821 resultados para knee arthroplasty


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This study aimed to compare the torque, torque ratio (Hamstrings:Quadriceps - H:Q), electromyographic (EMG) activity and EMG ratio (knee flexors:knee extensors EMG) in soccer players (SG, N=10) and active subjects (AG, N=10). Subjects performed three maximal voluntary isometric knee extensions and flexions at 45° and 90° to determine the peak torque and EMG activity. Torque and EMG activity of the knee flexor (biceps femoris [BF] and semitendinosus [ST]) were divided by the torque and EMG activity of the knee extensor (vastuls lateralis [VL] and rectus femoris [RF]) to calculate torque ratios (H:Q) and EMG ratios (BF:VL, BF:RF, ST:VL, ST:RF). The flexion torque was significantly higher for SG (p<0.05) in 45° and 90°. EMG activity for SG was significantly higher in agonist contractions for VL, RF and ST, and significantly lower in antagonist contractions for RF and ST when compared to AG Torque and EMG ratios were similar between groups and there were good correlations between torque ratio and BF:VL ratio (r=0.71, p=0.02) and BF:RF ratio (r=0.81, p=0.004) at 45. The EMG results could overestimate the joint balance calculated using torque ratios. Differences in recruitment pattern between soccer players and non-athletes can be related to the training routines and the EMG ratios presents applicable in trained populations.

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We report a case of a bather injured by a swordfish in shallow water off the coast of southern Brazil. The victim suffered multiple injuries from the fish's bill, including a puncture wound of his left knee and the tip of the bill remaining as a foreign body. The victim made a full recovery after field management and conservative care. The potential factors leading to this most unusual attack are discussed. © 2009 Wilderness Medical Society.

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Poplíteo lympho nodes in the dogs is placed, to the right and the left in popliteo an appointed space fossa, in distal part of the muscles femoral biceps, laterally and semi-tendinous, medially, projecting in the height of the face volume of the joint to femoro tibial e femoro patellar (joint of the knee). In this study twenty and five dogs, males and females adult, originating the Araçatuba municipal kennel had been used whose captures had been effected by the animal sanitary defense of this city. The arterial vessels destined to this structure always derive, of both the sides, the femoral artery distal volume and vary of 10 the 1, more frequently of 2 (7 times, 28%) to the right and of 6 the 2, equally more frequently of 2 (8 times, 32%). So soon as one has still to right 5 and 6 branches (3 times, 12%), 1, 7 and 10 (1 time, 4%). Relatively to the veins derived from this lympho nodes, always converges to the lateral safena vein, these vessels oscillates between 9 and 2, more frequently of 3 (6 times, 24%), to the right and of 12 the 2, more frequently of 3 (10 times, 40%) to the left. Thus, others deriving branches of popliteo lympho nodes right and that if they insert in the above-mentioned vein are in number of 2 and 5 (5 times, 20%), 4 and 6 (2 times, 8%) and 8 and 9 (1 time, 4%). In spite of, to the left side it is examined in number de 2 branches (6 times, 24%), 4 (4 times, 16%), 6 (3 times, 12%) and finishing 9 and 12 branches (1 time, 4%). The size of popliteo lympho node in seropositive dogs for Visceral Leishmaniasis can meets enters 7,8 × 3,8 × 6,1 a 50,0 × 20,7 × 28,5, in mm, being average 26,18 × 10,5 × 15,97 mm for right and 26,98 × 11,14 × 15,25 mm for left (concerning the measures dorsoventral, latero-lateral and cranial-caudal, respectively).

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Anterior cruciate ligament (ACL) injuries are common in sports. Studies investigating injury mechanisms have demonstrated that most injuries arise from landing tasks. Despite the demonstration of differences between male and female kinematics, there are no studies showing how males behave during different landing tasks. The objective of this study was to compare the angular and temporal kinematics of the lower limbs between two different landing tasks. Double leg and single leg landings were recorded in the frontal and sagittal plane in 15 male volleyball athletes by videogrammetry. Reduced hip and knee flexion and increased knee valgus were observed in the single leg landing task compared to the double leg landing task. No significant difference in landing time was observed between the two tasks. In conclusion, the results support the premise that lower limb kinematics change according to the task performed. Further studies are necessary to explore the impact of these kinematic differences on knee loading and to relate them to ACL injury mechanisms in men.

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Introduction: Data describing the relationships between postural alignment and stance stability are scarce and controversial. Objective: The aim of this study was to evaluate the effects of sensory disturbances on knee alignment in upright stance and the effects of knee hyperextension on stance stability. Method: Kinetic and kinematic data of 23 healthy adult women were collected while quietly standing in four sensory conditions. Kinematic data: knee angle (dependent variables) variations were analyzed across sensory conditions. Kinetic data: as subjects with hyperextended knees showed a clear tendency to flex their knees as balance challenge increased, center of pressure (COP) parameters (dependent variables) were analyzed in each sensory condition among trial sub-groups: Aligned-Trials (knee angle < 180°), Hyperextended-Trials (>180°) and Adjusted-Trials (>180° initially, turned <180° under challenging conditions). Results: Differences were found in mean velocity of COP in two conditions showing that knee alignment can affect stance stability. Conclusion: Knee hyperextension is a transient condition changing under postural challenges. Knee hyperextension affected postural control as mean velocity was the highest in the hyperextended group in natural standing sensory condition and lowest with sensory disturbance. © 2009 Elsevier Ltd.

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Feedback control systems have been used to move the muscles and joints of the limbs of paraplegic patients. The feedback signal, related to the knee joint angle, can be obtained by using an electrogoniometer. However, the use of accelerometers can help the measurements due the facility of adhering these devices to the skin. Accelerometers are also very suitable for these applications due their small dimensions and weight. In this paper a new method for designing a control system that can vary the knee joint angle using Functional Electrical Stimulation (FES) is presented, as well as a simulation with parameters values available in the literature. The nonlinear control system was represented by a Takagi-Sugeno fuzzy model and the feedback signals were obtained by using accelerometers. The design method considered all plant nonlinearities and was efficient and reliable to control the leg position of a paraplegic patient with the angle of the knee ranging from 0° to 30°, considering electric stimulation at the quadriceps muscle. The proposed method is viable and offers a new alternative for designing control systems of the knee joint angle using more comfortable sensors for the patients.

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Introduction: To analyze the contribution of knee range of motion in walking of hemiplegic and diplegic children, considering their asymmetries. Material and method: Twelve children, 6 hemiplegics and 6 diplegics, from 7 to 12 years of age (9.5 ± 1.93) participated. Spasticity was assessed with the Ashworth's Modified Scale and the passive knee range of motion using an electrogoniometer. The task was to walk on an 8 m long walkway, using their preferred speed. Six attempts were made, three of which were on the right and three on the left sagittal planes. Results: The Mann-Whitney's U test found differences in the type of cerebral palsy for knee extension/hyperextension, for the relative angle of the knee at the load acceptance phase and for the knee range of motion during stride. The Wilcoxon's test revealed differences in hemibody for hemiplegics in the relative angle of the knee in acceptance of the load. Conclusions: Children with spastic cerebral palsy use compensation strategies between the lower limbs during walking. These strategies differed according to the type of cerebral palsy. The knee joint has an important function in those strategies, especially in the load acceptance and propulsion phases. © 2010 Elsevier España, S.L. y SERMEF. Todos los derechos reservados.

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Purpose. Fatigue has been pointed as a fall risk in the elderly; however, the effects of prolonged gait on neuromuscular recruitment and on its pattern remain unknown. The aim of this study was to evaluate the effects of prolonged gait on neuromuscular recruitment levels and spatial-temporal gait variables. Methods. Eight healthy older women (age: 72.63 ± 6.55 years) walked at their preferred walking speed for twenty minutes on a treadmill. The Root Mean Square (RMS) from the vastus-lateralis, femoral biceps, tibialis anterior and lateral gastrocnemius muscles were determined at the first and last minute of the test during the moments of Heel Strike (HS), Terminal Stance and Terminal Swing (TS). In addition, coactivation in the knee and ankle as well as the stride cadence and length were measured in the test. The two RMS data (taken at the first and last minute) were compared by means of a Student's t-test. Results. Twenty minutes of walking induced fatigue in the subjects, as observed through an increase in RMS, notably during the HS and TS. Coactivation was also influenced by the prolonged gait test. The only gait phase where a risk of falling was enhanced was the HS. Nonetheless, subjects developed strategies to maintain a safe motor pattern, which was evidenced by an increase in stride length and a decrease in stride cadence. Conclusion. Tests lasting just twenty minutes on a treadmill were enough to induce fatigue in older adults. However, the level of fatigue was not enough to present a danger or fall risk to elderly individuals.

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Ankylosis of the temporomandibular joint in children is one the most difficult and complex conditions managed by oral and maxillofacial surgeons, and often leads to some facial deformity. Distraction osteogenesis of the mandible provides an excellent treatment for mandibular airway obstruction in children who do not respond to conservative measures, and allows for early removal of the tracheostomy. We report the case of a 1-year-old boy with severe micrognathia and temporomandibular ankylosis who was dependent on a tracheostomy; he was treated with piezosurgery and mandibular advancement by distraction osteogenesis. © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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Purpose. Isokinetic tests are often applied to assess muscular strength and EMG activity, however the specific ranges of motion used in testing (fully flexed or extended positions) might be constrictive and/or be painful for patients with injuries or under-going rehabilitation. The aim of this study was to examine the effects of different ranges of motion (RoM) when determining maximal EMG during isokinetic knee flexion and extension with different types of contractions and velocities. Methods. Eighteen males had EMG activity recorded on the vastus lateralis, vastus medialis, semitendinosus and biceps femoris muscles during five maximal isokinetic concentric and eccentric contractions for the knee flexors and extensors at 60° • s -1 and 180° • s -1. The root mean square of EMG was calculated at three different ranges of motion: (1) a full range of motion (90°-20° [0° = full knee extension]); (2) a range of motion of 20° (between 60°-80° and 40°-60° for knee extension and flexion, respectively) and (3) at a 10° interval around the angle where peak torque is produced. EMG measurements were statistically analyzed (ANOVA) to test for the range of motion, contraction velocity and contraction speed effects. Coefficients of variation and Pearson's correlation coefficients were also calculated among the ranges of motion. Results. Predominantly similar (p > 0.05) and well-correlated EMG results (r > 0.7, p ≤ 0.001) were found among the ranges of motion. However, a lower coefficient of variation was found for the full range of motion, while the 10° interval around peak torque at 180° • s -1 had the highest coefficient, regardless of the type of contraction. Conclusions. Shorter ranges of motion at around the peak torque angle provides a reliable indicator when recording EMG activity during maximal isokinetic parameters. It may provide a safer alternative when testing patients with injuries or undergoing rehabilitation.

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The patellofemoral pain syndrome (PFPS) is defined as a retropatellar or anterior knee pain, without another disease. It affects until 25% of the population, being more common in women and trained persons. As others pathologies, PFPS have been affected the training of elite and amateurs athletes. Thereby, the general purpose of this study was discuss the occurrence of PFPS as a sports injury, there prevention possibilities and the appropriate recovery training after injury. It had been developed a literature review addressing the specific characteristics of the syndrome, its diagnosis, its target population, its development, how it affects the training and which are their possibilities of prevention and treatment. © FTCD/FIP-MOC.

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Introduction. Physical activity can provide long-term benefits for systemic lupus erythematosus (SLE). Objective. This study sought to demonstrate the effects of progressive resistance training on the muscular strength, bone mineral density (BMD) and body composition of pre-menopausal women with SLE undergoing glucocorticoid (GC) treatment. Materials and Methods. This is the case report of a 43-year-old African-South American premenopausal woman with non-extensive SLE and low bone density. A six-month program with three bimonthly cycles of 70%, 80%, and 90% intensity according to the 10 maximum-repetition test was used. Dual-energy X-ray absorptiometry (DXA) was used to measure the BMD, T-scores and body composition, and indirect fluorescence was used to measure the levels of antinuclear antibodies. Student's t-test was used. Results. Statistical improvement was noted in all strength exercises, including the 45° leg press (Δ%=+50%, p<0.001) and knee extension (Δ%=+15%, p=0.003) to maintain the BMD of the L2-L4 lumbar (Δ%=+0.031%; p=0.46) as well as the trochanter (Δ%=+0.037%; p=0.31) and BMI (Δ%=-0.8, p=0.54). Conclusion. In this case study, the presented methodology had a positive effect on strength and contributed to the maintenance of BMD and body composition in a woman with SLE undergoing GC treatment. © 2012 Revista Andaluza de Medicina del Deporte.

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The aim of this study was to investigate the effect of fatigue induced by an exhaustive laboratory-based soccer-specific exercise on different hamstrings/quadriceps (H:Q) ratios of soccer players. Twenty-two male professional soccer players (23·1 ± 3·4 year) performed maximal eccentric (ecc) and concentric (con) contractions for knee extensors (KE) and flexors (KF) at 60° s-1 and 180° s-1 to assess conventional (Hcon:Qcon) and functional (Hecc:Qcon) ratios. Additionally, they performed maximal voluntary isometric contraction for KE and KF, from which the maximal muscle strength, rate of force development (RFD) and RFD H:Q strength ratio (RFDH:Q) were extracted. Thereafter, subjects were performed an exhaustive laboratory-based soccer-specific exercise and a posttest similar to the pretest. There was significant reduction in Hcon:Qcon (0·60 ± 0·06 versus 0·58 ± 0·06, P<0·05) and in Hecc:Qcon (1·29 ± 0·2 versus 1·16 ± 0·2, P<0·01) after the soccer-specific exercise. However, no significant difference between Pre and Post exercise conditions was found for RFDH:Q at 0-50 (0·53 ± 0·23 versus 0·57 ± 0·24, P>0·05) and 0-100 ms (0·53 ± 0·17 versus 0·55 ± 0·17, P>0·05). In conclusion, H:Q strength ratios based on peak force values are more affected by fatigue than RFDH:Q obtained during early contraction phase. Thus, fatigue induced by soccer-specific intermittent protocol seems not reduce the potential for knee joint stabilization during the initial phase of voluntary muscle contraction. copy; 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

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Objective: To examine the influence of a preventative training program (PTP) on sagittal plane kinematics during different landing tasks and vertical jump height (VJH) in males. Design: Six weeks prospective exercise intervention. Participants: Fifteen male volleyball athletes (13 ± 0.7 years, 1.70 ± 0.12 m, 60 ± 12 kg). Interventions: PTP consisting of plyometric, balance and core stability exercises three times per week for six weeks. Bilateral vertical jumps with double leg (DL) and single leg (SL) landings were performed to measure the effects of training. Main outcome measurements: Kinematics of the knee and hip before and after training and VJH attained during both tasks after training. The hypothesis was that the PTP would produce improvements in VJH, but would not generate great changes in biomechanical behavior. Results: The only change identified for the SL was the longest duration of landing, which represents the time spent from initial ground contact to maximum knee flexion, after training, while increased angular displacement of the knee was observed during DL. The training did not significantly alter the VJH in either the SL (difference: 2.7 cm) or the DL conditions (difference: 3.5 cm). Conclusions: Despite the PTP's effectiveness in inducing some changes in kinematics, the changes were specific for each task, which highlights the importance of the specificity and individuality in selecting prevention injury exercises. Despite the absence of significant increases in the VJH, the absolute differences after training showed increases corroborating with the findings of statistically powerful studies that compared the results with control groups. The results suggest that short-term PTPs in low risk young male volleyball athletes may enhance performance and induce changes in some kinematic parameters. © 2012 Elsevier Ltd.

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Objective: To determine the nervous activation, muscle strength, and biomechanical parameters that influence the cost of walking in older fallers and non-fallers. Methods: Maximal voluntary isokinetic torque was measured for the hip, knee and ankle of older women. Oxygen consumption was measured at rest and during 8 min of walking at self-selected speed. An additional minute of walking was performed to collect kinematic variables and the electromyographic signal of trunk, hip, knee, and ankle muscles, which was analyzed by the linear envelope. Cost of walking was calculated by subtracting resting body mass-normalized oxygen consumption from walking body mass-normalized oxygen consumption. Stride time and length, and ankle and hip range of motion were calculated from kinematic data. Findings: Older adult fallers had 28% lower knee extensor strength (p = 0.02), 47% lower internal oblique activation at heel contact (p = 0.03), and higher coactivation between tibialis anterior and gastrocnemius lateralis in each of the gait phases (p < 0.05). For fallers, a higher activation of gluteus maximus was associated with a higher cost of walking (r = 0.55, p < 0.05 and r = 0.71, p < 0.01, before and after heel contact, respectively). For non-fallers, an association between cost of walking and age (r = 0.60, p = 0.01) and cost of walking and thigh muscle coactivation (r = 0.53, p = 0.01) existed. Interpretation: This study demonstrated that there may be links between lower-extremity muscle weakness, muscle activation patterns, altered gait, and increased cost of walking in older fallers. © 2013 Elsevier Ltd. All rights reserved.