ligament after strain totally loses the reticular pattern, demonstrating the waste of the fibres to resist to the tension.

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It was evaluated movements of lower limb in the double pulley system equipment on ten male volunteers during contraction of gastrocnemius (caput laterale ) and gluteus maximus muscles in the following movements: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. Myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. We observed weak gastrocnemius muscle activity for all movements studied. In the case of gluteus maximus, the most important potentials were observed for movement 2, while for the remaining movements the actions were of reasonable intensity. Compared to gluteus, gastrocnemius was less required for all movements.

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Lesion of the anterior cruciate ligament (ACL) in the knee is a problem that affects animals as well as humans and may evolve with joint instability that is often symptomatic and incapacitating. The main option for ligament substitution is the autologous tendon graft. The graft undergoes tensioning during ACL reconstructive surgery to reestablish the normal laxity of the ACL- deficient knee. Although graft tensioning plays a fundamental role in postoperative clinical evolution, ideal tensioning levels have not been established in the literature. Therefore, graft elongation that may occur over time is still one of the main reasons for ligament reconstruction failure. In this study, ten bovine calcaneus tendons underwent two successive assays of physiological tensioning for a maximum deformation of 2.5% of the initial tendon length, maintained for 600s with force (N) values recorded at zero time (initial), 300s and 600s. At the end of the first assay, the tendon returned to its initial length and was maintained at rest for 300s and then the next tensioning assay was initiated, repeating the previous procedure. Statistical analysis revealed that tendon elongation is more pronounced during the initial 300s, reflecting a more accentuated decline in the tension values of the graft. Therefore, 300s after tensioning and fixing the graft, the surgeon can assess with more precision if the tensioning level was adequate.

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The purpose of this study was to investigate if chronic eccentric strength training (ST) affects heart rate (HR) and heart rate variability (HRV) during sub-maximal isometric voluntary contractions (SIVC). The training group (TG) (9 men, 62 ± 2) was submitted to ST (12 weeks, 2 days/week, 2 - 4 sets of 8-12 repetitions at 75-80% peak torque (PT). The control group (CG) (8 men, 64 ± 4) did not perform ST. The HR and the HRV (RMSSD index) were evaluated during SIVC of the knee extension (15, 30 and 40% of PT). ST increased the eccentric torque only in TG, but did not change the isometric PT and the duration of SIVC. During SIVC, the HR response pattern and the RMSSD index were similar for both groups in pre- and post-training evaluations. Although ST increased the eccentric torque in the TG, it did not generate changes in HR or HRV. © Springer-Verlag 2008.