Achilles Tendon Doppler Flow May be Associated with Mechanical Loading among Active Athletes

2008 ◽  
Vol 36 (11) ◽  
pp. 2210-2215 ◽  
Author(s):  
Peter Malliaras ◽  
Paula J. Richards ◽  
Giorgio Garau ◽  
Nicola Maffulli
Keyword(s):  
Achilles Tendon ◽  
Mechanical Load ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Cross Sectional Study ◽  
Activity Level ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Doppler Flow ◽  
Tendon Adaptation

Background Tendon Doppler flow may be associated with tendon pain in symptomatic patients, but the relationship between Doppler flow and pain among athletes who are still competing is unclear. Hypothesis Among active athletes, Doppler flow may partly reflect tendon adaptation to increased mechanical load and/or asymptomatic tendinopathy. Study Design Cross-sectional study; Level of evidence, 3. Methods The Achilles tendons of 61 badminton players (24 elite, 37 recreational) were examined with gray-scale and color Doppler ultrasound. Achilles tendon pain and activity level (badminton training, badminton playing, badminton years) were measured. Results Doppler flow was not associated with current Achilles tendon pain but was associated with an increased anteroposterior tendon diameter (an indicator of tendinopathy) ( P = .02). Athletes who had been playing badminton for longer were more likely to have Doppler flow ( P< .01), and there was a trend toward an association between a greater number of badminton playing hours per week and Doppler flow ( P = .07). Conclusion Achilles tendon Doppler flow appears to be a sign of asymptomatic tendinopathy rather than pain among active athletes. The association between weekly badminton hours and badminton years and Doppler flow suggests that Doppler flow may be a response to mechanical load in this cohort.

scholarly journals CAROTID ARTERY STENOSIS

2017 ◽  
Vol 24 (08) ◽  
pp. 1126-1131
Author(s):  
Muhammad Ishaq Khattak ◽  
Faramoz Khan ◽  
Zahid Fida ◽  
Adnan Zar
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Doppler Ultrasound ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Cross Sectional Study ◽  
Vascular Events ◽  
Cross Sectional ◽  
Carotid Artery Atherosclerosis

Objectives: The objective of this study is to determine the frequency of carotidartery atherosclerosis using color Doppler ultrasound in ischemic stroke patients. StudyDesign: Cross-sectional study. Period: July 2015 to June 2016. Setting: Khyber TeachingHospital, Peshawar. Method: Doppler ultrasonography was done to assess carotid artery statusin patients diagnosed with cerebral infarction. Results: Data comprised of 174 ischemic strokepatients between ages 37-95 years. 111 were males whereas 63 were males. Mean age wasfound to be 64.03±11.71 years. Doppler ultrasound revealed carotid artery atherosclerosis in52.3% (n=91) patients with 57% males and 34% females. Right carotid artery involvement wasfound in 28 patients and left carotid artery involvment in 38 patients. Both carotid arteries wereinvolved in 25 patients. Conclusion: We have concluded that carotid artery atherosclerosis is anindependent predictor for future vascular events. Our study reports carotif artery atherosclerosisin 52.3% patients with ischemic stroke.

Prevalence of Asymptomatic Achilles Tendinosis

2018 ◽  
Vol 39 (10) ◽  
pp. 1205-1209 ◽  
Author(s):  
Peter C. Noback ◽  
Christina E. Freibott ◽  
Direk Tantigate ◽  
Eugene Jang ◽  
Justin K. Greisberg ◽  
...  
Keyword(s):  
At Risk ◽  
Achilles Tendon ◽  
Clinical Symptoms ◽  
Significant Risk ◽  
Achilles Tendinopathy ◽  
Activity Level ◽  
Low Grade ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Asymptomatic Patients

Background: Most patients who sustain Achilles tendon ruptures (ATRs) have no clinical symptoms prior to ATR. The objective of this study was to define the prevalence of ultrasound-detectable Achilles tendinopathy in asymptomatic patients in an at-risk group. Methods: This was a cross-sectional study that collected data from a group of volunteers. All participants were given IPAQ questionnaires to gauge daily activity level, in addition to a demographic form. Participants underwent a physical examination, Silfverskiold test, and an ultrasonographic examination to evaluate for presence of Achilles tendinopathy. Fifty-one volunteers (30 female, 21 male) and 102 Achilles tendons were assessed in this study. The mean age was 27.4±6.3, with an average BMI of 23.5±3.9. Ninety-two percent of participants were categorized as having moderate or high activity levels per the iPAQ questionnaire. Results: Sixteen tendons had at least 1 abnormality: 10 (9.8%) had hypoechoic foci, 9 (8.8%) had calcifications, 1 (0.9%) had increased vascularity, and 1 (0.9%) had a low-grade interstitial tear. Approximately 40% of patients were noted to have a gastroc equinus contracture on Silfverskiold testing. In addition, 14.7% of patients with a gastroc equinus had a hypoechoic focus compared to 8.6% of patients without gastroc equinus ( P = .5003). Logistic regression analysis demonstrated that an increased BMI was a significant risk factor for having an Achilles tendon abnormality on ultrasonography ( P < .01, odds ratio = 1.41). Conclusion: In this study, 16% of the Achilles tendons were abnormal and had at least 1 abnormality on ultrasonography. This group of patients was generally young, healthy, and active, thus a group at risk for ATRs. Only 40% of patients had gastrocnemius equinus, although a slightly higher non-significant percentage of those with hypoechoic foci had gastrocnemius equinus. It may be advantageous to prophylactically treat these patients with rehabilitation exercises to minimize the risk of ATR. Level of Evidence: Level II, comparative prognostic study.

scholarly journals Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls

2016 ◽  
Vol 9 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Robert H. Brophy ◽  
Carolyn M. Hettrich ◽  
Shannon Ortiz ◽  
Brian R. Wolf ◽  
Keith M. Baumgarten ◽  
...  
Keyword(s):  
Risk Factor ◽  
Shoulder Instability ◽  
Cross Sectional Study ◽  
Activity Level ◽  
Healthy Population ◽  
Healthy Controls ◽  
Shoulder Stabilization ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Activity Scale

Background: Shoulder activity level may be a risk factor for shoulder instability, an indication for surgical intervention, and a risk factor for failure of operative stabilization. Hypothesis: Patients undergoing shoulder stabilization surgery have a higher activity level compared with sex- and age-matched healthy controls. Study Design: Cross-sectional study. Level of Evidence: Level 2. Methods: Patients undergoing shoulder stabilization surgery aged 18 to 50 years were prospectively enrolled. As part of data collection, patients completed a previously validated shoulder activity scale, which generates a score reporting frequency of activity ranging from 0 (least active) to 20 (most active). The activity level of these patients was compared with sex- and age-matched norms for a healthy population with no history of shoulder disorders. Results: A total of 409 subjects (343 male, 66 female) undergoing shoulder instability surgery completed the activity scale. Seventy-seven percent of patients had higher shoulder activity level than sex- and age-matched controls. Seventy-nine percent aged 18 to 30 years had a higher shoulder activity level than controls, with an identical distribution for men (79%) and women (79%). Among patients aged 31 to 50 years, 70% had higher activity than controls. However, men were more likely to have a higher activity level than controls (72%) versus women (59%). In patients aged 18 to 30 years, median activity level for instability patients was 14 in men compared with 10 in controls, and 13 in women compared with 8 in controls. In patients aged 31 to 50 years, median activity level was 13 in men compared with 10 in controls and 10 in women compared with 8 in controls. Conclusion: Patients undergoing shoulder stabilization surgery have a higher activity level than sex- and age-matched healthy controls. Clinical Relevance: Shoulder activity is especially elevated in younger, male instability patients.

scholarly journals Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097789
Author(s):  
Rodolfo Morales-Avalos ◽  
Adriana Tapia-Náñez ◽  
Mario Simental-Mendía ◽  
Guillermo Elizondo-Riojas ◽  
Michelle Morcos-Sandino ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Alpha Angle ◽  
Cross Sectional Study ◽  
Level Of Evidence ◽  
Crossover Sign ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Morphological Variations ◽  
Pelvic Radiographs ◽  
Center Edge

Background: Radiographic findings related to the cam and pincer variants of femoroacetabular impingement (FAI) include measurements of the alpha angle and lateral center-edge angle (LCEA). The function of these radiographic findings has been put into question because of high heterogeneity in reported studies. Purpose: The aim of this study was 3-fold: (1) to determine the prevalence of cam and pincer variants according to sex and age on anteroposterior (AP) pelvic radiographs from an asymptomatic nonathletic population, (2) to identify the most common radiographic signs of cam- and pincer-type variants, and (3) to determine if there are variations in the prevalence of these radiographic signs according to sex and age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: There were 3 independent observers who retrospectively analyzed the 939 AP pelvic radiographs (1878 hips) of patients aged 18 to 50 years who did not have hip symptoms and who were not professional athletes. The prevalence of the cam and pincer variants according to the alpha angle and LCEA, respectively, and the presence of other radiographic signs commonly associated with these variables were determined in the overall population and by subgroup according to sex and age group (18-30, 31-40, and 41-50 years). Descriptive and inferential statistics were used to analyze the study sample. Results: The mean age of the included population was 31.0 ± 9.2 years, and 68.2% were male. The prevalence of the cam-type variant was 29.7% (558/1878), and that of the pincer-type variant was 24.3% (456/1878). The radiographic signs that were most associated with the cam and pincer variants were a pistol-grip deformity and the crossover sign, respectively. Significant differences ( P < .001) in the prevalence of these variants were identified between men and women in both variants. No differences were observed in the alpha angle or LCEA according to sex or age. Conclusion: Radiographic findings suggestive of FAI had significant variations with respect to sex and age in this study sample. This study provides information to determine the prevalence of these anatomic variants in the general population.

Head Impact Biomechanics in Youth Flag Football: A Prospective Cohort Study

2021 ◽  
pp. 036354652110266
Author(s):  
Landon B. Lempke ◽  
Rachel S. Johnson ◽  
Rachel K. Le ◽  
Melissa N. Anderson ◽  
Julianne D. Schmidt ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Acceleration ◽  
Cross Sectional Study ◽  
Head Impact ◽  
Rotational Acceleration ◽  
Event Type ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Head Impact Biomechanics ◽  
Impact Biomechanics

Background: Youth flag football participation has rapidly grown and is a potentially safer alternative to tackle football. However, limited research has quantitatively assessed youth flag football head impact biomechanics. Purpose: To describe head impact biomechanics outcomes in youth flag football and explore factors associated with head impact magnitudes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We monitored 52 player-seasons among 48 male flag football players (mean ± SD; age, 9.4 ± 1.1 years; height, 138.6 ± 9.5 cm; mass, 34.7 ± 9.2 kg) across 3 seasons using head impact sensors during practices and games. Sensors recorded head impact frequencies, peak linear ( g) and rotational (rad/s2) acceleration, and estimated impact location. Impact rates (IRs) were calculated as 1 impact per 10 player-exposures; IR ratios (IRRs) were used to compare season, event type, and age group IRs; and 95% CIs were calculated for IRs and IRRs. Weekly and seasonal cumulative head impact frequencies and magnitudes were calculated. Mixed-model regression models examined the association between player characteristics, event type, and seasons and peak linear and rotational accelerations. Results: A total of 429 head impacts from 604 exposures occurred across the study period (IR, 7.10; 95% CI, 4.81-10.50). Weekly and seasonal cumulative median head impact frequencies were 1.00 (range, 0-2.63) and 7.50 (range, 0-21.00), respectively. The most frequent estimated head impact locations were the skull base (n = 96; 22.4%), top of the head (n = 74; 17.2%), and back of the head (n = 66; 15.4%). The combined event type IRs differed among the 3 seasons (IRR range, 1.45-2.68). Games produced greater IRs (IRR, 1.24; 95% CI, 1.01-1.53) and peak linear acceleration (mean difference, 5.69 g; P = .008) than did practices. Older players demonstrated greater combined event–type IRs (IRR, 1.46; 95% CI, 1.12-1.90) and increased head impact magnitudes than did younger players, with every 1-year age increase associated with a 3.78 g and 602.81-rad/s2 increase in peak linear and rotational acceleration magnitude, respectively ( P≤ .005). Conclusion: Head IRs and magnitudes varied across seasons, thus highlighting multiple season and cohort data are valuable when providing estimates. Head IRs were relatively low across seasons, while linear and rotational acceleration magnitudes were relatively high.

scholarly journals Effect of the COVID-19 pandemic on the ability of level 1 trauma centers to meet American College of Surgeons research requirements

2021 ◽  
Vol 6 (1) ◽  
pp. e000692
Author(s):  
Robert M Madayag ◽  
Erica Sercy ◽  
Gina M Berg ◽  
Kaysie L Banton ◽  
Matthew Carrick ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Trauma Centers ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
American College Of Surgeons ◽  
The Usa ◽  
Virus Exposure ◽  
Level 1 ◽  
Verification Process ◽  
Question Survey

IntroductionThe COVID-19 pandemic has had major effects on hospitals’ ability to perform scientific research while providing patient care and minimizing virus exposure and spread. Many non-COVID-19 research has been halted, and funding has been diverted to COVID-19 research and away from other areas.MethodsA 28-question survey was administered to all level 1 trauma centers in the USA that included questions about how the pandemic affected the trauma centers’ ability to fulfill the volume and research requirements of level 1 verification by the American College of Surgeons (ACS).ResultsThe survey had a 29% response rate (40/137 successful invitations). Over half of respondents (52%) reported reduced trauma admissions during the pandemic, and 7% reported that their admissions dropped below the volume required for level 1 verification. Many centers diverted resources from research during the pandemic (44%), halted ongoing consenting studies (33%), and had difficulty fulfilling research requirements because of competing clinical priorities (40%).DiscussionResults of this study show a need for flexibility in the ACS verification process during the COVID-19 pandemic, potentially including reduction of the required admissions and/or research publication volumes.Level of evidenceLevel IV, cross-sectional study.

scholarly journals Factors Associated With Knee Pain and Heel Pain in Youth Soccer Players Aged 8 to 12 Years

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988337 ◽  
Author(s):  
Toshiyuki Iwame ◽  
Tetsuya Matsuura ◽  
Naoto Suzue ◽  
Joji Iwase ◽  
Hirokazu Uemura ◽  
...  
Keyword(s):  
Knee Pain ◽  
Cross Sectional Study ◽  
Heel Pain ◽  
Older Age ◽  
Soccer Players ◽  
Clinical Factors ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Youth Soccer ◽  
Study Participants

Background: Soccer is played by many children younger than 12 years. Despite its health benefits, soccer has also been linked to a high number of sport-related injuries. Purpose: To investigate the relationship between clinical factors and knee or heel pain in youth soccer players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants included 602 soccer players aged 8 to 12 years who were asked whether they had experienced episodes of knee or heel pain. Data were collected on age, body mass index, years of playing soccer, playing position, and training hours per week. Associations of clinical factors with the prevalence of knee or heel pain were examined by univariate and multivariate logistic regression analyses. Results: Episodes of knee and heel pain were reported by 29.4% and 31.1% of players, respectively. Multivariate analyses revealed that older age and more years of playing soccer were significantly and positively associated with the prevalence of knee pain ( P = .037 and P = .015 for trend, respectively) but did not identify any significant associations for heel pain. Conclusion: In this study of youth soccer players, knee pain was associated with older age and more years of play, but heel pain was not significantly associated with any factor.

Acetabular Chondral Lesions in Hip Arthroscopy: Relationships Between Grade, Topography, and Demographics

2017 ◽  
Vol 45 (11) ◽  
pp. 2501-2506 ◽  
Author(s):  
Carlos Suarez-Ahedo ◽  
Chengcheng Gui ◽  
Stephanie M. Rabe ◽  
Sivashankar Chandrasekaran ◽  
Parth Lodhia ◽  
...  
Keyword(s):  
Traumatic Injury ◽  
Demographic Factors ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Chondral Lesion ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Chondral Lesions ◽  
Chondral Damage ◽  
Male Sex

Background: Hip pain remains a challenge given the multiple factors that can cause damage to the articular cartilage, such as traumatic injury, metabolic damage, and morphologic variations such as femoroacetabular impingement (FAI) and that can contribute to progression of osteoarthritis. However, a direct relationship between patient characteristics, the extent of acetabular chondral damage, and topologic characteristics of chondral lesions has not been established. Purpose: To compare the grade of acetabular chondral damage, measured in terms of acetabular labrum articular disruption (ALAD) classification, to the size and position of the chondral lesions, matching patients’ demographic factors such as age and body mass index (BMI). Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study included all hip arthroscopies performed by the corresponding author from August 7, 2008, to November 19, 2014, in which acetabular chondral lesions were intraoperatively identified and measured in terms of ALAD grade, clockface location, and size. Bivariate analyses and multiple logistic regression were used to identify the demographic factors, characteristics of the acetabular chondral lesion, and other anatomic characteristics that were related to the ALAD grade of the acetabular chondral lesion. Results: Acetabular chondral lesions were measured in 1502 patients during the study period. Multivariate analysis showed that higher ALAD grade of acetabular chondral damage was significantly related to male sex, more advanced age, the area of the acetabular chondral lesion, anterior extension of the acetabular chondral lesion within the anterosuperior quadrant, labral detachment from the acetabular cartilage, and posterior extension of the labral tear. Conclusion: Higher grades of acetabular chondral damage were related to male sex, increased age, height, weight, BMI, and the size of the lesion. Chondral lesions were generally found in the anterosuperior region of the acetabulum, consistent with labral lesions and the weightbearing area of the acetabulum.

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