ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo compare different types of rehabilitation for anterior knee pain.DesignProspective, randomized, blinded, and controlled study of 64 participants with anterior knee pain.SettingOutpatient rehabilitation clinic and testing laboratory.ParticipantsParticipants were assigned in randomized fashion to three rehabilitation groups: traditional home rehabilitation (n = 20); physical therapy (n = 21); and home rehabilitation with a modified vastus medialis obliquis (VMO) specific straight leg raise (Muncie method; n = 23).Interventions and Main Outcome MeasuresClinical data was obtained at 0, 2, 6, and 12 weeks. Cybex testing was performed at 0, 6, and 12 weeks.ResultsClinical outcome for the Muncie method indicated a statistically significant improvement in subjective pain and functional impairment ratings. Cybex testing in patients using the Muncie method demonstrated a statistically significant improvement in pain-free isometric contractions and maximum voluntary contraction. There were no significant differences between traditional home therapy and physical therapy.ConclusionFindings suggest that the Muncie method results in improved clinical outcome at a lower cost than traditional home and physical therapy and possibly improved VMO/quadriceps muscle balance. Patients with anterior knee pain may benefit from applying the Muncie method in a home therapy program.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo study the incidence and types of injuries sustained by professional roller hockey players in practices and games, and to compare these statistics with those from ice hockey.DesignThis injury survey used a strict definition of injury, standardized reporting strategies, and diagnosis by a team physician as standards by which to analyze the characteristics of roller hockey injuries.SettingThe injuries were recorded after the players had been examined by a team physician at the game or practice site or in the physician's office.ParticipantsDuring three seasons for one roller hockey team and one season for another team, an average of 22 players per team participated in the study. Due to personnel changes, the team rosters were modified between seasons. Each player injury was included in the study. An injury was defined as any physical impairment caused during a practice or game that eliminated the player from that practice or game or the next day's practice session or contest, or any physical ailment that necessitated a physical examination by the team physicians.Main Outcome MeasureInjury data were categorized and injury rates were calculated.Results122 injuries were recorded during four professional roller hockey seasons, resulting in an overall participation injury rate of 14.4 per 1,000 player hours. The game injury rate was 304.9 per 1,000 player hours. The players were 105.1 times more likely to be injured during a game than during practice. Preseason practices produced 4.5 times more injuries than regular season practices. In comparison, sample data from the only other published study of roller hockey injuries and from several studies of ice hockey have indicated game injury rates of 139.0 (roller hockey), 119.0, 96.1, 78.4, 78.8, and 66.0 per 1,000 player hours, respectively.ConclusionResults of this study demonstrate that roller hockey produces a higher rate of both contact and noncontact injuries than ice hockey; this contradicts the findings of the only other published research study on injuries in roller versus ice hockey. This increased incidence of injury may be due in part to the differences in surfaces, and can prove hazardous to even the recreational roller hockey player or in-line skater.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo evaluate the clinical efficacy of magnetic resonance imaging (MRI) of the knee in acute injuries with indeterminate clinical findings, using arthroscopy as a gold standard.DesignA prospective double-blind study was performed. All patients underwent MRI on a 1.5 T magnet using dual spin echo pulse sequences. This was followed by arthroscopy.SettingTertiary care referral center.PatientsTwenty-three patients with an average age of 26 years satisfied the study criteria. Patients had to have been seen by one of two orthopaedic surgeons within 6 weeks of sudden trauma to the knee complicated by a hemarthrosis, clinical assessment of which was equivocal.ResultsThe respective sensitivity and specificity for MRI of the knee were 90% (18/20) and 67% (2/3) for detecting any anterior cruciate ligament injury, 50% (1/2) and 86% (18/21) for detecting medial meniscal tears, and 88% (7/8) and 73% (11/15) for detecting lateral meniscal tears. MRI also identified injuries that could not be assessed on arthroscopy, including 14 bone bruises, five posterior cruciate ligament tears, nine medial collateral ligament tears, and one lateral collateral ligament tear. The detection of composite injury requiring surgical intervention yielded a sensitivity of 100% (16/16) and a specificity of 71% (5/7). Prospective use of MRI evaluation of the knee could have prevented 22% (5/23) of diagnostic arthroscopic procedures.ConclusionEquivocal clinical findings in patients with acute knee injury should lead to use of MRI in an appropriate clinical setting. To our knowledge a prospective study of the efficacy of MRI of the knee in this patient population has not been reported. In the presence of such inclusion criteria, the results of our study support the use of early MRI to guide further surgical management.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveRegular physical activity can reduce the incidence and prevalence of many chronic diseases. A vast majority of Americans cite their physician as their primary source of information regarding healthy lifestyle decisions. This study was designed to obtain information about the personal exercise behavior and counseling practices of primary care physicians, to evaluate the relationship between their personal and professional exercise practices, and to determine whether physician specialty is associated with these practices.DesignA cross-sectional survey was mailed to a randomly selected sample of primary care physicians in the United States. A questionnaire was used to obtain detailed information on the personal exercise habits, counseling practices, and barriers to counseling of these physicians, regarding both aerobic exercise and strength training.Participants298 primary care physicians, comprising 84 family practitioners, 79 pediatricians, 58 geriatricians, and 77 internists.Main Outcome MeasuresFrequency of physician exercise, exercise counseling, and relationship between these practices.ResultsPhysicians who perform aerobic exercise regularly are more likely to counsel their patients on the benefits of these exercises, as are physicians who perform strength training. Pediatricians and geriatricians counsel fewer patients about aerobic exercise than family practitioners and internists. Counseling regarding strength training is less common in all physician groups surveyed, and lowest among pediatricians, of whom 50% did not advise these exercises for any of their patients. Inadequate time was noted by 61% and inadequate knowledge and/or experience by 16% of respondents as the major barriers to counseling regarding aerobic exercise.ConclusionPhysicians who exercise are more likely to counsel their patients to exercise. Inadequate time and knowledge/experience regarding exercise are the most common barriers to counseling identified. These findings suggest strategies that might increase physician exercise counseling behavior.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo document use of diagnostic imaging during a multi-sport games to assist in planning for future such competitions.MethodsMedical records from the 1997 Canada Summer Games and from the Brandon General Hospital were reviewed. All uses of diagnostic imaging were compiled as were results of the imaging examinations. These data were correlated with demographic information.ResultsA total of 80 imaging examinations were performed during the 1997 Canada Summer Games. These were mainly plain radiographs (n = 77), with two nuclear medicine examinations and one computed tomography (CT) scan. Ultrasound and magnetic resonance imaging (MRI) were available but not used. Use of imaging examinations correlated well with the risk category of the sports, and was almost identical between female and male athletes; women accounted for 42.5% of the imaging examinations and 42.7% of the participants.ConclusionThese data may be helpful in planning for other multi-sport competitions. The mix of sports is of greater predictive value than the ratio of female to male athletes when predicting the demand for diagnostic imaging services.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo evaluate a method of medical care at an ultradistance triathlon, with the aim of reducing the incidence of hyponatremia.DesignDescriptive research.SettingNew Zealand Ironman triathlon (3.8 km swim, 180 km cycle, 42.2 km run).Participants117 of 134 athletes seeking medical care after the triathlon (involving 650 race starters).InterventionsA prerace education program on appropriate fluid intake was undertaken. The number of support stations was decreased to reduce the availability of fluid. A body weight measurement before the race was introduced as a compulsory requirement, so that weight change during the race could be included in the triage assessment. An on-site laboratory was established within the race medical tent.Main Outcome MeasuresNumbers of athletes and diagnoses, including the incidence of symptomatic hyponatremia (defined as symptoms of hyponatremia in association with a pretreatment plasma sodium concentration [Na] < 135 mmol/L); weight changes; and changes in [Na].ResultsThe common diagnoses in the 117 athletes receiving attention were exercise-associated collapse (27%), musculoskeletal complaints (26%), and dehydration (12%). There was a significant reduction in the number of athletes receiving medical care for hyponatremia, from 25 of the 114 athletes who received care in 1997 (3.8% of race starters) to 4 of the 117 athletes who received care in 1998 (0.6% of race starters). Mean weight change among athletes in the 1998 race was −3.1 kg, compared with −2.6 kg in 1997.ConclusionA preventive strategy to decrease the incidence of hyponatremia, including education on fluid intake and appropriate placement of support stations, was associated with a decrease in the incidence of symptomatic hyponatremia.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveBlood volume (BV) and hemoglobin concentration ([Hb]) play important roles in oxygen transport. Manipulation of both BV and [Hb] can markedly affect systemic oxygen transport and maximal aerobic capacity (&OV0312;O2max). However, the role of BV in oxygen transport and aerobic performance is not well understood. It has recently been postulated that an acute expansion of BV using plasma volume (PV), independent of changes in [Hb], may represent a potential ergogenic property. Therefore, the primary objective of this review was to determine the potential ergogenic properties of volume loading.Data SourcesAn extensive research of Medline and SportDiscus along with cross-referencing was conducted. Articles were included on the basis of their relevancy to the purpose of this review. Only articles published in English were included in the analysis.Study SelectionAll study designs using human participants were reviewed.Data ExtractionA systematic analysis of data regarding the effect of BV on the determination of oxygen transport, aerobic capacity, and endurance performance was conducted. Particular emphasis was given to articles that examined BV as the key independent variable. Articles relevant to the evaluation of the impact of BV on aerobic capacity and endurance performance were reviewed according to the strengths of the individual study designs.ResultsSeven investigations evaluated the impact of acute changes in BV, independent of changes in [Hb], on &OV0312;O2max. Of these investigations, three revealed that acute manipulations of BV result in no change or a slight reduction in &OV0312;O2max. Three investigations revealed a significant improvement in &OV0312;O2max after acute PV expansion. One investigation revealed a nonsignificant increase in &OV0312;O2max after acute PV expansion. Seven investigations evaluated the impact of acute changes in BV, independent of changes in [Hb], on endurance performance: two revealed a significant improvement in endurance performance after acute PV expansion, and five revealed an unchanged or reduced endurance performance after acute PV expansion. The majority of investigations showing an improvement in &OV0312;O2max and/or endurance performance after acute PV expansion were conducted using untrained individuals.ConclusionVolume loading does not result in an improvement in &OV0312;O2max and/or endurance performance in endurance athletes. Volume loading in untrained individuals may improve &OV0312;O2max, but does not bring these individuals to the aerobic capacity of endurance-trained athletes. Also, volume loading generally does not lead to improvement in endurance performance, irrespective of its effects on &OV0312;O2max.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID