Post-operative bracing after ACL reconstruction has no effect on knee joint effusion. A prospective, randomized study.

PubMed

Lindström, Maria; Wredmark, Torsten; Wretling, Marie-Louise; Henriksson, Marketta; Felländer-Tsai, Li

2015-12-01

It is unclear what factors contribute to knee joint effusion after anterior cruciate ligament (ACL) injury and reconstruction. Knee homeostasis after injury and surgery is crucial for rehabilitation and knee well-being. We examined if effusion was affected by post-operative bracing, and if patients with effusion fit into a common profile. Patients were randomized to wearing or not wearing a post-operative brace for three weeks after ACL reconstruction with semitendinosus-gracilis tendons. Knee joint effusion was detected by computed tomography in 60 patients (22 women), before and three and 12 months after surgery. Joint effusion, clinical and subjective tests were analyzed. This is the first prospective, randomized study on post-operative bracing for patients with a semitendinosus-gracilis graft showed that bracing had no effect on three-months presence of joint effusion. Excessive joint effusion was present in 68% of the patients three months after surgery and was associated to prior meniscus injury (p=0.05) and higher prior Tegner activity level (p=0.006). We found a positive association between longer time from injury to surgery and joint effusion three months post-operatively (rho=0.29, p<0.05). Twelve months post-operatively, joint effusion had diminished to baseline levels. Subjective scores and activity levels were lower for women. Three-months joint effusion predicted lower final outcome scores in women. Prior meniscus injury and pre-injury Tegner activity levels are predictive significant variables for excessive knee joint effusion after ACL reconstruction. Post-operative bracing had no effect. A larger clinical cohort is needed to confirm findings of this logistic regression. Copyright © 2015 Elsevier B.V. All rights reserved.

Sports Activity After Reconstruction of Osteochondral Lesions of the Talus With Autologous Spongiosa Grafts and Autologous Matrix-Induced Chondrogenesis.

PubMed

Wiewiorski, Martin; Werner, Lorenzo; Paul, Jochen; Anderson, Andrew E; Barg, Alexej; Valderrabano, Victor

2016-10-01

For the treatment of osteochondral lesions of the talus (OCLTs), autologous matrix-induced chondrogenesis (AMIC) is a safe 1-step procedure with good clinical and radiological results. However, data regarding postoperative sports activity after AMIC are limited. To identify significant factors influencing the rate of postoperative sports and recreational activities. Case series; Level of evidence, 4. The sports and recreational activities of 60 patients (mean age, 34.9 ± 11.5 years) undergoing the AMIC procedure were retrospectively analyzed at a mean of 46.9 ± 17.8 months (range, 24.5-87.0 months) postoperatively. The visual analog scale (VAS) for pain score, Tegner activity scale score, activity rating scale (ARS) score, and satisfaction with surgery outcomes were assessed. Corrective calcaneal osteotomy was performed in 38 of 60 (63.3%) patients. Ligament repair was performed in 41 of 60 (68.3%) patients. The mean VAS score improved significantly from 6.9 ± 1.6 points (range, 5-10 points) preoperatively to 2.3 ± 1.9 points (range, 0-6 points) at latest follow-up (P < .001). No significant change in the mean Tegner activity scale score (3.3 ± 2.0 preoperatively to 3.4 ± 2.2 postoperatively; P = .526) and the mean ARS score (2.6 ± 4.3 preoperatively to 2.3 ± 3.4 postoperatively; P = .874) was noted. The percentage of patients involved in sports activity before the onset of symptoms became significantly lower at the time of surgery (from 95.0% to 53.3%; P < .001); no significant difference was noted postoperatively (from 53.3% to 58.3%; P = .663). No significant difference of the weekly sports frequency and the duration of sports activity was found postoperatively. Patients undergoing AMIC repair of an OCLT participate at a similar low postoperative sports and recreational activity level compared with the preoperative level. © 2016 The Author(s).

Adductor tenotomy: its role in the management of sports-related chronic groin pain.

PubMed

Atkinson, Henry Dushan E; Johal, Parminder; Falworth, Mark S; Ranawat, Vijai S; Dala-Ali, Benan; Martin, David K

2010-08-01

Chronic adductor-related groin pain in athletes is debilitating and is often challenging to treat. Little is published on the surgical treatment when conservative measures fail. This single center study reviews the outcomes of 48 patients (68 groins) who underwent percutaneous adductor tenotomy for sports-related chronic groin pain. Questionnaire assessments were made preoperatively and at a minimum follow-up of 25 months. Mean pre-injury Tegner activity scores of 8.8 reduced to 6.1 post-injury and these improved to 7.7 following surgery (p < 0.001). Sixty percent of patients regained or bettered their pre-injury Tegner activity scores after the adductor surgery; however, mean post-surgical Tegner scores still remained lower than pre-injury scores (p < 0.001). No patient had been able to engage in their chosen sport at their full ability pre-operatively, and 40% had been unable to participate in any sporting activity. The mean return to sports was at 18.5 weeks postoperatively, with 54% returning to their pre-injury activity levels, and only 8% still unable to perform athletic activities at latest follow-up. Seventy-three percent patients rated the outcome of their surgery as excellent or very satisfactory, and only three patients would not have wished to undergo the procedure again if symptoms recurred or developed on the opposite side. No patients reported their outcome as worse. A 78.1% mean improvement in function and an 86.5% mean improvement in pain were reported, and these two measures showed statistically significant correlation (p = 0.01). Groin disability scores improved from a mean of 11.8 to 3.9, post-operatively (p < 0.001). Bruising was seen in 37% of procedures, 3 patients developed a scrotal hematoma and 1 patient had a superficial wound infection. One patient developed recurrent symptoms following re-injury 26 months post-surgery, and fully recovered following a further adductor tenotomy. Adductor tenotomy provides good symptomatic and functional improvement in chronic adductor-related groin pain refractory to conservative treatment.

Return-to-activity after anatomical reconstruction of acute high-grade acromioclavicular separation.

PubMed

Saier, T; Plath, J E; Beitzel, K; Minzlaff, P; Feucht, J M; Reuter, S; Martetschläger, F; Imhoff, Andreas B; Aboalata, M; Braun, S

2016-04-02

To evaluate return-to-activity (RtA) after anatomical reconstruction of acute high-grade acromioclavicular joint (ACJ) separation. A total of 42 patients with anatomical reconstruction of acute high-grade ACJ-separation (Rockwood Type V) were surveyed to determine RtA at a mean 31 months follow-up (f-u). Sports disciplines, intensity, level of competition, participation in overhead and/or contact sports, as well as activity scales (DASH-Sport-Module, Tegner Activity Scale) were evaluated. Functional outcome evaluation included Constant score and QuickDASH. All patients (42/42) participated in sporting activities at f-u. Neither participation in overhead/contact sports, nor level of activity declined significantly (n.s.). 62 % (n = 26) of patients reported subjective sports specific ACJ integrity to be at least the same as prior to the trauma. Sporting intensity (hours/week: 7.3 h to 5.4 h, p = .004) and level of competition (p = .02) were reduced. If activity changed, in 50 % other reasons but clinical symptoms/impairment were named for modified behavior. QuickDASH (mean 6, range 0-54, SD 11) and DASH-Sport-Module (mean 6, range 0-56, SD 13) revealed only minor disabilities at f-u. Over time Constant score improved significant to an excellent score (mean 94, range 86-100, SD 4; p < .001). Functional outcome was not correlated with RtA (n.s.). All patients participated in sporting activities after anatomical reconstruction of high-grade (Rockwood Type V) ACJ-separation. With a high functional outcome there was no significant change in activity level (Tegner) and participation in overhead and/or contact sports observed. There was no correlation between functional outcome and RtA. Limiting, there were alterations in time spent for sporting activities and level of competition observed. But in 50 % those were not related to ACJ symptoms/impairment. Unrelated to successful re-established integrity and function of the ACJ it should be considered that patients decided not return-to-activity but are very content with the procedure.

Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors.

PubMed

Janssen, Rob P A; du Mée, Arthur W F; van Valkenburg, Juliette; Sala, Harm A G M; Tseng, Carroll M

2013-09-01

Analysis of long-term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors. A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4-strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT-1000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X-rays. Radiological classifications were according to Ahlbäck and Kellgren & Lawrence. Statistical analysis included univariate and multivariate logistic regressions. RESULTS CLINICAL OUTCOME: A significant improvement (p < 0.001) between preoperative and postoperative measurements could be demonstrated for the Lysholm and Tegner scores, IKDC patient subjective assessment, KT-1000 measurements, pivot shift test, IKDC score and one-leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50%) patients and correlated with lower levels of activity (p < 0.022). Radiological outcome: At follow-up, 46 (53.5%) patients had signs of osteoarthritis (OA). In this group, 33 patients (72%) had chondral lesions (≥grade 2) at the time of ACL reconstruction. A history of medial meniscectomy before or at the time of ACL reconstruction increased the risk of knee OA 4 times (95% CI 1.41-11.5). An ICRS grade 3 at the time of ACL reconstruction increased the risk of knee OA by 5.2 times (95% CI 1.09-24.8). There was no correlation between OA and activity level (Tegner score ≥6) nor between OA and a positive pivot shift test. Transtibial ACL reconstruction with 4-strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10-year follow-up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction. II.

Lateral ankle instability in high-demand athletes: reconstruction with fibular periosteal flap.

PubMed

Benazzo, Francesco; Zanon, Giacomo; Marullo, Matteo; Rossi, Stefano Marco Paolo

2013-09-01

Fibular periosteal flaps have been used to address chronic lateral ankle instability, but there are no studies in the literature reporting functional outcomes after this particular procedure in high-demand athletes. We postulated that for chronic instability, nonanatomical reconstruction of the lateral ankle ligament with a fibular periosteal flap will return high-demand athletes to their previous levels of activity. Forty patients who had grade III ankle sprain and experienced no success after a course of supervised conservative management lasting at least six months and who had a preinjury Tegner score of ≥ 6 underwent a lateral compartment reconstruction with a fibular periosteal flap. Each patient was given the Tegner and Karlsson questionnaire and was evaluated by the Zwipp method, Foot and Ankle Outcome Score (FAOS) and the American Orthopaedic Foot and Ankle Society (AOFAS) score at the six-month, one, two and three-year time points. Range of motion (ROM) of the affected ankle was assessed, and stress X-rays were performed. Mean patient age was 24.5 (range17-30) years, and no patient was lost to follow-up. Mean follow-up was 36 (minimum 18) months, mean Tegner scores at the one, two and three-year time points were 8.8, 8.9 and 8.9, respectively, and mean Karlsson scores were 93 ± 5.2, 95 ± 3.1 and 94.9, respectively. AOFAS and FAOS scores improved from a mean of 69.4 and 71.4, respectively, in the preoperative group to a mean of 97.2 and 94.4, respectively, at the last follow-up. The ROM was equal to the contralateral ankle in all but two patients at the two-year follow-up. No major complications were found. Nonanatomical ligament reconstruction with a fibular periosteal flap for chronic lateral ankle instability was effective in returning high-demand athletes to their preinjury functional levels.

Successful return to sports in athletes following non-operative management of acute isolated posterior cruciate ligament injuries: medium-term follow-up.

PubMed

Agolley, D; Gabr, A; Benjamin-Laing, H; Haddad, F S

2017-06-01

The aim of this study was to report the outcome of the non-operative treatment of high-grade posterior cruciate ligament (PCL) injuries, particularly Hughston grade III injuries, which have not previously been described. This was a prospective study involving 46 consecutive patients who were athletes with MRI-confirmed isolated PCL injuries presenting within four weeks of injury. All had Hughston grade II (25 athletes) or III (21 athletes) injuries. Our non-operative treatment regimen involved initial bracing, followed by an individualised rehabilitation programme determined by the symptoms and physical signs. The patients were reviewed until they had returned to sports-specific training, and were reviewed again at a mean of 5.2 years (3 to 9). The mean time to return to sports-specific training was 10.6 weeks and the mean time to return to full competitive sport was 16.4 weeks (10 to 40). A total of 42 patients (91.3%) were playing at the same or higher level of sport two years after the injury, with a mean Tegner activity score of 9 (5 to 10). At five years, 32 patients (69.5%) were playing at the same or higher level of sport, and 38 patients (82.6%) were playing at a competitive level, with a mean Tegner activity score of 9 (5 to 10). Medium-term review of a series of athletes suggests that commencing the non-operative management of isolated, Hughston grade II and III PCL injuries within four weeks of injury gives excellent functional outcomes with a high proportion returning to the same or higher level of sport. Cite this article: Bone Joint J 2017;99-B:774-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

Return to Sport after ACL Surgery: A Comparison between Two Different Reconstructive Techniques.

PubMed

Baldassarri, Matteo; Perazzo, Luca; Ghinelli, Diego; Ricciarelli, Marco; Pilla, Federico; Buda, Roberto

2018-05-23

The anterior cruciate ligament reconstruction (ACLR) has become a very common surgical procedure. One of the main success indicators of the surgical procedure is the return to preinjury sporting level. In recent years, reconstructive techniques have been geared toward less morbidity and optimized ligaments process to speed up the recovery of sports activity. This study compares clinical and imaging data, to evaluate the timing of return to sport, of two populations undergoing ACLR using two different techniques: ACLR with hamstring maintaining tibial insertion (MHG) and an all-inside technique with complete hamstring detachment (DHG). Patients were clinically evaluated with Marx rating scale, International Knee Documentation Committee (IKDC) score, and Tegner activity scale at a minimum follow-up (FU) of 4 years. The two groups have homogeneous characteristics: age, sex, type, and level of sports activity. Since November 2012, 59 patients with unilateral ACL insufficiency underwent ACLR: 31 patients using the MHG technique and 28 patients using the DHG technique. In both groups, a significant improvement in the clinical scores of the administered tests was observed. The MHG group reported a higher percentage of normal knees (83.8%) compared with the DHG group (78.6%). IKDC subjective score improved at each FU. Comparing the two techniques, at 12 months' FU the MHG group achieved better IKDC results (89.6) compared with the DHG technique (84.2). Marx and Tegner score values improved over time reaching comparable results at final FU. At final FU, 98% of patients returned to the same preinjury professional sporting level. Both techniques have been able to provide good clinical results. The MHG group, however, had a resumption of sports activity of the same level and intensity slightly longer (6.3 months) than that in the DHG group (5.9 months). Furthermore, the resumption of training and athletic gestures for the type of sport practiced was earlier than the DHG group. However, in the long run the level of sporting activity leveled in both groups, demonstrating the effectiveness of both techniques. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Returning to sport after anterior cruciate ligament reconstruction in amateur sports men: a retrospective study.

PubMed

Notarnicola, Angela; Maccagnano, Giuseppe; Barletta, Federico; Ascatigno, Leonardo; Astuto, Leopoldo; Panella, Antonio; Tafuri, Silvio; Moretti, Biagio

2016-01-01

According to the literature, 95% of professional athletes return to their sport after anterior cruciate ligament (ACL) reconstruction surgery. The main objective of this study was to verify the return to sport after ACL reconstruction in a homogenous group of amateur sportsmen and sportswomen in a series of Italian patients. We designed a retrospective study in which we analyzed the amateur sports patients operated for ACL reconstruction. We verified whether they had returned to sporting activities by comparing the pre- and post-operative Tegner activity scores. We then analyzed the average time to restart the sporting activity and the Lysholm and International Knee Documenting Committee (IKDC) scores. We analyzed 80 subjects: 47.5% restarted a sports activity, on average after eight months, with a significant reduction of their competitive level or physical commitment, as expressed by the Tegner activity score (pre-operative: 6.9; post-operative: 3.9; p<0.01). The functional knee recovery was good, as expressed by the average score of the Lyshom Knee Scoring Scale (93.5) and the IKDC (74.7). In the literature, a return to sport for international case studies and amateur sports is higher than our data. In our population we found the lack of information provided by the medical staff at discharge and follow-up. The assessment at a short-term follow up allowed us to verify that at the end of the post-surgical rehabilitation program the patients were uninformed about the timing and the ability to resume a sporting activity. An efficacious relationship between orthopedic doctor, physiotherapist and a doctor in motorial science may ensure proper treatment the patient after ACL reconstruction. It is important to guarantee the restarting of the sports activity to have a better quality of life in amateur sports. Level of evidence: V.

Returning to sport after anterior cruciate ligament reconstruction in amateur sports men: a retrospective study

PubMed Central

Notarnicola, Angela; Maccagnano, Giuseppe; Barletta, Federico; Ascatigno, Leonardo; Astuto, Leopoldo; Panella, Antonio; Tafuri, Silvio; Moretti, Biagio

2016-01-01

Summary Background According to the literature, 95% of professional athletes return to their sport after anterior cruciate ligament (ACL) reconstruction surgery. The main objective of this study was to verify the return to sport after ACL reconstruction in a homogenous group of amateur sportsmen and sportswomen in a series of Italian patients. Materials and methods We designed a retrospective study in which we analyzed the amateur sports patients operated for ACL reconstruction. We verified whether they had returned to sporting activities by comparing the pre- and post-operative Tegner activity scores. We then analyzed the average time to restart the sporting activity and the Lysholm and International Knee Documenting Committee (IKDC) scores. Results We analyzed 80 subjects: 47.5% restarted a sports activity, on average after eight months, with a significant reduction of their competitive level or physical commitment, as expressed by the Tegner activity score (pre-operative: 6.9; post-operative: 3.9; p<0.01). The functional knee recovery was good, as expressed by the average score of the Lyshom Knee Scoring Scale (93.5) and the IKDC (74.7). Conclusions In the literature, a return to sport for international case studies and amateur sports is higher than our data. In our population we found the lack of information provided by the medical staff at discharge and follow-up. The assessment at a short-term follow up allowed us to verify that at the end of the post-surgical rehabilitation program the patients were uninformed about the timing and the ability to resume a sporting activity. An efficacious relationship between orthopedic doctor, physiotherapist and a doctor in motorial science may ensure proper treatment the patient after ACL reconstruction. It is important to guarantee the restarting of the sports activity to have a better quality of life in amateur sports. Level of evidence: V. PMID:28217571

Validity and reliability of the Dutch version of the Copenhagen Hip And Groin Outcome Score (HAGOS-NL) in patients with hip pathology.

PubMed

Giezen, Hilde; Stevens, Martin; van den Akker-Scheek, Inge; Reininga, Inge H F

2017-01-01

The Copenhagen Hip And Groin Outcome Score (HAGOS) was developed to assess disease-specific consequences in young to middle-aged, physically active hip and/or groin patients. The study aimed to determine validity and reliability of the Dutch version of the HAGOS (HAGOS-NL) for middle-aged patients with hip complaints. To assess validity, 117 participants completed five questionnaires: HAGOS-NL, international Hip Outcome Tool (iHOT-12NL), Hip disability and Osteoarthritis Outcome Score (HOOS), RAND-36 Health Survey and Tegner activity scale. Structural validity was determined by conducting confirmatory factor analysis. Construct validity was analyzed by formulating predefined hypotheses regarding relationships between the HAGOS-NL and subscales of the iHOT-12NL, HOOS, RAND-36 and Tegner activity scale. The HAGOS-NL was filled out again by 67 patients to explore test-retest reliability. Reliability was assessed in terms of Cronbach's alpha, Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). The Bland and Altman method was used to explore absolute agreement. Factor analysis confirmed that the HAGOS-NL consists of six subscales. All hypotheses were confirmed, indicating good construct validity. Internal consistency was good, with Cronbach's alpha values ranging from 0.89 to 0.98. Test-retest reliability was considered good, with ICC values of 0.80 and higher. The SEM ranged from 6.6 to 12.3, and MDC at individual level from 18.3 to 34.1 and at group level from 2.3 to 4.4. Bland and Altman analyses showed no bias. The HAGOS-NL is a reliable and valid instrument for measuring pain, physical functioning and quality of life in middle-aged patients with hip complaints.

Bone mineral decreases in the calcanei in men after arthroscopic shoulder surgery: a prospective study over 5 years.

PubMed

Elmlund, Anna O; Kartus, Jüri; Ejerhed, Lars

2016-12-01

It is well known that injuries and surgical procedures in the lower extremities affect bone mineral both in the injured limb and in the contralateral limb. The possible effect on bone mineral after upper extremity surgery is not well studied, and the aim of this study was to study the effect on bone mineral in the calcanei after arthroscopic shoulder surgery. Twenty-two men scheduled for arthroscopic shoulder surgery underwent bone mineral area (BMA) mass measurements in both calcanei using the Calscan DXL device prior to surgery and after 6, 18, 36 and 60 months. On every occasion, the Tegner activity score and EuroQoL 5-dimensions (EQ-5D) were assessed. During 5 years, there was a significant decrease in the BMA in both calcanei (p = 0.003). The Tegner activity score decreased from preinjury to the operation and did not increase significantly after the operation. The EQ-5D increased significantly after the operation. The bone mineral in the calcanei in men during the 5-year study period decreased more than the expected age-dependent decline after arthroscopic shoulder surgery. There was an increase in health-related quality of life as measured with the EQ-5D after arthroscopic Bankart reconstruction. Case-control study, Level III.

Management of traumatic patellar dislocation in a regional hospital in Hong Kong.

PubMed

Lee, H L; Yau, W P

2017-04-01

The role of surgery for acute patellar dislocation without osteochondral fracture is controversial. The aim of this study was to report the short-term results of management of patellar dislocation in our institute. Patients who were seen in our institution with patella dislocation from January 2011 to April 2014 were managed according to a standardised management algorithm. Pretreatment and 1-year post-treatment International Knee Documentation Committee score, Tegner activity level scale score, and presence of apprehension sign were analysed. A total of 41 patients were studied of whom 20 were first-time dislocators and 21 were recurrent dislocators. Among the first-time dislocators, there was a significant difference between patients who received conservative treatment versus surgical management. The conservative treatment group had a 33% recurrent dislocation rate, whereas there were no recurrent dislocations in the surgery group. There was no difference in Tegner activity level scale score or apprehension sign before and 1 year after treatment, however. Among the recurrent dislocators, there was a significant difference between those who received conservative treatment and those who underwent surgery. The recurrent dislocation rate was 71% in the conservative treatment group versus 0% in the surgery group. There was also significant improvement in International Knee Documentation Committee score from 67.7 to 80.0 (P=0.02), and of apprehension sign from 62% to 0% (P<0.01). A management algorithm for patellar dislocation is described. Surgery is preferable to conservative treatment in patients who have recurrent patellar dislocation, and may also be preferable for those who have an acute dislocation.

Clinical efficacy and safety of mesenchymal stem cell transplantation for osteoarthritis treatment: A meta-analysis

PubMed Central

Li, Li; Tao, Sun; Bo, Lin; Lin, Chen

2017-01-01

Purpose The aim of this study was to evaluate the therapeutic efficacy and safety of mesenchymal stem cells (MSCs) for the treatment of patients with knee osteoarthritis (OA). Materials We performed a meta-analysis of relevant published clinical studies. An electronic search was conducted for randomized controlled trials (RCTs) of MSC-based therapy in knee OA. The visual analogue scale (VAS), International Knee Documentation Committee (IKDC) form, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne algofunctional indices (Lequesne), Lysholm knee scale (Lysholm), Tegner activity scale (Tegner) and adverse events (AEs) were evaluated. Results Eleven eligible trials with 582 knee OA patients were included in the present meta-analysis. We demonstrated that MSC treatment could significantly decrease VAS and increase IKDC scoresafter a 24-month follow-up compared with controls (P<0.05). MSC therapy also showed significant decreases in WOMAC and Lequesne scores after the 12-month follow-up (P<0.01). Analysis of Lysholm (24-month) and Tegner (12- and 24-month) scores also demonstrated favorable results for MSC treatment (P<0.05). Conclusion Overall, MSC transplantation treatment was shown to be safe and has great potential as an efficacious clinical therapy for patients with knee OA. PMID:28448518

Mesenchymal stem cell implantation in osteoarthritic knees: is fibrin glue effective as a scaffold?

PubMed

Kim, Yong Sang; Choi, Yun Jin; Suh, Dong Suk; Heo, Dong Beom; Kim, Yong Il; Ryu, Jae-Sung; Koh, Yong Gon

2015-01-01

The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions. To investigate the clinical and second-look arthroscopic outcomes of the implantation of MSCs loaded in fibrin glue as a scaffold in patients with OA knees and to compare these outcomes with those of MSC implantation without a scaffold. Cohort study; Level of evidence, 3. This study retrospectively evaluated 54 patients (56 knees) who were examined with second-look arthroscopy after MSC implantation for cartilage lesions in their OA knees. Patients were divided into 2 groups: 37 patients (39 knees) were treated with MSC implantation without a scaffold (group 1), and 17 patients (17 knees) underwent implantation of MSCs loaded in fibrin glue as a scaffold (group 2). Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed with the International Cartilage Repair Society (ICRS) grade. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes. At final follow-up (mean, 28.6 months; range, 24-34 months), the mean IKDC score and Tegner activity scale in each group significantly improved: group 1, from 38.1±7.7 to 62.0±11.7 (IKDC) and from 2.5±0.9 to 3.5±0.8 (Tegner); group 2, from 36.1±6.2 to 64.4±11.5 (IKDC) and from 2.2±0.8 to 3.8±0.8 (Tegner) (P<.001 for all). According to the overall ICRS cartilage repair grades, 9 of the 39 lesions (23%) in group 1 and 12 of the 17 lesions (58%) in group 2 achieved a grade of I or II. There was a significant difference in ICRS grades between the groups (P=.028). Overweight (body mass index≥27.5 kg/m2) and large lesion size (≥5.7 cm2) were significant predictors of poor clinical and arthroscopic outcomes in group 1 (P<.05 for both). There was a similar trend in group 2, but the differences were not significant, possibly owing to the smaller sample size. Clinical and arthroscopic outcomes of MSC implantation were encouraging for OA knees in both groups, although there were no significant differences in outcome scores between groups. However, at second-look arthroscopy, there were better ICRS grades in group 2. © 2014 The Author(s).

Osteochondral transplantation of the talus: long-term clinical and magnetic resonance imaging evaluation.

PubMed

Imhoff, Andreas B; Paul, Jochen; Ottinger, Benjamin; Wörtler, Klaus; Lämmle, Lena; Spang, Jeffrey; Hinterwimmer, Stefan

2011-07-01

Osteochondral lesions of the ankle are a common injury after ankle sprains, especially in young and active patients. The Osteochondral Autograft Transfer System (OATS) is the only 1-step surgical technique designed to replace the entire osteochondral unit. This study was conducted to evaluate the long-term clinical and radiographic outcomes of the OATS procedure for the talus and compare the results of patients who have had prior surgical interventions with patients for whom OATS represents the primary surgical treatment. Case series; Level of evidence, 4. The authors retrospectively analyzed 26 talus OATS procedures (25 patients) with an average follow-up of 84 months (range, 53-124 months); 9 patients had OATS as a second surgical intervention. The patients completed the American Orthopaedic Foot & Ankle Society (AOFAS) and Tegner scores plus the visual analog scale (VAS) preoperatively and at follow-up. Magnetic resonance imaging examinations were conducted on a 1.5-T whole-body magnet that assessed transplant congruency, adjacent surface of the talus, the corresponding distal tibia, and joint effusion. The authors found significant increases for the AOFAS score (50 to 78 points, P < .01) and the Tegner score (3.1 to 3.7, P < .05) and a significant decrease for the VAS (7.8 to 1.5, P < .01) from preoperative to postoperative. Patients with normal integration or minor incongruity of the transplant on magnetic resonance imaging (81%) had significantly better AOFAS scores (P = .03). Other magnetic resonance imaging criteria did not predict clinical results. Patients for whom OATS represented a second procedure had significantly worse clinical AOFAS and Tegner scores plus a higher VAS. Long-term clinical and magnetic resonance imaging results after osteochondral transplantation are good and patients significantly benefit from this surgery. Magnetic resonance imaging should not be a routine control but appears to be indicated when clinical symptoms persist after osteochondral transplantation.

Impact of Patient Sex on Clinical Outcomes

PubMed Central

Teitsma, Xavier M.; van der Hoeven, Henk; Tamminga, Rob; de Bie, Rob A.

2014-01-01

Background: The Combined Quality Care Anterior Cruciate Ligament registry provides data for clinical research regarding primary anterior cruciate ligament (ACL) surgery. Purpose: To explore the data with regard to the clinical outcomes between sexes after ACL reconstruction in a Dutch population. Study Design: Cohort study; Level of evidence, 3. Methods: Data involving patients diagnosed with an ACL tear and eligible for surgery were recorded. Isokinetic muscle strength, functional muscle performance, and anterior-posterior translation of the knee joint were documented preoperatively and at 3, 6, 9, and 12 months postoperatively. Patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm, and Tegner rating scales during each examination using a web-based questionnaire. Results: Approximately 90% of ACL injuries occurred during sport activities. The mean (SD) age at surgery was 28 (11) years for both men and women, and the majority of patients were treated with hamstring tendon autografts (94%). Four percent received bone–patellar tendon–bone autografts, and 2% of the patients received other grafts. Preoperatively, the KOOS, Lysholm, and Tegner scores were significantly higher in males. Twelve months postoperatively, both sexes showed comparable isokinetic strength (P = .336), knee laxity (P = .680), and hop test for distance (P = .122) when comparing the injured with the uninjured side. Self-reported knee function was comparable between sexes as assessed by the KOOS (P = .202), Lysholm (P = .872), and Tegner (P = .767) questionnaires during the 12-month follow-up. Conclusion: One year after ACL surgery, all patients had improved greatly, showing only minor differences between sexes. The male group showed slightly better results when evaluating self-reported knee questionnaires. Comparable outcomes and knee function between sexes can therefore be presumed with patients who are treated with hamstring tendon autografts in a Dutch population. Clinical Relevance: These results can be used during the clinical evaluation of patients who are eligible for ACL reconstruction. PMID:26535365

Double-layer versus single-layer bone-patellar tendon-bone anterior cruciate ligament reconstruction: a prospective randomized study with 3-year follow-up.

PubMed

Mei, Xiaoliang; Zhang, Zhenxiang; Yang, Jingwen

2016-12-01

To evaluate the clinical results of a randomized controlled trial of single-layer versus double-layer bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction. Fifty-eight subjects who underwent primary ACL reconstruction with a BPTB allograft were prospectively randomized into two groups: single-layer reconstruction (n = 31) and double-layer reconstruction (n = 27). The following evaluation methods were used: clinical examination, KT-1000 arthrometer measurement, muscle strength, Tegner activity score, Lysholm score, subjective rating scale regarding patient satisfaction and sports performance level, graft retear, contralateral ACL tear, and additional meniscus surgery. Forty-eight subjects (24 in single-layer group and 24 in double-layer group) who were followed up for 3 years were evaluated. Preoperatively, there were no differences between the groups. At 3-year follow-up, the Lachman and pivot-shift test results were better in the double-layer group (P = 0.019 and P < 0.0001, respectively). KT measurements were better in the double-layer group (mean 2.9 versus 1.5 mm; P = 0.0025). The Tegner score was also better in the double-layer group (P = 0.024). There were no significant differences in range of motion, muscle strength, Lysholm score, subjective rating scale, graft retear, and secondary meniscal tear. In ACL reconstruction, double-layer BPTB reconstruction was significantly better than single-layer reconstruction regarding anterior and rotational stability at 3-year follow-up. The results of KT measurements and the Lachman and pivot-shift tests were significantly better in the double-layer group, whereas there was no difference in the anterior drawer test results. The Tegner score was also better in the double-layer group; however, there were no differences in the other subjective findings.

Accelerated Return to Sport After Osteochondral Autograft Plug Transfer

PubMed Central

Werner, Brian C.; Cosgrove, Chris T.; Gilmore, C. Jan; Lyons, Matthew L.; Miller, Mark D.; Brockmeier, Stephen F.; Diduch, David R.

2017-01-01

Background: Previous studies have reported varying return-to-sport protocols after knee cartilage restoration procedures. Purpose: To (1) evaluate the time for return to sport in athletes with an isolated chondral injury who underwent an accelerated return-to-sport protocol after osteochondral autograft plug transfer (OAT) and (2) evaluate clinical outcomes to assess for any consequences from the accelerated return to sport. Study Design: Case series; Level of evidence, 4. Methods: An institutional cohort of 152 OAT procedures was reviewed, of which 20 competitive athletes met inclusion and exclusion criteria. All patients underwent a physician-directed accelerated rehabilitation program after their procedure. Return to sport was determined for all athletes. Clinical outcomes were assessed using International Knee Documentation Committee (IKDC) and Tegner scores as well as assessment of level of participation on return to sport. Results: Return-to-sport data were available for all 20 athletes; 13 of 20 athletes (65%) were available for clinical evaluation at a mean 4.4-year follow-up. The mean time for return to sport for all 20 athletes was 82.9 ± 25 days (range, 38-134 days). All athletes were able to return to sport at their previous level and reported that they were satisfied or very satisfied with their surgical outcome and ability to return to sport. The mean postoperative IKDC score was 84.5 ± 9.5. The mean Tegner score prior to injury was 8.9 ± 1.7; it was 7.7 ± 1.9 at final follow-up. Conclusion: Competitive athletes with traumatic chondral defects treated with OAT managed using this protocol had reduced time to preinjury activity levels compared with what is currently reported, with excellent clinical outcomes and no serious long-term sequelae. PMID:28451623

Return to sport: Does excellent 6-month strength and function following ACL reconstruction predict midterm outcomes?

PubMed

Sousa, Paul L; Krych, Aaron J; Cates, Robert A; Levy, Bruce A; Stuart, Michael J; Dahm, Diane L

2017-05-01

The purpose of this study was to determine whether patients with excellent 6-month functional testing after ACL reconstruction had (1) higher risk of subsequent ACL tears, (2) superior knee function, and (3) increased activity levels compared to those with delayed clearance for return to sports at midterm follow-up. A total of 223 patients underwent primary ACL reconstruction by a single surgeon and had functional and isokinetic testing performed 6 months post-operatively between 1998 and 2005. Of the 223 patients, 52 (23 %) made the excellent group and were allowed return to sport at 6 months, and the remaining 171 (77 %) constituted the delayed group. Rate of ACL graft tear and native contralateral ACL tear was compared between groups. In addition, IKDC and Tegner scores were compared at a mean 4-year follow-up. The graft rupture rate was similar in the excellent group (3.8 %, n = 2) compared to the delayed group (4.7 %, n = 8; p = 0.30). However, there was a higher rate of contralateral ACL tear in the excellent group (15.4 %, n = 8 vs. 5.3 %, n = 9; p = 0.003). The excellent 6-month group had superior IKDC scores (94.3 ± 6.4 vs. 90.9 ± 9.7; p = 0.04) and Tegner scores (6.6 ± 1.8 vs. 5.7 ± 1.6; p = 0.01). Patients with an excellent performance on their isokinetic strength and functional testing at 6 months after ACL reconstruction have superior knee function and higher activity levels at midterm follow-up. However, these patients appear to be at greater risk of contralateral ACL injury, which may be related to their increased activity level. When isokinetic and functional testing is used for return-to-sport decisions, physicians should caution patients about the risk of contralateral ACL injury for high performing patients. Retrospective Review with Control, Level III.

Rapid chondrolysis of the knee after partial lateral meniscectomy in professional athletes.

PubMed

Sonnery-Cottet, Bertrand; Archbold, Pooler; Thaunat, Mathieu; Carnesecchi, Olivier; Tostes, Marcelo; Chambat, Pierre

2014-03-01

Postoperative knee joint chondrolysis is a rare but serious complication. The aim of our study is to report the clinical presentation, the early, mid and long-term outcomes of rapid chondrolysis after a partial lateral meniscectomy in elite athletes. Clinical records of 10 consecutive cases of rapid chondrolysis after partial lateral meniscectomy in eight professional athletes were retrospectively reviewed. There were seven males and one female with a mean age of 25.2 years (range 20-32 years) at index procedure. An initial conservative approach to its treatment was attempted in all cases. Arthroscopic lavage was advocated in two cases. Patients were clinically reviewed at last follow-up with comparative X-rays, a subjective IKDC, a Lysholm and Tegner scale. All patients resumed their pre-injury level of activity at a mean 8 (±2.45) months after the index procedure. At a mean of 82 (±36) months of follow-up, the mean subjective IKDC, Lyshom and Tegner scale were respectively 82.64 (±8.61), 86.6 (±6.44), 9 (±1.41). All knees demonstrated joint space narrowing scored Kellgren and Lawrence II (n=1) III (n=4) or IV (n=5) on conventional radiographs. By reviewing the common factors in each of these cases we believe that rapid chondrolysis occurs primarily due to the excessive loading of the articular cartilage in the lateral compartment of the knee. In this series, although the results in the medium term were good, the long-term outcome must be guarded due to the high rate of radiographic osteoarthritis of the lateral compartment seen in this population. Retrospective case series, Level IV. Copyright © 2014 Elsevier B.V. All rights reserved.

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome.

PubMed

Schepers, Tim; Vogels, Lucas M M; Van Lieshout, Esther M M

2011-12-01

In the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half the peroneus brevis tendon. We performed a retrospective cohort study of patients who underwent hemi-Castaing ligamentoplasty for chronic lateral ankle instability between 1993 and 2010, with a minimum of one year follow-up. Patients were sent a postal questionnaire comprising five validated outcome measures: Olerud-Molander Ankle Score (OMAS), Karlsson Ankle Functional Score (KAFS), Tegner Activity Level Score (pre-injury, prior to surgery, at follow-up), visual analog scale on pain (VAS) and the Short Form 36 (SF-36). Twenty patients completed the questionnaire on functional outcome. The OMAS showed good to excellent outcome in 80% and the KAFS in 65%, the Tegner Score improved from surgery but did not reach pre-injury levels, the VAS on pain was 1 of 10 and the SF-36 returned to normal compared with the average population. Even though most patients were satisfied with the results, outcome at long-term follow-up was less favourable compared with the literature on anatomical reconstructions. In accordance with the literature, we therefore conclude that the initial surgical treatment of chronic lateral ankle instability should be an anatomical repair with augmentation (i.e. the Broström-Gould technique) and the non-anatomical repair should be reserved for unsuccessful cases after anatomical repair or in cases where no adequate ligament remnants are available for reconstruction.

Outcomes after repair of chronic bucket-handle tears of medial meniscus.

PubMed

Espejo-Reina, Alejandro; Serrano-Fernández, José Miguel; Martín-Castilla, Belén; Estades-Rubio, Francisco Javier; Briggs, Karen K; Espejo-Baena, Alejandro

2014-04-01

The purpose of this study was to determine the outcomes after repair of chronic bucket-handle medial meniscal tears by use of magnetic resonance imaging, clinical examination, and patient-reported outcomes. A retrospective review of patients with chronic bucket-handle medial meniscal tears that had been repaired with meniscal sutures was undertaken. The following criteria for inclusion were adopted: minimum tear length of 2 cm and chronic medial meniscal tear identified at the time of arthroscopy. The tears were susceptible to dislocation with probing. Data collected included demographic, clinical, radiologic, and surgical data. Postoperative healing was assessed with the clinical criteria of Barrett et al. The International Knee Documentation Committee rating, Lysholm score, and Tegner activity level were determined, and postoperative magnetic resonance imaging was used to evaluate healing in accordance with the criteria of Henning et al. Twenty-four patients fulfilled the inclusion criteria. The mean time from injury to surgery was 10 months (range, 2 to 60 months). Sixteen patients underwent anterior cruciate ligament reconstruction, 1 patient underwent posterior cruciate ligament reconstruction, and 6 patients underwent meniscus repair only. A median of 5 sutures (range, 3 to 6 sutures) were used for repair. Four cases (all of which had undergone meniscus repair only) required revision. Complete healing was achieved in 83% of cases according to the criteria of Barrett et al. The mean follow-up time was 48 months (range, 24 to 112 months). An International Knee Documentation Committee rating of A or B was achieved in the 20 patients who did not require revision. The median Lysholm score was 95 (range, 92 to 100). The median Tegner activity level before injury was 7, and it remained unchanged after surgery in all cases. This study showed that repair of chronic bucket-handle meniscal tears can lead to good clinical outcomes and a relatively low (17%) failure rate. In addition, repairs of isolated meniscal tears had a significantly higher risk of failure than repairs performed in conjunction with anterior cruciate ligament reconstruction. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Return to Sport and Clinical Outcomes After Hip Arthroscopic Labral Repair in Young Amateur Athletes: Minimum 2-Year Follow-Up.

PubMed

Mohan, Rohith; Johnson, Nick R; Hevesi, Mario; Gibbs, Christopher M; Levy, Bruce A; Krych, Aaron J

2017-09-01

To determine the rate of return of young amateur athletes to sport after hip arthroscopy, their clinical outcomes, and pathologic risk factors for worse outcomes 2 years after surgery. This study included all patients between age 13 and 23 who participated in a sport prior to surgery with intent to return who underwent hip arthroscopy after failure of comprehensive nonoperative management for whom 2-year outcome scores were available. Outcomes collected retrospectively included modified Harris Hip Score (mHHS) and the Hip Outcome Scores (HOS) subscales for activities of daily living (ADL) and sport (HOS Sport). In addition, sport played, return to sport rates, and Tegner Scores were measured preinjury and postoperatively. Descriptive statistics were used to present demographic data. A priori analysis was used to determine the sample size needed to show minimal clinically important differences for mHHS, HOS ADL, and HOS Sport. The study population included 50 patients with a mean age of 17.8 years. Athletes returned to sport at a rate of 92% (46/50). At a mean follow-up of 34 months, the mean mHHS, HOS ADL, and HOS Sport outcome scores were 85, 91, and 80 for the entire study group; 87, 92, and 84 for the group that returned to sport; and 67, 82, and 41 for the group that did not return to sport, respectively. Median preinjury and postoperative Tegner levels were 8 and 7, respectively. Labral takedown and reattachment was associated with lower HOS ADL (P = .01) and HOS Sport scores (P = .02). Athletes returned to sport at a high rate (92%; 46/50) after hip arthroscopy and perform activities at near preinjury levels. In this group of athletes, arthroscopic labral repair with chondrolabral preservation, which reflected less severe chondrolabral pathology, performed better than labral repair with takedown and reattachment. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Multiligament Knee Injuries in Older Adolescents: A 2-Year Minimum Follow-up Study

PubMed Central

Godin, Jonathan A.; Cinque, Mark E.; Pogorzelski, Jonas; Moatshe, Gilbert; Chahla, Jorge; LaPrade, Robert F.

2017-01-01

Background: Multiligament knee injuries cause significant functional impairment. Adults undergoing anatomic reconstruction of multiligament knee injuries have excellent outcomes postoperatively. However, less is known about the outcomes in adolescent patients following multiligament reconstruction. Purpose/Hypothesis: We aimed to assess patient outcomes and failure rates following unstaged multiligament reconstruction in an adolescent population at a minimum 2-year follow-up. We hypothesized that outcomes of multiligament reconstruction in these patients would be comparable to previously reported outcomes in the adult population. Study Design: Case series; Level of evidence, 4. Methods: The study included patients who had undergone multiligament knee reconstruction at 19 years of age or younger and had at least 2 years of follow-up. All procedures were performed by the same surgeon. Exclusion criteria included patient age 14 years or younger at the time of surgery, open physes, prior ipsilateral meniscal or knee ligament surgery, or a tibial plateau fracture at the time of injury. Multiligament reconstruction was defined as a reconstruction of at least 1 cruciate ligament and at least 1 component of the posterolateral corner or the medial knee. Patients were evaluated according to Lysholm score, Tegner score, Short Form–12 physical component summary (SF-12 PCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and postoperative patient satisfaction. Results: Twenty patients (mean age, 17.7 years; mean follow-up, 37.1 months) were included in this study. No patient required additional ligament surgery after the index surgery because of graft failure. The median preoperative Lysholm score was 49.5 (range, 18-90), and the median postoperative Lysholm score was 86 (range, 44-100) (P < .001). The median preoperative Tegner activity score was 2 (range, 0-9), and the median postoperative Tegner activity score was 6 (range, 2-10) (P = .012). The median SF-12 PCS improved from 40.5 preoperatively to a median of 56.1 postoperatively (P < .001). WOMAC total score improved from a median of 26.5 preoperatively to a median of 2 postoperatively (P < .001). Median postoperative patient satisfaction was 10 (range, 5-10). Conclusion: Single-stage multiligament knee reconstruction is a reliable procedure that improves knee function at 2-year follow-up in adolescent patients. Patient satisfaction was excellent, but longer follow-up in a larger series of patients is required to determine the long-term benefits of multiligament reconstruction in this patient population. PMID:28975131

Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up.

PubMed

Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Grassi, Alberto; Roberti di Sarsina, Tommaso; Raggi, Federico; Signorelli, Cecilia; Urrizola, Francisco; Spinnato, Paolo; Rimondi, Eugenio; Marcacci, Maurilio

2017-12-01

There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction. To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up. Case series; Level of evidence, 4. Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25.5 ± 7.6 years). Twenty-nine patients were available for prospective evaluations: clinical (Lysholm, Tegner, and objective International Knee Documentation Committee [IKDC]), instrumented (KT-2000), and radiographic (standard, long-standing, and Merchant views). Subjective KOOS (Knee injury and Osteoarthritis Outcome Score) and objective inertial sensor pivot-shift analysis (KiRA) were carried out at final follow-up. Twenty-three patients were investigated by phone interview for subjective Tegner score and documented complications, rerupture, or revision surgery. At final follow-up, mean Lysholm score was 85.7 ± 14.6; median Tegner score, 4 (range, 3-5); sport activity resumption, 86.2%; and objective IKDC score, good or excellent in 86% of patients (31%, A; 55%, B). Only 3 of 26 patients (12%) had >5-mm manual maximum KT-2000 side-to-side difference. KiRA system documented positive pivot-shift (>0.9-m/s 2 tibial acceleration side-to-side difference) in these 3 of 26 patients (12%). Statistically significant changes were as follows: decrease in Tegner score from 7 (range, 6-8) at 5-year follow-up to 4 (range, 3-5) at 10 years ( P < .0001) and decrease in Lysholm score from 96.1 ± 7.3 at 10-year follow-up to 85.7 ± 14.6 at 20 years ( P = .0003). Radiographic evaluation demonstrated significant difference of medial joint space between injured and healthy knees in patients with concomitant medial meniscectomy (n = 8, 3.2 ± 0.6 vs 5.0 ± 1.8 mm, P = .0114). No significant differences were reported regarding lateral or patellofemoral joint space. One patient (2%) experienced rerupture, with 3 of 52 (5.8%) having a contralateral ACL injury (excluded from KT-2000 and radiographic evaluations). Overall, 4 of 29 clinical failures (objective IKDC, KT-2000) and 1 rerupture among 52 patients were registered at final follow-up. Studied surgical technique demonstrated good results in laxity control at 20-year minimum follow-up. The lateral extra-articular plasty associated with ACL reconstruction did not generate lateral knee or patellofemoral osteoarthritis. The factor increasing osteoarthritis was meniscectomy.

Focal articular prosthetic resurfacing for the treatment of full-thickness articular cartilage defects in the knee: 12-year follow-up of two cases and review of the literature.

PubMed

Becher, C; Cantiller, E B

2017-09-01

The rationale of focal articular prosthetic resurfacing used as a primary arthroplasty procedure in the treatment of articular cartilage defects is still under debate. Conflicting reports raise concern about high rates of re-operations and continued development of osteoarthritis, while others have reported good outcomes. The goal of this paper is to present the long-term results of two patients with a 12-year follow-up and to report the results of a literature review. Two patients (male, 70 years; female 63 years) with a follow-up of 12 years were reviewed. Patients were evaluated with standard radiographs to assess the progression of osteoarthritis (OA), a clinical examination including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale. The literature review was performed using the search terms HemiCAP, focal, femoral, condyle, inlay, and resurfacing to identify articles published in the English language up until September 25, 2016. The clinical and radiographic follow-ups of the patients were 11.9 and 11.8 years, respectively. Both patients were satisfied with their outcome and would have the operation again. Comparing the first postoperative to 12-year follow-up X-rays, the radiographic results demonstrated no signs of periprosthetic loosening, preservation of joint space, and no change in the osteoarthritic stage. KOOS Scores were 86 and 83 for pain, 89 and 93 for symptoms, 88 and 100 for activities of daily living (ADL), 75 and 65 for sports and recreation, and 75 and 81 for quality of life (QOL). The Tegner activity level was 5 and 4. The literature review comprised 6 studies with 169 focal articular prosthetic resurfacing procedures in 169 patients (84 male, 85 female) with a mean age at implantation ranging from 44.7 to 53.7 years and a follow-up range of 20 months to 7 years. Five studies were classified as level 4 and one as level 3. Clinical and radiographic results showed mainly good to excellent outcomes but were different among the studies depending on the indication. Re-operation rates ranged from 0 to 23% depending on the length of follow-up. The results suggest that focal articular prosthetic resurfacing is an effective and safe treatment option in selected cases.

Sports activity after surgical treatment of intra-articular tibial plateau fractures in skiers.

PubMed

Loibl, Markus; Bäumlein, Martin; Massen, Felix; Gueorguiev, Boyko; Glaab, Richard; Perren, Thomas; Rillmann, Paavo; Ryf, Christian; Naal, Florian D

2013-06-01

Tibial plateau fractures occur frequently while participating in winter sports, but there is no information on whether skiers can resume sports and recreational activities after internal fixation of these fractures. Skiers can resume low-impact sports activity after internal fixation of tibial plateau fractures. Case series; Level of evidence, 4. A total of 103 patients were surveyed by postal questionnaires to determine their sports activities at a mean of 7.8 ± 1.8 years after internal fixation of intra-articular tibial plateau fractures. The survey also included the Lysholm score, the Tegner activity scale, and a visual analog scale (VAS) for pain. At the time of the survey, 88% of the patients were engaged in sports activities (rate of return to sports, 88%), and 53% continued to participate in downhill skiing. The median number of different activities declined from 5 (range, 1-17) preoperatively to 4 (range, 0-11) postoperatively (P < .01). Sports frequency and duration per week did not change: 3 (range, 1-7) preoperatively versus 3 (range, 0-7) postoperatively (P = .275) and 4 hours (range, 1-16 hours) preoperatively versus 3.5 hours (range, 0-15 hours) postoperatively (P = .217), respectively. Median values of all outcome scores declined: Lysholm score, 100 (range, 85-100) preoperatively versus 94.5 (range, 37-100) postoperatively (P < .01); VAS, 0 (range, 0-7) preoperatively versus 1 (range, 0-8) postoperatively (P < .01). Median Tegner activity scale scores declined in all age groups except for patients aged 51 to 60 years. The ability to participate in sports at the time of follow-up compared with the ability before the accident was rated as "similar" by 57 patients (62.0%) and as "worse" by 35 patients (38.0%). The more severe fracture types, B3 and C3 according to the AO classification system, were associated with poorer outcomes related to return to sports and functional scores. A large percentage of skiers with surgically treated intra-articular tibial plateau fractures cannot continue to participate in downhill skiing; however, the majority could resume an active lifestyle for several years after the trauma. Fracture type seems to be an important factor influencing physical activity and general functional outcome.

Torsional osteotomies of the tibia in patellofemoral dysbalance.

PubMed

Dickschas, Jörg; Tassika, Aliki; Lutter, Christoph; Harrer, Jörg; Strecker, Wolf

2017-02-01

Anterior knee pain or patellofemoral instability is common symptom of patellofemoral dysbalance or maltracking. Tibial torsional deformities can be the reason of this pathology. After appropriate diagnostic investigation, the treatment of choice is a torsional osteotomy. This study addresses the diagnostic investigation, treatment, and the outcome of torsional osteotomies of the tibia. Does this treatment result in patellofemoral stability and provide pain relief? Forty-nine tibial torsional osteotomies were included. The major symptoms were patellofemoral instability in 19 cases and anterior knee pain in 42 cases. In addition to clinical and radiographic analysis, a torsional angle CT scan was performed pre-operatively. A visual analog scale (VAS), the Japanese Knee Society score, the Tegner activity score, and the Lysholm score were assessed pre-operatively and at the 42-month follow-up. Mean tibial external torsion was 47.4° (SD 5.41; range 37°-66°; standard value 34°). Surgical treatment consisted of an acute supratuberositary tibial internal torsional osteotomy (mean 10.8°; SD 3.01°; range 5°-18°). At the follow-up investigation, the Tegner activity score was increased 0.4 points (p value 0.014) from 3.9 (SD 1.33; range 2-7) to 4.3 (SD 1.25; range 0-7). The Lysholm score increased 26 points (SD 16.32; p value 0.001) from 66 (SD 14.94; range 32-94) to 92 (SD 9.29; range 70-100) and the Japanese Knee Society score increased 18 points (SD 14.70; p value 0.001) from 72 (SD 13.72, range 49-100) to 90 (SD 9.85, range 60-100). VAS was reduced 3.4 points (SD 2.89; p value 0.001) from 5.7 (SD 2.78; range 0-10) to 2.3 (SD 1.83; range 0-7). As regards patellofemoral instability, no redislocation occurred in the follow-up period. The results of this study show that in cases of tibial maltorsion, a torsional osteotomy can lead to patellofemoral stability and pain relief, and should be considered as a treatment option. The improved clinical scores in the present investigation show the value of the procedure. Level of evidence Level IV.

Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy.

PubMed

Abat, F; Gelber, P E; Polidori, F; Monllau, J C; Sanchez-Ibañez, J M

2015-04-01

To investigate the outcome of ultrasound (US)-guided intratissue percutaneous electrolysis (EPI(®)) and eccentric exercise in the treatment of patellar tendinopathy during a long-term follow-up. Forty patients with patellar tendinopathy were prospectively evaluated over a 10-year follow-up period. Pain and function were evaluated before treatment, at 3 months and at 2, 5 and 10 years using the Victorian Institute of Sport Assessment-Patella (VISA-P) score, the Tegner score and Blazina's classification. According to VISA-P score at baseline, patients were also dichotomized into Group 1 (<50 points) and Group 2 (≥50 points). There were 21 patients in Group 1 and 19 in Group 2. Patient satisfaction was measured according to the Roles and Maudsley score. The VISA-P score improved globally by 41.2 points (p < 0.01) after a mean 4.1 procedures. In Group 1, VISA-P score improved from 33.1 ± 13 to 78.9 ± 14.4 at 3-month and to 88.8 ± 10.1 at 10-year follow-up (p < 0.001). In Group 2, VISA-P score improved from 69.3 ± 10.5 to 84.9 ± 9 at 3-month and to 96.0 ± 4.3 at 10-year follow-up (p < 0.001). After 10 years, 91.2 % of the patients had a VISA-P score >80 points. The same level (80 % of patients) or the Tegner score at no more than one level lower (20 % of patients) was restored, and 97.5 % of the patients were satisfied with the procedure. Treatment with the US-guided EPI(®) technique and eccentric exercises in patellar tendinopathy resulted in a great improvement in knee function and a rapid return to the previous level of activity after few sessions. The procedure has proved to be safe with no recurrences on a long-term basis. Therapeutic study, Level IV.

Comparative Matched-Pair Analysis of the Injection Versus Implantation of Mesenchymal Stem Cells for Knee Osteoarthritis.

PubMed

Kim, Yong Sang; Kwon, Oh Ryong; Choi, Yun Jin; Suh, Dong Suk; Heo, Dong Beom; Koh, Yong Gon

2015-11-01

The mesenchymal stem cell (MSC)-based tissue engineering approach has been developed to address the problem of articular cartilage repair in knee osteoarthritis (OA). However, the most effective method of MSC application has not yet been established. To compare the injection and implantation of MSCs in patients with knee OA in terms of clinical and second-look arthroscopic outcomes. Cohort study; Level of evidence, 3. Among 182 patients treated with arthroscopic surgery using MSCs for knee OA from October 2010 to August 2012, patients treated with an injection of MSCs in combination with platelet-rich plasma (injection group; n = 20) were pair-matched with patients who underwent MSC implantation on a fibrin glue scaffold (implantation group; n = 20) based on sex, age, and lesion size. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score and Tegner activity scale, and cartilage repair was assessed arthroscopically with the International Cartilage Repair Society (ICRS) grading system. The mean (±SD) IKDC and Tegner activity scores significantly improved from 38.5 ± 9.2 to 55.2 ± 15.0 and from 2.5 ± 1.2 to 3.5 ± 1.2, respectively, in the injection group and from 36.6 ± 4.9 to 62.7 ± 14.1 and from 2.3 ± 0.9 to 3.6 ± 1.1, respectively, in the implantation group at the time of second-look arthroscopic surgery (mean, 12.6 months postoperatively) (P < .001 in all cases). At final follow-up (mean, 28.6 months postoperatively), the mean IKDC and Tegner activity scores in the implantation group had improved further to 64.8 ± 13.4 and 3.9 ± 1.0, respectively (P < .001 and P = .035, respectively), while no significant improvements were found in the injection group (P = .130 and P = .655, respectively). At final follow-up, there was a significant difference in the mean IKDC score between groups (P = .049). Significant correlations between the number of administered MSCs and the postoperative clinical outcomes were found only in the injection group. Significant correlations between the clinical outcomes and the ICRS grades were found in both groups. The ICRS grades were significantly better in the implantation group (P = .041). In the injection group, 2 of the 20 lesions (10%) were grade I (normal), 5 (25%) were grade II (near normal), 8 (40%) were grade III (abnormal), and 5 (25%) were grade IV (severely abnormal). In the implantation group, 6 of the 20 lesions (30%) were grade I, 7 (35%) were grade II, 4 (20%) were grade III, and 3 (15%) were grade IV. Utilizing the described method, MSC implantation for knee OA resulted in better clinical and second-look arthroscopic outcomes than an MSC injection. © 2015 The Author(s).

[Rudolph Tegner: The blind from Marrakech (1949-1950)].

PubMed

Norn, M; Permin, H

1999-01-01

The Danish sculptor and painter Rudolph Tegner (1873-1950) has built his own Museum in Dronningmolle, where his sculptures enrich the unique landscape. His last and incomplete plaster on a simple, raw wooden scaffold sculpture The Blind from Marrakech (Fig. 1) show five persons moan about, carrying a dead body. All persons are missing their arms. Tegner had a number of years earlier been in Marrakech and had watched a funeral procession, where blind beggars had carried a dead old woman raised high above the bearers on a kind of pall. In a small version of the statue cast, later in bronze from 1963, showed 15 bearers, on both sides of the bier (Fig. 2 & 3). Nine and 15 bearers are looking up, two right in front, and the rest are looking down. Totally blind people can not see the light but can see up to the divine Heaven. Some blind have kept the gleam. The confusion with the eye direction shows that they really are blind. However 10 of the 15 blind people had hollow in the eye (excenteratio orbitae) in contrast to the dead woman. The dead woman had been the blinds' mistress. The last work The Blind in Marrakech may also be the despair of the artist.

Translation, Cross-Cultural Adaptation, and Validation of the Activity Rating Scale for Disorders of the Knee.

PubMed

Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva

2017-09-01

The Activity Rating Scale (ARS) for disorders of the knee evaluates the level of activity by the frequency of participation in 4 separate activities with high demands on knee function, with a score ranging from 0 (none) to 16 (pivoting activities 4 times/wk). To translate and cross-culturally adapt the ARS into Swedish and to assess measurement properties of the Swedish version of the ARS. Cohort study (diagnosis); Level of evidence, 2. The COSMIN guidelines were followed. Participants (N = 100 [55 women]; mean age, 27 years) who were undergoing rehabilitation for a knee injury completed the ARS twice for test-retest reliability. The Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale (TAS), and modernized Saltin-Grimby Physical Activity Level Scale (SGPALS) were administered at baseline to validate the ARS. Construct validity and responsiveness of the ARS were evaluated by testing predefined hypotheses regarding correlations between the ARS, KOOS, TAS, and SGPALS. The Cronbach alpha, intraclass correlation coefficients, absolute reliability, standard error of measurement, smallest detectable change, and Spearman rank-order correlation coefficients were calculated. The ARS showed good internal consistency (α ≈ 0.96), good test-retest reliability (intraclass correlation coefficient >0.9), and no systematic bias between measurements. The standard error of measurement was less than 2 points, and the smallest detectable change was less than 1 point at the group level and less than 5 points at the individual level. More than 75% of the hypotheses were confirmed, indicating good construct validity and good responsiveness of the ARS. The Swedish version of the ARS is valid, reliable, and responsive for evaluating the level of activity based on the frequency of participation in high-demand knee sports activities in young adults with a knee injury.

An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 2: Functional Performance Tests Correlate With Return-to-Sport Outcomes.

PubMed

McGrath, Timothy M; Waddington, Gordon; Scarvell, Jennie M; Ball, Nick; Creer, Rob; Woods, Kevin; Smith, Damian; Adams, Roger

2017-02-01

Additional high-quality prospective studies are needed to better define the objective criteria used in relation to return-to-sport decisions after anterior cruciate ligament (ACL) reconstruction in active populations. To investigate prospectively the relationship between functional performance test results at 24 weeks postoperative and return-to-sport activity (Tegner activity score) at 12 and 24 months, respectively, after synthetic (ligament advanced reinforcement system [LARS]) and autograft (doubled semitendinosus/gracilis [2ST/2GR]) ACL reconstructions. Case series; Level of evidence, 4. A total of 64 patients who underwent ACL reconstruction (32 LARS, 32 2ST/2GR autograft; mean age, 27.9 years; body mass index [BMI], 24.9 kg/m 2 ) were assessed preoperatively and at staged intervals postoperatively up to 24 weeks for isokinetic testing of quadriceps and hamstring average power per repetition at 60 deg/s and 180 deg/s, a battery of hop tests, peak vertical ground-reaction force (vGRF), and time to peak vGRF (in seconds) during a step- and jump-down task onto a force platform and peak speed (m/s) using a global positioning system (GPS unit) during a running task. A cohort of 32 healthy matched participants (mean age, 26.31 years; BMI, 25.7 kg/m 2 ) were also tested to act as reference. Pearson correlation was calculated to assess correlation of each performance measure at 24 weeks postoperative with activity outcomes (Tegner score) at 12 and 24 months. The strongest correlation between physical performance tests and return-to-sport outcomes was observed with peak speed during running. Large correlations were also observed for hamstring isokinetic power and hop test for distance. Moderate correlations were observed for timed hop, peak vGRF during a jump-down task, and quadriceps isokinetic power. No statistical correlations were observed for time to peak vGRF during a step-down and jump-down task as well as peak vGRF during a step-down task. When the performance tests were pooled together, mean postoperative improvements of 24% were observed from preoperative to 24 weeks within the surgical cohort. For each performance test, preoperative level of function strongly correlated with performance levels on the same test at 24 weeks. The results of this study indicate that clinicians might seek to prioritize these tests and the rehabilitation themes they imply when seeking to maximize postoperative ACL activity outcomes. The observed strength between pre- and postoperative performance tests and return-to-sport outcomes within this study highlights the potential value of preoperative conditioning before undergoing ACL reconstruction. Future research should examine absolute predictive criterion thresholds for functional performance-based tests and reinjury risk reduction after ACL reconstruction.

Effectiveness of the Intratissue Percutaneous Electrolysis (EPI®) technique and isoinertial eccentric exercise in the treatment of patellar tendinopathy at two years follow-up.

PubMed

Abat, Ferran; Diesel, Wayne-J; Gelber, Pablo-E; Polidori, Fernando; Monllau, Joan-Carles; Sanchez-Ibañez, Jose-Manuel

2014-04-01

to show the effect of Intratissue Percutaneous Electrolysis (EPI®) combined with eccentric programme in the treatment of patellar tendinopathy. prospective study of 33 athlete-patients consecutively treated for insertional tendinopathy with Intratissue Percutaneous Electrolysis (EPI®) and followed for 2 years. Functional assessment was performed at the first visit, at three months and two years with the Tegner scale and VISA-P. an average improvement in the VISA-P of 35 points was obtained. The mean duration of treatment was 4.5 weeks. Some 78.8% of the patients returned to the same level of physical activity as before the injury by the end of treatment, reaching 100% at two years. intratissue percutaneous electrolysis (EPI®) combined with an eccentric-based rehab program offers excellent results in terms of the clinical and functional improvement of the patellar tendon with low morbidity in a short-term period. Therapy, level 4.

Sport and physical activity following unicompartmental knee arthroplasty: a systematic review.

PubMed

Waldstein, Wenzel; Kolbitsch, Paul; Koller, Ulrich; Boettner, Friedrich; Windhager, Reinhard

2017-03-01

Unicompartmental knee arthroplasty (UKA) can be a surgical treatment option for patients with high expectations regarding the post-operative level of physical activity. A systematic review was undertaken to answer three research questions: (1) is there an improvement of physical activity based on validated activity scores following UKA? (2) What are the sport disciplines and the sport patterns of UKA patients? (3) What are the pre- and post-operative sport participation rates and the return to activity rates of UKA patients? Following the PRISMA guidelines, EMBASE, MEDLINE, ISI Web of Science and the Cochrane Central Register of Controlled Trials were searched for studies reporting the level of sport and/or physical activity before and after UKA, and/or included at least one activity score before and after UKA. Seventeen studies were identified reporting on 2972 UKAs, of which 89 % were medial UKAs and 92 % were mobile-bearing implants, respectively. Ten studies reported a statistically significant improvement of physical activity following UKA according to the UCLA activity score, the Tegner activity score or the High Activity Arthroplasty Score, respectively. Hiking, cycling and swimming are the most common activities following UKA. Sport participation before the onset of restricting symptoms ranged from 64 to 93 % and slightly decreased by 2-9 % following UKA. The return to activity rate ranged from 87 to 98 %. Patients following UKA are physically active according to validated activity scores. A significant increase in low-impact activities and a decrease in high-impact activities after UKA was observed. Patients with a UKA regularly participate in sports; however, sport participation slightly decreased compared to pre-arthritic levels. This systematic review helps physicians to manage the expectations of patients regarding the level of physical activity following UKA. III.

Isolated and combined medial patellofemoral ligament reconstruction in revision surgery for patellofemoral instability: a prospective study.

PubMed

Kohn, Ludwig M; Meidinger, Gebhart; Beitzel, Knut; Banke, Ingo J; Hensler, Daniel; Imhoff, Andreas B; Schöttle, Philip B

2013-09-01

Persistent pain and redislocations after surgical treatment of patellofemoral instability are described in up to 40% of patients. However, prospective outcome data about revision surgery are missing. To evaluate the clinical outcome after revision medial patellofemoral ligament (MPFL) reconstruction using isolated and combined procedures, with a follow-up of 24 months. Case series; Level of evidence, 4. Study participants were 42 patients (median age, 22 years; range, 13-46 years) who underwent revision surgery between January 2007 and December 2009 because of persistent patellofemoral instability after a mean of 1.8 previous failed surgical interventions (lateral release, medial imbrication/vastus medialis obliquus distalization, medialization of the tuberosity). An isolated MPFL reconstruction was performed in 15 cases, while a combination procedure was performed in 27 cases. The clinical results were evaluated preoperatively and 24 months postoperatively using the International Knee Documentation Committee (IKDC), Kujala, and Tegner scores as well as a subjective questionnaire. Patellar shift, tilt, and height, as well as level of degeneration, were defined preoperatively and at the latest follow-up on plain radiographs and magnetic resonance imaging. At 24-month follow-up, 87% of the patients were satisfied or very satisfied with the treatment. No apprehension or redislocation was reported at follow-up, and there was a significant decrease in pain during daily activities. There were significant improvements (P < .001) in IKDC (from 50 to 80), Kujala (from 51 to 85), and Tegner scores (from 2.4 to 4.9). Patellar shift, tilt, and height decreased significantly (P < .05) to anatomic values, and there was no aggravation to the level of pre-existing degeneration. No significant difference was noticed between the isolated and combined procedures. As patellofemoral instability is a multifactorial problem, revision surgery should be indicated only after a comprehensive examination. The results of this study show that MPFL reconstruction, alone or in combination, seems to be an effective treatment for recurrent patellar dislocations after a failed previous surgery, leading to significant increases in stability and functionality as well as a reduction in pain.

Clinical and Functional Outcomes following Primary Repair versus Reconstruction of the Medial Patellofemoral Ligament for Recurrent Patellar Instability

PubMed Central

Kuenze, Christopher M.; Diduch, David R.; Miller, Mark D.; Milewski, Matthew D.; Hart, Joseph P.

2014-01-01

Background. The purpose of this study was to compare outcomes of medial patellofemoral ligament (MPFL) repair or reconstruction. Methods. Fourteen knees that underwent MPFL repair and nine (F5, M4) knees that underwent reconstruction at our institution were evaluated for objective and subjective outcomes. The mean age at operation was 20.1 years for repair and 19.8 years for reconstruction. All patients had a minimum of 2 years of follow-up (range: 24–75 months). Patient subjective outcomes were obtained using the International Knee Documentation Committee (IKDC) and Kujala patellofemoral subjective evaluations, as well as Visual Analog (VAS) and Tegner Activity Scales. Bilateral isometric quadriceps strength and vastus medialis obliquus (VMO) and vastus lateralis (VL) surface EMG were measured during maximal isometric quadriceps contractions at 30° and 60° of flexion. Results. There were no redislocations in either group. There was no difference in IKDC (P = 0.16), Kujala (P = 0.43), Tegner (P = 0.12), or VAS (P = 0.05) scores at follow-up. There were no differences between repair and reconstruction in torque generation of the involved side at 30° (P = 0.96) and 60° (P = 0.99). In addition, there was no side to side difference in torque generation or surface EMG activation of VL or VMO. Conclusions. There were minimal differences found between patients undergoing MPFL repair and MPFL reconstruction for the objective and subjective evaluations in this study. PMID:26464893

Revision anterior cruciate ligament reconstruction with nonirradiated fresh-frozen patellar tendon allograft.

PubMed

Fox, Jeff A; Pierce, Mark; Bojchuk, John; Hayden, Jennifer; Bush-Joseph, Charles A; Bach, Bernard R

2004-10-01

To evaluate the effectiveness of a revision anterior cruciate ligament reconstruction with nonirradiated patellar tendon allograft used to salvage a failed index patellar tendon autograft procedure. Retrospective case series with minimum 2-year follow-up. Between 1993 and 1999, 39 patients underwent a revision reconstruction. Clinical, radiographic, arthrometric, and functional evaluations were performed. The Tegner, Lysholm, Noyes, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and SF-12 rating scales were used. Statistical analysis was conducted with our Biostatistics Department. Thirty-two of 38 patients (84%) were personally evaluated. The mean patient age was 28 years (range, 16 to 57 years); the mean follow-up was 4.8 years (range, 2.1 to 12.1 years). After revision, there were significant improvements in the Lachman and pivot-shift test results: 87% had a grade 0/1+ Lachman and a 0/1+ pivot-shift. However, 25% had a grade 1+ pivot-shift. Postoperatively, KT-1000 testing revealed that 84% had a maximum manual side-to-side difference of < or =3 mm and 6% had >5 mm. Functional testing revealed a mean 4% difference in side-to-side comparisons for a single-leg hop for distance and time, as well as vertical jump. The mean results of Noyes sports function (72), Lysholm (75), Tegner (6.3), KOOS sports activity scale (67), SF-12 physical component (48), SF-12 mental component (55), and IKDC (71) were obtained. The Noyes sports activity score showed a significant improvement from 55 preoperatively to 70 at follow-up. Subjectively, 87% of patients indicated that they were completely or mostly satisfied with the surgical outcome. One patient required another revision. The 2- to 11-year follow-up showed that the results of revision ACL reconstruction with a nonirradiated patellar tendon allograft were less favorable than those of a primary anterior cruciate ligament reconstruction, with a lower subjective satisfaction level and a higher percentage of patients with grade 1+ or higher pivot-shift results. However, when compared with previously published reports, our results were comparable and underscore that revision anterior cruciate ligament surgery should be approached with tempered enthusiasm and careful preoperative counseling, and considered as a salvage procedure. Level IV.

Comparison of arthroscopic medial meniscal suture repair techniques: inside-out versus all-inside repair.

PubMed

Choi, Nam-Hong; Kim, Tae-Hyung; Victoroff, Brian N

2009-11-01

There are no reports comparing meniscal healing between inside-out and all-inside repairs using sutures. No difference in healing rate exists between meniscal repairs with inside-out and all-inside suture repair in conjunction with anterior cruciate ligament reconstruction with hamstring tendon. Cohort study; Level of evidence, 2. Forty-eight consecutive patients underwent meniscal repairs of longitudinal tears of the posterior horn of the medial meniscus combined with anterior cruciate ligament reconstructions. All-inside repair was attempted when the tears were located in the red-red zone or the ramp area of the meniscus. If a tear that was in the ramp area or red-red zone extended to the midbody of the meniscus, or if there was a tear in red-white zone, the inside-out repair technique was used. Fourteen patients had all-inside meniscal repairs, and 34 patients had inside-out meniscal repairs with absorbable sutures. Identical postoperative rehabilitation protocols were used. Postoperative evaluations included Lysholm knee scoring scale, Tegner activity levels, Lachman and pivot-shift tests, and KT-1000 arthrometer. Assessment of meniscal status was performed using joint line tenderness, McMurray test, and range of motion. Follow-up magnetic resonance imaging scans were obtained on all patients. Mean follow-up was 35.7 months. No patient had joint line tenderness or reported pain or clicking on McMurray test. There was no significant difference in range of motion between groups. Follow-up magnetic resonance imaging scans demonstrated that 10 (71.4%) menisci were healed and 4 (28.6%) partially healed in the all-inside group; 24 (70.6%) menisci were healed and 10 (29.4%) partially healed in the inside-out group. There was no significant difference in meniscal healing between groups. There were no differences in Lachman test, KT-1000 arthrometer side-to-side differences measurements, Lysholm scores, and Tegner activity scales. There was a significant difference in pivot-shift test between groups (P = .023). There were 2 complications associated with surgery. In the inside-out group, 1 patient required manipulation, and 2 patients had limited motion at final follow-up. Two patients in the inside-out group experienced transient saphenous nerve injury. There was no significant difference in meniscal healing between inside-out and all-inside repair techniques in combination with anterior cruciate ligament reconstructions.

Repair of Meniscal Ramp Lesions Through a Posteromedial Portal During Anterior Cruciate Ligament Reconstruction: Outcome Study With a Minimum 2-Year Follow-up.

PubMed

Thaunat, Mathieu; Jan, Nicolas; Fayard, Jean Marie; Kajetanek, Charles; Murphy, Colin G; Pupim, Barbara; Gardon, Roland; Sonnery-Cottet, Bertrand

2016-11-01

To evaluate the results of arthroscopic all-inside suture repair of medial meniscal ramp lesions through a posteromedial portal during anterior cruciate ligament (ACL) reconstruction. All patients who underwent a suture of the posterior segment of the medial meniscus using a suture hook device through a posteromedial portal during ACL reconstruction with minimum 2 year-follow-up were included in the study. Repair was performed for longitudinal tears within the rim of less than 3 mm (capsulomeniscal junction or red-red zone) or 3 to 5 mm (red-white zone) of an unstable torn meniscus. Patients were assessed pre- and postoperatively with IKDC score and Tegner activity scale. Instrumented knee testing was performed with the Rolimeter arthrometer. Complications including reoperation for failed meniscal repair were also recorded. One hundred thirty-two patients met the inclusion criteria. The mean follow-up time was 27 months (range, 24 to 29 months). The average subjective IKDC rose from 63.8 ± 13.5 (range, 27 to 92) preoperatively to 85.7 ± 12 (range, 43 to 100) at last follow-up (P < .0001). The Rolimeter test decreased from a side-to-side difference in anterior knee laxity of 7 mm (range, 5 to 14 mm) to a mean value of 0.4 mm (range, -3 to 5 mm) at last follow-up (P < .0001). The Tegner activity scale at the last follow-up (6.9 ± 1.72) was slightly lower than that before surgery (7.2 ± 1.92; P = .0017). Nine patients (6.8%) had failure of the meniscal repair. In 5 cases, recurrent tears were related to a newly formed tear located anterior to the initial tear. Our results show that arthroscopic meniscal repair of ramp lesions during ACL reconstruction through a posteromedial portal provided a high rate of meniscus healing at the level of the tear and appeared to be safe and effective in this group of patients. Level IV, therapeutic study, case series (no control group). Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Posterior Meniscal Root Repairs: Outcomes of an Anatomic Transtibial Pull-Out Technique.

PubMed

LaPrade, Robert F; Matheny, Lauren M; Moulton, Samuel G; James, Evan W; Dean, Chase S

2017-03-01

Outcomes after transtibial pull-out repair for posterior meniscal root tears remain underreported, and factors that may affect outcomes are unknown. Purpose/Hypothesis: The purpose of this study was to compare patient-centered outcomes after transtibial pull-out repair for posterior root tears in patients <50 and ≥50 years of age. We hypothesized that improvement in function and activity level at minimum 2-year follow-up would be similar among patients <50 years of age compared with patients ≥50 years and among patients undergoing medial versus lateral root repairs. Cohort study; Level of evidence, 3. Inclusion criteria were patients aged 18 years or older who underwent anatomic transtibial pull-out repair of the medial or lateral posterior meniscus root by a single surgeon. All patients were identified from a data registry consisting of prospectively collected data in a consecutive series. Cohorts were analyzed by age (<50 years [n = 35] vs ≥50 years [n = 15]) and laterality (lateral [n = 15] vs medial [n = 35]). Patients completed a subjective questionnaire preoperatively and at minimum of 2 years postoperatively (Lysholm, Tegner, Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], 12-Item Short Form Health Survey [SF-12], and patient satisfaction with outcome). Failure was defined as revision meniscal root repair or partial meniscectomy. The analysis included 50 knees in 49 patients (16 females, 33 males; mean age, 38.3 years; mean body mass index, 26.6). Of the 50 knees, 45 were available for analysis. Three of 45 (6.7%) required revision surgery. All failures were in patients <50 years old, and all failures underwent medial root repair. No significant difference in failure was found based on age ( P=.541) or laterality ( P = .544). For age cohorts, Lysholm and WOMAC scores demonstrated significant postoperative improvement. For laterality cohorts, all functional scores significantly improved postoperatively. No significant difference was noted in postoperative Lysholm, WOMAC, SF-12, Tegner, or patient satisfaction scores for the age cohort or the laterality cohort. Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. Patients <50 years had outcomes similar to those of patients ≥50 years, as did patients who underwent medial versus lateral root repair. Transtibial double-tunnel pull-out meniscal root repair provided improvement in function, pain, and activity level, which may aid in delayed progression of knee osteoarthritis.

Does an injection of a stromal vascular fraction containing adipose-derived mesenchymal stem cells influence the outcomes of marrow stimulation in osteochondral lesions of the talus? A clinical and magnetic resonance imaging study.

PubMed

Kim, Yong Sang; Lee, Ho Jin; Choi, Yun Jin; Kim, Yong Il; Koh, Yong Gon

2014-10-01

Marrow stimulation for the treatment of osteochondral lesions of the talus (OLTs) is controversial in patients with poor prognostic factors of OLTs. Currently, mesenchymal stem cells (MSCs) are expected to biologically augment the treatment of OLTs. To compare the clinical and magnetic resonance imaging (MRI) outcomes between an injection of MSCs with marrow stimulation and marrow stimulation alone in patients with OLTs. Cohort study; Level of evidence, 3. A total of 49 patients (50 ankles) with OLTs underwent follow-up MRI after arthroscopic treatment. Among these 50 ankles, 26 underwent marrow stimulation alone (conventional group), and 24 underwent marrow stimulation with an injection of a stromal vascular fraction (SVF) containing MSCs (MSC group). Clinical outcomes were evaluated according to the visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and Tegner activity scale. The magnetic resonance observation of cartilage repair tissue (MOCART) score was used for the MRI evaluation of repaired lesions. The mean VAS score, AOFAS score, and Tegner score improved from 7.1 ± 1.2, 68.5 ± 5.6, and 3.4 ± 0.6 to 3.9 ± 0.8, 78.3 ± 4.9, and 3.5 ± 0.8, respectively, in the conventional group and from 7.1 ± 0.8, 67.7 ± 4.7, and 3.4 ± 0.5 to 3.2 ± 0.8, 83.3 ± 7.0, and 3.9 ± 0.7, respectively, in the MSC group. All clinical outcomes, including the VAS, AOFAS, and Tegner scores, improved significantly in the MSC group compared with the conventional group (P = .003, .009, and .041, respectively). There was a significant difference (P = .037) in the mean MOCART score between the conventional and MSC groups (49.4 ± 16.6 vs 62.1 ± 21.8, respectively), and significant correlations of the MOCART score with clinical outcomes were found in both groups (P < .05). Patient age (≥46.1 years), large lesion size (≥151.2 mm(2)), and the presence of subchondral cysts were associated with a worse MOCART score in the conventional group (P = .015, .004, and .013, respectively) but not in the MSC group. Clinical and MRI outcomes of an injection of an SVF containing MSCs with marrow stimulation were encouraging, compared with marrow stimulation alone, for the treatment of OLTs. Therefore, an injection of an SVF containing MSCs with marrow stimulation should be considered as a treatment for OLTs, even when poor prognostic factors, including older age, large-sized lesion, or the presence of subchondral cysts, exist. © 2014 The Author(s).

[Clinical and radiographic correlation after anterior cruciate ligament reconstruction].

PubMed

González Perales, Aldo Alán; Negrete Corona, Jorge; Chávez Hinojosa, Edgard

2010-01-01

The purpose of this work is to correlate the clinical, functional and radiographic results of the anterior cruciate ligament (ACL) reconstruction with the angulation and orientation of the femoral and tibial tunnels. The ACL is one of the most frequently injured articular structures of the knee. The reason for this being that it is the primary limiting structure of anterior tibial translation; its tear causes kinematic alterations and results in long-term degenerative and functional changes. Repair can restore the kinematics. 26 patients, 20-50 years old, post-ACL reconstruction with the semitendinous-gracilis technique. From November 2006 to July 2007. Clinical and functional assessments: Tegner and Lysholm. Radiographic assessment: anteroposterior view with knee extension and lateral view with 30 degrees flexion. Pearson correlations (r) were used in the analysis. 26 patients (100%), 20 males (76.92%), 6 females (23.08%). Mean of 2.4 in the Lysholm scale (fair to good); standard deviation 1.2. Bernard-Lysholm quadrant r = -0.772. Tegner quadrant r = 0.790. The Lysholm and Tegner scale is associated with the graft quadrant. The situation of the tibial implant in the saggital plane is associated with the Lysholm scale. The correlation of patients with an inadequate placement with respect to the quadrants was associated with good-to-excellent results and fair-to-good results. Two patients had a poor clinical outcome; the orientation of the AP angle and the quadrant were within acceptable parameters, with the exception of the lateral angle-shaft axis.

A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability.

PubMed

Endres, Stefan; Wilke, Axel

2011-02-18

A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS) and Tegner-Score. Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

Translation, Cross-Cultural Adaptation, and Validation of the Activity Rating Scale for Disorders of the Knee

PubMed Central

Flosadottir, Vala; Roos, Ewa M.; Ageberg, Eva

2017-01-01

Background: The Activity Rating Scale (ARS) for disorders of the knee evaluates the level of activity by the frequency of participation in 4 separate activities with high demands on knee function, with a score ranging from 0 (none) to 16 (pivoting activities 4 times/wk). Purpose: To translate and cross-culturally adapt the ARS into Swedish and to assess measurement properties of the Swedish version of the ARS. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The COSMIN guidelines were followed. Participants (N = 100 [55 women]; mean age, 27 years) who were undergoing rehabilitation for a knee injury completed the ARS twice for test-retest reliability. The Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale (TAS), and modernized Saltin-Grimby Physical Activity Level Scale (SGPALS) were administered at baseline to validate the ARS. Construct validity and responsiveness of the ARS were evaluated by testing predefined hypotheses regarding correlations between the ARS, KOOS, TAS, and SGPALS. The Cronbach alpha, intraclass correlation coefficients, absolute reliability, standard error of measurement, smallest detectable change, and Spearman rank-order correlation coefficients were calculated. Results: The ARS showed good internal consistency (α ≈ 0.96), good test-retest reliability (intraclass correlation coefficient >0.9), and no systematic bias between measurements. The standard error of measurement was less than 2 points, and the smallest detectable change was less than 1 point at the group level and less than 5 points at the individual level. More than 75% of the hypotheses were confirmed, indicating good construct validity and good responsiveness of the ARS. Conclusion: The Swedish version of the ARS is valid, reliable, and responsive for evaluating the level of activity based on the frequency of participation in high-demand knee sports activities in young adults with a knee injury. PMID:28979920

Measuring physical activity and sports participation after autologous cartilage implantation: a systematic review.

PubMed

Santos-Magalhaes, Andre Filipe; Hambly, Karen

2014-08-01

The assessment of physical activity and return to sport and exercise activities is an important component in the overall evaluation of outcome after autologous cartilage implantation (ACI). To identify the patient-report instruments that are commonly used in the evaluation of physical activity and return to sport after ACI and provide a critical analysis of these instruments from a rehabilitative perspective. A computerized search was performed in January 2013 and repeated in March 2013. Criteria for inclusion required that studies (1) be written in English and published between 1994 and 2013; (2) be clinical studies where knee ACI cartilage repair was the primary treatment, or comparison studies between ACI and other techniques or between different ACI generations; (3) report postoperative physical activity and sport participation outcomes results, and (4) have evidence level of I-III. Twenty-six studies fulfilled the inclusion criteria. Three physical activity scales were identified: the Tegner Activity Scale, Modified Baecke Questionnaire, and Activity Rating Scale. Five knee-specific instruments were identified: the Lysholm Knee Function Scale, International Knee Documentation Committee Score Subjective Form, Knee Injury and Osteoarthritis Outcome Score, Modified Cincinnati Knee Score, and Stanmore-Bentley Functional Score. Considerable heterogeneity exists in the reporting of physical activity and sports participation after ACI. Current instruments do not fulfill the rehabilitative needs in the evaluation of physical activity and sports participation.

Clinical Outcome and Return to Competition after Microfracture in the Athlete’s Knee

PubMed Central

Mithoefer, Kai; Gill, Thomas J.; Cole, Brian J.; Williams, Riley J.; Mandelbaum, Bert R.

2010-01-01

Microfracture is frequently used for articular cartilage repair in athletes. This study aimed to define the strength and weaknesses of this minimally invasive cartilage repair technique in the athletic population in an effort to optimize indications, functional outcome, and athletic participation after microfracture in the athlete’s knee. A systematic analysis of original studies using microfracture in athletes was performed. Functional outcome was assessed by activity outcome scores, ability to return to sports participation, timing of the return to sport, level of postoperative sports activity, and continuation of athletic competition over time. Thirteen studies describing 821 athletes were included in the analysis with an average follow-up of 42 months. Good or excellent results were reported in 67% of athletes with normal International Knee Documentation Committee (IKDC) scores in 80% and significant increase of Lysholm scores, Tegner activity scores, and Knee injury and Osteoarthritis Outcome Score (KOOS) sports subscales. Return to sports was achieved in 66% at an average of 8 months after surgery, with return to competition at the preinjury level in 67%. Forty-nine percent of athletes continued to compete without change in level of play, while decreasing function was observed in 42% after 2 to 5 years. Athlete’s age, preoperative duration of symptoms, level of play, lesion size, and repair tissue morphology affected sports activity after microfracture. Microfracture improves knee function and frequently allows for return to sports at the preinjury level, but deterioration of athletic function occurs in some patients. Several independent factors were identified that can help to optimize the return to athletic competition after microfracture in the athlete’s knee. PMID:26069542

Outcomes and Return to Sport After Revision Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

PubMed Central

Saper, Michael; Pearce, Stephanie; Shung, Joseph; Zondervan, Robert; Ostrander, Roger; Andrews, James R.

2018-01-01

Background: The number of adolescent anterior cruciate ligament (ACL) injuries is rising with increased participation in higher level athletics at earlier ages. With an increasing number of primary ACL reconstructions (ACLRs) comes a rise in the incidence of revision ACLRs. Purpose: To evaluate the clinical results of revision ACLR across a group of high-level adolescent athletes with at least 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of 21 adolescent athletes (age range, 10-19 years) who underwent revision ACLR with at least 2-year follow-up was conducted. Patient-reported outcome measures (PROMs) included the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm knee scoring scale, Tegner activity level scale, and modified Cincinnati Knee Rating System. Return to sport (RTS) and overall patient satisfaction were also assessed. Results: The mean age at the time of surgery was 16.5 years (range, 14-19 years), and the mean follow-up was 46.4 months (range, 24-97 months); 42.9% of patients were female, and 52.4% of patients participated in collision sports. The mean time to failure after primary ACLR was 13.1 ± 8.0 months, and the most common mechanism of failure was noncontact in at least 66.7% of cases. The revision graft type included bone–patellar tendon–bone (BPTB) in 71.4% of cases; 26.7% of BPTB grafts were from the contralateral extremity. Concomitant procedures were performed for intra-articular lesions in 71.4% of patients. The mean patient satisfaction rate was 95.3%. There were 3 cases of a graft reinjury at a mean of 25 months postoperatively. The mean PROM scores were as follows: IKDC, 87.5 ± 12.7; Tegner, 7.2 ± 2.0; Lysholm, 93.7 ± 9.8; and Cincinnati, 93.4 ± 10.0. Of those attempting to RTS, 68.4% of patients successfully returned at the same level of competition. Patients with a lateral compartment chondral injury were less likely to RTS (P < .05). Independent variables shown to have no significant relationship to PROMs or RTS included age, follow-up, sport classification, associated meniscal tears, revision graft size/type, and concomitant procedures. Conclusion: Revision ACLR can be an effective surgical option in adolescents participating in collision and contact sports, with good to excellent subjective outcome scores. At a minimum 2-year follow-up, a graft rupture after revision ACLR occurred in 14% of cases. Of the athletes attempting to RTS, 68.4% returned to their preinjury level of competition. PMID:29662910

Visual-Motor Control of Drop Landing After Anterior Cruciate Ligament Reconstruction.

PubMed

Grooms, Dustin R; Chaudhari, Ajit; Page, Stephen J; Nichols-Larsen, Deborah S; Onate, James A

2018-05-11

  Visual feedback is crucial in the control of human movement. When vision is obstructed, alterations in landing neuromuscular control may increase movements that place individuals at risk for injury. Anterior cruciate ligament (ACL) injury may further alter the motor-control response to alterations in visual feedback. The development of stroboscopic glasses that disrupt visual feedback without fully obscuring it has enabled researchers to assess visual-motor control during movements that simulate the dynamic demands of athletic activity.   To investigate the effect of stroboscopic visual-feedback disruption (SVFD) on drop vertical-jump landing mechanics and to determine whether injury history influenced the effect.   Cohort study.   Movement-analysis laboratory.   A total of 15 participants with ACL reconstruction (ACLR; 7 men, 8 women; age = 21.41 ± 2.60 years, height = 1.72 ± 0.09 m, mass = 69.24 ± 15.24 kg, Tegner Activity Scale score = 7.30 ± 1.30, time since surgery = 36.18 ± 26.50 months, hamstrings grafts = 13, patellar tendon grafts = 2) and 15 matched healthy control participants (7 men, 8 women; age = 23.15 ± 3.48 years, height = 1.73 ± 0.09 m, mass = 69.98 ± 14.83 kg, Tegner Activity Scale score = 6.77 ± 1.48).   Drop vertical-jump landings under normal and SVFD conditions.   The SVFD effect for knee sagittal- and frontal-plane excursion, peak moments, and vertical ground reaction force were calculated during landing and compared with previously established measurement error and between groups.   The SVFD altered knee sagittal-plane excursion (4.04° ± 2.20°, P = .048) and frontal-plane excursion (1.98° ± 1.53°, P = .001) during landing above within-session measurement error. Joint-moment difference scores from full vision to the SVFD condition were not greater than within-session error. We observed an effect of ACLR history only for knee flexion (ACLR group = 3.12° ± 3.76°, control group = -0.84° ± 4.45°; P = .001). We did not observe an effect of side or sex.   The SVFD altered sagittal- and frontal-plane landing knee kinematics but did not alter moments. Anterior cruciate ligament reconstruction may induce alterations in sagittal-plane visual-motor control of the knee. The group SVFD effect was on a level similar to that of an in-flight perturbation, motor-learning intervention, or plyometric-training program, indicating that visual-motor ability may contribute to knee neuromuscular control on a clinically important level. The individual effects of the SVFD indicated possible unique sensorimotor versus visual-motor movement strategies during landing.

ACL reconstruction in patients aged 40 years and older: a systematic review and introduction of a new methodology score for ACL studies.

PubMed

Brown, Christopher A; McAdams, Timothy R; Harris, Alex H S; Maffulli, Nicola; Safran, Marc R

2013-09-01

Treatment of the anterior cruciate ligament (ACL)-deficient knee in older patients remains a core debate. To perform a systematic review of studies that assessed outcomes in patients aged 40 years and older treated with ACL reconstruction and to provide a new methodological scoring system that is directed at critical assessment of studies evaluating ACL surgical outcomes: the ACL Methodology Score (AMS). Systematic review. A comprehensive literature search was performed from 1995 to 2012 using MEDLINE, EMBASE, and Scopus. Inclusion criteria for studies were primary ACL injury, patient age of 40 years and older, and mean follow-up of at least 21 months after reconstruction. Nineteen studies met the inclusion criteria from the 371 abstracts from MEDLINE and 880 abstracts from Scopus. Clinical outcomes (International Knee Documentation Committee [IKDC], Lysholm, and Tegner activity scores), joint stability measures (Lachman test, pivot-shift test, and instrumented knee arthrometer assessment), graft type, complications, and reported chondral or meniscal injury were evaluated in this review. A new methodology scoring system was developed to be specific at critically analyzing ACL outcome studies and used to examine each study design. Nineteen studies describing 627 patients (632 knees; mean age, 49.0 years; range, 42.6-60.0 years) were included in the review. The mean time to surgery was 32.0 months (range, 2.9-88.0 months), with a mean follow-up of 40.2 months (range, 21.0-114.0 months). The IKDC, Lysholm, and Tegner scores and knee laxity assessment indicated favorable results in the studies that reported these outcomes. Patients did not demonstrate a significant difference between graft types and functional outcome scores or stability assessment. The mean AMS was 43.9 ± 7.2 (range, 33.5-57.5). The level of evidence rating did not positively correlate with the AMS, which suggests that the new AMS system may be able to detect errors in methodology or reporting that may not be taken into account by the classic level of evidence rating. Patients aged 40 years and older with an ACL injury can have satisfactory outcomes after reconstruction. However, the quality of currently available data is still limited, such that further well-designed studies are needed to determine long-term efficacy and to better inform our patients with regard to expected outcomes.

Collagen Augmentation Improves the Quality of Cartilage Repair After Microfracture in Patients Undergoing High Tibial Osteotomy: A Randomized Controlled Trial.

PubMed

Kim, Man Soo; Koh, In Jun; Choi, Young Jun; Pak, Kyu Hyung; In, Yong

2017-07-01

The quality of cartilage repair after marrow stimulation is unpredictable. To overcome the shortcomings of the microfracture technique, various augmentation techniques have been developed. However, their efficacies remain unclear. The quality of cartilage repair and clinical outcomes would be superior in patients undergoing high tibial osteotomy (HTO) with microfracture and collagen augmentation compared to those undergoing HTO with microfracture alone without collagen augmentation for the treatment of medial compartment osteoarthritis (OA) of the knee. Randomized controlled trial; Level of evidence, 2. Twenty-eight patients undergoing HTO were randomized into 2 groups: microfracture alone (group 1, n = 14) or microfracture with collagen augmentation (group 2, n = 14). At 1 year postoperatively, second-look arthroscopic surgery and biopsy of repaired cartilage were performed at the time of HTO plate removal. Biopsy specimens were graded using the International Cartilage Repair Society Visual Assessment Scale II (ICRS II). In addition, imaging outcomes in terms of the magnetic resonance observation of cartilage repair tissue (MOCART) score were assessed based on magnetic resonance imaging (MRI). Finally, clinical outcomes in terms of the visual analog scale (VAS) for pain score, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, and Tegner activity scale score were evaluated. The mean ICRS II score in group 2 was significantly higher than that in group 1 (1053.2 vs 885.4, respectively; P = .002). Group 2 showed greater improvement in tissue morphology, cell morphology, surface architecture, middle/deep zone assessment, and overall assessment compared with group 1 ( P < .050 for all comparisons). Imaging outcomes based on the MOCART score were superior in group 2 compared to those in group 1 on MRI at 1 year postoperatively (64.6 vs 45.4, respectively; P = .001). The degree of defect repair was better in group 2 than in group 1 ( P = .040). Clinical outcomes in terms of the VAS for pain score, KOOS, IKDC score, and Tegner activity scale score were improved in both groups without between-group differences ( P > .100 for all comparisons). The quality of cartilage repair after microfracture with collagen augmentation was superior to that after microfracture alone in patients undergoing HTO. Clinical results after 1 year did not reflect this difference in tissue repair. Therefore, a longer follow-up of the cohort is needed to answer this question.

Results of arthroscopic treatment in unresolved Osgood-Schlatter disease in athletes.

PubMed

Circi, Esra; Beyzadeoglu, Tahsin

2017-02-01

In this study we aimed to determine outcomes following arthroscopic ossicle excision in athletes with unresolved Osgood-Schlatter disease (OSD). Arthroscopy was performed on 11 patients (11 knees) with OSD between September 2008 and November 2014. Surgical treatment inclusion criteria were determined as: failure of conservative treatment; isolated pain over the tibial tubercle and distal patellar tendon; pain limiting sporting performance at a competitive level. All patients had a documented history of OSD; the mean duration of persistent pain over the tibial tubercle was 15.5 months. The mean age was 23 years. The mean follow-up period was 66.1 months. The mean latency in returning to sports related training activities after the surgery was 6.7 weeks. The mean Kujala patello-femoral score improved from 82.9 points pre-operatively, to 98.5 points at the final follow-up (p < 0.01). The mean Lysholm knee scale score was 87.5 points in the pre-operative period, increasing to a score of 96.9 points at final follow-up (p < 0.01). The mean Tegner activity level score was 7.5 in the pre-operative period, increasing to 8.5 post-operatively (p < 0.01). We investigated the functional outcomes after arthroscopic treatment of unresolved OSD in athletes. All athletes with OSD showed satisfactory functional recovery following arthroscopic treatment. All patients were able to return to the same level of athletic activity. Arthroscopic surgery for unresolved OSD has the major advantage of faster recovery and avoiding damage to the patellar tendon.

Calcium phosphate cement augmentation in the treatment of depressed tibial plateau fractures with open reduction and internal fixation.

PubMed

Oztürkmen, Yusuf; Caniklioğlu, Mustafa; Karamehmetoğlu, Mahmut; Sükür, Erhan

2010-01-01

We aimed to evaluate the clinical and radiological outcomes of open reduction and internal fixation augmented with calcium phosphate cement (CPC) in the treatment of depressed tibial plateau fractures. Twenty-eight knees of 28 patients [19 males and 9 females; mean age, 41.2 years (range 22-72 years)] who had open reduction and internal fixation combined with CPC augmentation were included in this study. Seventeen fractures were Schatzker type II, 5 were type III, 3 were type IV, 2 were type V, and 1 was type VI. CPC was used to fill the subchondral bone defects in all knees. Fixation of the fragments was done with screws in 3 knees (10%). Standard proximal tibial plates or buttress plates were used in 25 knees (90%) with an additional split fragment extending distally to achieve internal fixation. Full weight-bearing was allowed in 6.4 weeks (range 6-12 weeks) after surgery. Resorption of CPC granules was defined as the decrease in the size and density of grafting material on radiographs. Rasmussen's radiological and clinical scores were determined postoperatively. Functionality was assessed with Lysholm knee scoring system. Activity was graded with Tegner's activity scale. Union was achieved in all patients with a mean follow-up of 22.2 months (range 6-36 months). There were no intraoperative complications. At the latest follow-up radiographs, resorption of the graft was observed in 25 knees (89%). Rasmussen's radiologic score was excellent in 17 patients (61%), good in 9 patients (32%), and fair in 2 patients (7%). Rasmussen's clinical score was excellent in 9 patients (32%), good in 18 patients (64%), and fair in 1 patient (4%). According to the Lysholm knee score, functional results were excellent in 16 patients (57%), good in 8 patients (29%), and fair in 4 patients (14%). Twenty-two patients (78%) achieved the preoperative activity level after surgery, and there was no significant difference between the mean preoperative and postoperative Tegner scores (4.11±0.68 and 4.04±0.64, respectively, p=0.161). CPC is a safe biomaterial with many advantages in augmenting the open reduction and internal fixation of depressed tibial plateau fractures, including elimination of morbidity associated with bone graft harvesting, the unlimited supply of bone substitute, the optimum filling of irregular bone defects, and shortening of the postoperative full weight-bearing time.

How does lower leg alignment differ between soccer players, other athletes, and non-athletic controls?

PubMed

Colyn, William; Agricola, Rintje; Arnout, Nele; Verhaar, Jan A N; Bellemans, Johan

2016-11-01

The influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited. Standardized full-leg standing digital radiographs were obtained from 100 males and 100 females on which 8 different alignment parameters were measured. Participants were questioned on their sports activities during different stages of growth. Sports activities were graded according to the Tegner score. The mean (±SD) hip-knee-ankle angle (HKA) was significantly lower (p < 0.001) in high-activity male athletes (-2.8° ± 2.4°) than in low-activity male athletes (-0.9° ± 1.9°). No differences in HKA were observed between different activity levels in females. Males who practiced soccer between 10-12 years and 15-17 years had, in turn, a lower HKA than athletes practicing other high-activity sports in these age categories (mean difference ≥1.2°, p ≤ 0.046). The most contributing factor for the varus alignment in male soccer players was a lower medial proximal tibial angle (MPTA). High-activity sports participation during youth is associated with varus alignment at the end of growth in males. The most pronounced bowlegs were observed in male soccer players, and this was primarily determined by the proximal tibia. Adjustments in loads applied to the knees during skeletal growth in males might prevent the development of varus alignment and associated pathology, but further studies are required. Diagnostic study, Level III.

Prevalence of knee stiffness after arthroscopic bone suture fixation of tibial spine avulsion fractures in adults.

PubMed

Thaunat, M; Barbosa, N C; Gardon, R; Tuteja, S; Chatellard, R; Fayard, J-M; Sonnery-Cottet, B

2016-09-01

Tibial spine avulsion fractures (TSAFs) occur chiefly in adolescents. Few published data are available on outcomes after arthroscopic surgical treatment of TSAFs in adults. To evaluate outcomes of consecutive patients with TSAFs managed by arthroscopic bone suture followed by a standardised non-aggressive rehabilitation programme. Arthroscopic bone suture followed by non-aggressive rehabilitation therapy reliably produces satisfactory outcomes in adults with TSAF. Thirteen adults were included. Outcomes were evaluated based on the Tegner score, International Knee Documentation Committee (IKDC) score, anterior-posterior knee laxity, passive and active motion ranges, and radiological appearance. After a mean follow-up of 41±27months (12-94months), all 13 patients had healed fractures without secondary displacement. No patient had knee instability. Post-operative stiffness was noted in 5 patients (2 with complex regional pain syndrome and 3 with extension lag), 1 of whom required surgical release. The mean IKDC score was 91.3±11.7. The mean Tegner score was 5.46±1.37 compared to 6.38±0.70 before surgery. Mean tibial translation (measured using the Rolimeter) was 1.09±1.22mm, compared to 5.9±1.85mm before surgery. The outcomes reported here support the reliability of arthroscopic bone suture for TSAF fixation. Nevertheless, a substantial proportion of patients experienced post-operative stiffness, whose contributory factors may include stunning of the quadriceps due to the short time from injury to surgery and the use of a gentle rehabilitation programme. IV, retrospective study of treatment outcomes. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Long-Term Outcomes of Anterior Cruciate Ligament Reconstruction Using Either Synthetics With Remnant Preservation or Hamstring Autografts: A 10-Year Longitudinal Study.

PubMed

Chen, Tianwu; Zhang, Peng; Chen, Jiwu; Hua, Yinghui; Chen, Shiyi

2017-10-01

The optimal graft choice of anterior cruciate ligament (ACL) reconstruction remains controversial. To compare the outcomes, especially the long-term cumulative failure rate, of ACL reconstruction using either synthetics with remnant preservation or hamstring autografts (4-strand semitendinosus and gracilis tendons). Cohort study; Level of evidence, 2. A total of 133 patients who underwent ACL reconstruction (synthetics: n = 43; hamstring autografts: n = 90) between July 2004 and December 2007 were included. Questionnaires (Tegner activity scale, Lysholm knee scale, and International Knee Documentation Committee [IKDC] subjective form) were completed preoperatively and at 6 months, 1 year, 5 years, and 10 years postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was additionally applied at 10 years' follow-up. The physical examination was based on the 2000 IKDC form. The manual maximum side-to-side difference (KT-1000 arthrometer), single-hop test, thigh muscle atrophy, and joint degeneration (Kellgren and Lawrence classification) were evaluated. The Kaplan-Meier curve and log-rank test (Mantel-Cox, 95% CI) were used to compare graft survivorship. Ten years postoperatively, 111 patients were available, with 38 (88.4%) patients (mean age, 27.6 ± 9.3 years; 28 men) with synthetics and 73 (81.1%) patients (mean age, 28.6 ± 8.8 years; 64 men) with hamstring autografts. Among them, 104 patients (synthetics: n = 35 [81.4%]; hamstring autografts: n = 69 [76.7%]) completed subjective evaluations, and 89 patients (synthetics: n = 30 [69.8%]; hamstring autografts: n = 59 [65.6%]) completed objective evaluations. For hamstring autografts and synthetics, the cumulative failure rates were 8.2% and 7.9%, respectively, and the log-rank test demonstrated no significant difference between the 2 Kaplan-Meier survival curves ( P = .910). At 6 months postoperatively, for hamstring autografts and synthetics, the mean Lysholm score was 83.0 ± 7.8 and 88.1 ± 7.5, respectively ( P < .001); the mean IKDC score was 83.8 ± 7.8 and 86.9 ± 4.5, respectively ( P = .036); and the mean Tegner score was 3.7 ± 1.1 and 5.0 ± 1.5, respectively ( P < .001). At 1 year postoperatively, the mean Tegner score was 5.5 ± 1.9 and 6.5 ± 2.0, respectively ( P = .011). No statistically significant difference was observed on other subjective evaluation findings, physical examination findings (overall IKDC grade A: 45.8% of hamstring autografts, 50.0% of synthetics), side-to-side difference (1.5 ± 1.5 mm for synthetics, 2.4 ± 2.1 mm for hamstring autografts), single-hop test findings (grade A: 84.7% of hamstring autografts, 93.3% of synthetics), grade A/B thigh muscle atrophy (88.1% of hamstring autografts, 93.3% of synthetics), ipsilateral radiographic osteoarthritis (55.9% of hamstring autografts, 50.0% of synthetics), and graft survivorship. In this prospective cohort study, primary ACL reconstruction using either synthetics with remnant preservation or hamstring autografts showed satisfactory outcomes, especially the long-term cumulative failure rate, at 10 years postoperatively. Patient-reported outcomes suggested that symptom relief and restoration of function might occur earlier in those with synthetics.

Comparison of clinical outcomes and second-look arthroscopic findings after ACL reconstruction using a hamstring autograft or a tibialis allograft.

PubMed

Yoo, Seung-Hyun; Song, Eun-Kyoo; Shin, Young-Rok; Kim, Sung-Kyu; Seon, Jong-Keun

2017-04-01

The purpose of this prospective randomized clinical study was to compare the clinical and radiological outcomes, including tibial tunnel widening and the progression of osteoarthritis after ACL reconstruction using a hamstring autograft or a tibialis allograft. In addition, we compared the graft tear and synovial coverage of grafts in patients that underwent the second-look arthroscopy. Among 184 patients with an ACL injury who underwent ACL reconstruction, 68 patients of autograft group and 64 patients of tibialis allograft group were included for this study after minimum of 2-year follow-up. The Lachman and pivot-shift tests, Tegner activity score, Lysholm knee score, and IKDC score were compared between the two groups. The quadriceps and hamstring isokinetic strengths using dynamometer were also compared. Degree of OA was determined using the Kellgren-Lawrence grading system on the weight-bearing radiographs. In total, 51 patients (26 patients in autograft group and 25 in the tibialis allograft group) underwent the second-look arthroscopy, in which we compared the apparent tear of graft and synovial coverage of grafts. At the final follow-up, there were no statistical significances in the two groups in Lachman and pivot-shift tests (n.s.). The Tegner activity, Lysholm knee score, and IKDC scores were similar in the two groups. Moreover, no significant differences were observed in the muscle power (n.s.). Some patients showed the progression of OA (five in autograft and four in allograft groups) without intergroup difference (n.s.). Regarding the findings of second-look arthroscopy, although there was no significant difference in graft tear, synovial coverage was better in autograft group than in allograft group. Even though hamstring autografts and tibialis allografts provided good functional outcomes without significant differences, the second-look arthroscopy revealed that hamstring autografts produced better synovial coverage than tibialis allograft. I.

Arthroscopic Transplantation of Synovial Stem Cells Improves Clinical Outcomes in Knees With Cartilage Defects.

PubMed

Sekiya, Ichiro; Muneta, Takeshi; Horie, Masafumi; Koga, Hideyuki

2015-07-01

Transplantation of mesenchymal stem cells (MSCs) is one possible strategy to achieve articular cartilage repair. We previously reported that synovial MSCs were highly proliferative and able to undergo chondrogenesis. We also found that placing a suspension of synovial MSCs on a cartilage defect for 10 minutes promoted cartilage repair in rabbit and pig models. However, the in vivo efficacy of this approach has not been tested clinically. We asked whether transplantation of synovial MSCs improves (1) MRI features, (2) histologic features, and (3) clinical evaluation scores in patients with cartilage defects in the knee? Patients with a symptomatic single cartilage lesion of the femoral condyle were indicated for inclusion in our study, and between April 2008 and April 2011, 10 patients were enrolled in this study. All patients completed followups of 3 years or more. The average followup period was 52 months (range, 37-80 months). Synovial MSCs were expanded with 10% autologous human serum for 14 days after digestion. For transplantation, the patient was positioned so that the cartilage defect was facing upward, and synovial MSC suspension was placed on the cartilage defect with a syringe under arthroscopic control. The defect with the applied suspension then was held in the upward position for 10 minutes. Five patients underwent concomitant ACL reconstructions, among whom two had meniscus suturing performed simultaneously. For MRI quantification, the cartilage defect was scored from 0 to 5. Second-look arthroscopy was performed for four patients and biopsy specimens were evaluated histologically. Clinical outcome was assessed using the Lysholm score and Tegner Activity Level Scale at final followup. Comparisons of MRI and Lysholm scores before and after treatment for each patient were analyzed using the Wilcoxon signed-rank test. MRI score (median ± 95% CI) was 1.0 ± 0.3 before and 5.0 ± 0.7 after, and increased after treatment in each patient (p = 0.005). Second-look arthroscopy in four patients showed that the cartilage defect appeared to be qualitatively better in all cases. Histologic analyses showed hyaline cartilage in three patients and fibrous cartilage in one at the deep zone. The Lysholm score (median ± 95% CI) was 76 ± 7 before and 95 ± 3 after, and increased after treatment in each patient (p = 0.005). The Tegner Activity Level Scale did not decrease after treatment in each patient. For this small initial case series, transplantation of synovial MSCs was effective in terms of MRI score, qualitative histology, and Lysholm score. The use of synovial MSCs has an advantage in that the cells can be prepared at passage 0 in only 14 days. Transplantation of synovial MSCs may be less invasive than mosaicplasty and autologous chondrocyte implantation. To conclusively show the effectiveness of this treatment requires comparative studies, especially with more established arthroscopic procedures, such as marrow stimulation techniques. Level IV, therapeutic study.

Long-term absorption of beta-tricalcium phosphate poly-L-lactic acid interference screws.

PubMed

Barber, F Alan; Dockery, William D

2008-04-01

The purpose of this study was to evaluate the long-term in vivo degradation of biodegradable interference screws made of poly-L-lactic acid (PLLA) and beta-tricalcium phosphate (beta-TCP). Twenty patients undergoing patellar tendon autograft anterior cruciate ligament reconstruction fixed at both the femur and tibia with beta-TCP-PLLA screws at least 44 months earlier were evaluated by physical, radiographic, and computed tomography (CT) evaluations. This study was approved by the institutional review board. Lysholm, Tegner, Cincinnati, and International Knee Documentation Committee scores were also obtained. CT data were measured in Hounsfield units. We evaluated 13 male and 7 female patients at a mean of 50 months after surgery (range, 44 to 56 months). CT scans and radiographs showed the bone plug fused to the tunnel wall with no beta-TCP-PLLA screw remaining. The screws were replaced with clearly calcified non-trabecular material, denser than soft tissue. Osteoconductivity was present in 75% of the tunnels and complete in 10%. No positive pivot-shift tests were found. Lysholm, Tegner, and Cincinnati scores improved from 60.4, 3.7, and 53.3, respectively, preoperatively to 90.8, 5.8, and 86.4, respectively, at follow-up. The mean side-to-side difference determined by use of the KT arthrometer (MEDmetric, San Diego, CA) was 0.4 mm. The beta-TCP-PLLA interference screw (Bilok; ArthroCare, Sunnyvale, CA) completely degraded, and no remnant was present 4 years after insertion. Osteoconductivity was confirmed by CT scans at 75% of the screw sites and completely filled the site in 10%. The addition of beta-TCP to PLLA results in a biocomposite interference screw that is osteoconductive. Level IV, therapeutic case series.

Moore I postero-medial articular tibial fracture in alpine skiers: Surgical management and return to sports activity.

PubMed

Morin, Vincent; Pailhé, Régis; Sharma, Akash; Rouchy, René-Christopher; Cognault, Jérémy; Rubens-Duval, Brice; Saragaglia, Dominique

2016-06-01

Over the past 10 years, like many authors, we observed an increasing number of Moore I tibial plateau fractures related to alpine skiing for which the surgeon may face difficult choices regarding surgical approach and fixation means. Some authors have recently been suggesting a posterior approach associated to open reduction and osteosynthesis by a buttress plate. But in our knowledge there is no specific study on sports activity recovery after Moore I tibial fractures. The aim of this work was to assess sports activities and clinical outcomes after surgically treated Moore I tibial plateau fractures in an athletic population of skiers. We conducted a prospective case series between 2012 and 2014. This included fifteen patients aged 39.6±7 years whom presented with a Moore I tibial plateau fracture during a skiing accident. 12 cases (80%) presented with an associated tibial spine fracture. Treatment consisted of a standard antero-medial approach, with a medial para patellar arthrotomy to allow direct visualisation of articular reduction and spinal fixation. Two or three 6.5mm long cancellous bone screws were placed antero-posteriorly so as to ensure perfect compression of the fracture site. Radiological and functional results were assessed by an independent observer (Lysholm-Tegner, UCLA, KOOS scores) at the longest follow-up. Mean follow-up was 18.2±6 months (12-28). An immediate postoperative anatomical reduction was achieved in all cases and remained stable in time. At last follow-up Lysholm mean score was 85±14 points (59-100), UCLA score was 7.3±1.6 (4-10) and Tegner score was 4.6±1.3 (3-6). Mean KOOS score was 77±15 (54-97). 87% of patients had resumed their skiing activity and 93% were satisfied or very satisfied from their post-operative surgical outcome. We observed no pseudarthrosis or secondary varus displacement. In our series 87% of patients had resumed back to their sporting activities. Surgical management of Moore I tibial plateau fractures by isolated antero-posterior screwing provides excellent clinical and radiological results. The anteromedial incision has a dual advantage of anatomical reduction, tibial spine fixation (in 80% of our cases) and posteromedial fragment reduction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Anterior Cruciate Ligament Reconstruction with Tibial Attachment Preserving Hamstring Graft without Implant on Tibial Side

PubMed Central

Sinha, Skand; Naik, Ananta Kumar; Maheshwari, Mridul; Sandanshiv, Sumedh; Meena, Durgashankar; Arya, Rajendra K

2018-01-01

Background: Tibial attachment preserving hamstring graft could prevent potential problems of free graft in anterior cruciate ligament (ACL) reconstruction such as pull out before graft-tunnel healing or rupture before ligamentization. Different implants have been reportedly used for tibial side fixation with this technique. We investigated short-term outcome of ACL reconstruction (ACLR) with tibial attachment sparing hamstring graft without implant on the tibial side by outside in technique. Materials and Methods: Seventy nine consecutive cases of ACL tear having age of 25.7 ± 6.8 years were included after Institutional Board Approval. All subjects were male. The mean time interval from injury to surgery was of 7.5 ± 6.4 months. Hamstring tendons were harvested with open tendon stripper leaving the tibial insertion intact. The free ends of the tendons were whip stitched, quadrupled, and whip stitched again over the insertion site of hamstring with fiber wire (Arthrex). Single bundle ACLR was done by outside in technique and the femoral tunnel was created with cannulated reamer. The graft was pulled up to the external aperture of femoral tunnel and fixed with interference screw (Arthrex). The scoring was done by Lysholm, Tegner, and KT 1000 by independent observers. All cases were followed up for 2 years. Results: The mean length of quadrupled graft attached to tibia was 127.65 ± 7.5 mm, and the mean width was 7.52 ± 0.78 mm. The mean preoperative Lysholm score of 47.15 ± 9.6, improved to 96.8 ± 2.4 at 1 year. All cases except two returned to the previous level of activity after ACLR. There was no significant difference statistically between preinjury (5.89 ± 0.68) and postoperative (5.87 ± 0.67) Tegner score. The anterior tibial translation (ATT) (KT 1000) improved from 11.44 ± 1.93 mm to 3.59 ± 0.89 mm. The ATT of operated knee returned to nearly the similar value as of the opposite knee (3.47 ± 1.16 mm). The Pivot shift test was negative in all cases. None had a failure of graft till final followup. Conclusion: Attachment sparing hamstring graft without a tibial implant is a simple, cost-effective technique that provides a consistently satisfactory outcome. PMID:29576645

Anterior cruciate ligament injury: post-traumatic bone marrow oedema correlates with long-term prognosis.

PubMed

Filardo, Giuseppe; Kon, Elizaveta; Tentoni, Francesco; Andriolo, Luca; Di Martino, Alessandro; Busacca, Maurizio; Di Matteo, Berardo; Marcacci, Maurilio

2016-01-01

Bone marrow oedema (BME) in the knee is a feature of several pathological conditions, and it has been described with high frequency in patients with acute anterior cruciate ligament (ACL) injury. The aim of this study is to evaluate the significance of BME, assessed in MRIs performed for ACL injury, with regards to clinical outcome and return to sport. A total of 134 patients (98 men, 36 women) with ACL tear and MRI knee scan within six months from trauma were analysed. The presence of BME was evaluated on MRI images considering: extension and hyperintensity, the WORMS score oedema classification, and measuring the BME area. The clinical results were documented by IKDC-subjective score and the sport activity level by Tegner score at a minimum of five years follow up. BME was present in 74 knees (55.2 %), with a mean area of 523 ± 370 mm². The presence of BME showed a gradual decrease over time (p = 0.008), being detectable in MRIs performed more than three months after trauma in just 25.0 % of cases. Although 54 % of the patients without BME after three months returned to their previous sport level, no patients with oedema reached a full sport recovery (p = 0.01). In the group that underwent ACL reconstruction, the BME area was significantly correlated with a return to the previous sport level at the mid/long-term follow-up (p = 0.038). BME is a common finding, which decreases over time after injury. However, when BME is still detectable it correlates with clinical prognosis, and even in sport-active patients undergoing ACL reconstruction, a higher BME area is a negative predictive factor for a successful outcome at the mid/long-term follow-up.

ICRS Recommendation Document

PubMed Central

Roos, Ewa M.; Engelhart, Luella; Ranstam, Jonas; Anderson, Allen F.; Irrgang, Jay J.; Marx, Robert G.; Tegner, Yelverton; Davis, Aileen M.

2011-01-01

Objective: The purpose of this article is to describe and recommend patient-reported outcome instruments for use in patients with articular cartilage lesions undergoing cartilage repair interventions. Methods: Nonsystematic literature search identifying measures addressing pain and function evaluated for validity and psychometric properties in patients with articular cartilage lesions. Results: The knee-specific instruments, titled the International Knee Documentation Committee Subjective Knee Form and the Knee injury and Osteoarthritis and Outcome Score, both fulfill the basic requirements for reliability, validity, and responsiveness in cartilage repair patients. A major difference between them is that the former results in a single score and the latter results in 5 subscores. A single score is preferred for simplicity’s sake, whereas subscores allow for evaluation of separate constructs at all levels according to the International Classification of Functioning. Conclusions: Because there is no obvious superiority of either instrument at this time, both outcome measures are recommended for use in cartilage repair. Rescaling of the Lysholm Scoring Scale has been suggested, and confirmatory longitudinal studies are needed prior to recommending this scale for use in cartilage repair. Inclusion of a generic measure is feasible in cartilage repair studies and allows analysis of health-related quality of life and health economic outcomes. The Marx or Tegner Activity Rating Scales are feasible and have been evaluated in patients with knee injuries. However, activity measures require age and sex adjustment, and data are lacking in people with cartilage repair. PMID:26069575

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up.

PubMed

Widuchowski, Wojciech; Widuchowska, Malgorzata; Koczy, Bogdan; Dragan, Szymon; Czamara, Andrzej; Tomaszewski, Wieslaw; Widuchowski, Jerzy

2012-06-27

If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed. The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique. Fifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs. Good overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003). According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05). ACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for revision surgery. BPTB femoral press-fit fixation technique can be safely applied in clinical practice and enables patients to return to preinjury activities including high-risk sports.

Combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction in knees with osteoarthritis and deficient anterior cruciate ligament.

PubMed

Tian, Shaoqi; Wang, Bin; Wang, Yuanhe; Ha, Chengzhi; Liu, Lun; Sun, Kang

2016-08-05

Relative young and more active patients with osteoarthritis (OA) of the isolated medial femorotibial compartment in conjunction with anterior cruciate ligament (ACL) deficiency are difficult to treat. The aim of this study was to explore the early clinical outcomes of combined Oxford unicompartmental knee arthroplasty (UKA) and ACL reconstruction for the patients presenting ACL deficiency and isolated OA of the medial compartment. Twenty-eight patients were included into the study. All patients were treated by combined Oxford UKA and ACL reconstruction. Plain radiographs in the antero-posterior and lateral view and long-leg standing radiographs were routinely performed prior to and after surgery. Stress radiographs in valgus were additionally available in order to verify the well-preserved lateral compartment. The varus deformity of the knee prior to surgery and the valgus degree after surgery, the posterior slope of the tibial component and the range of motion (ROM) of the knee after surgery were measured and recorded. Clinical evaluations include Oxford Knee Score (OKS), Knee Society Score (KSS-clinical score; KSS-function score) and Tegner activity score. All the patients were followed up for 52 ± 8 months. The leg alignment showed 3.1 ± 0.6° of varus deformity prior to surgery and 4.0 ± 0.7° of valgus after surgery. The OKS, KSS and Tegner activity score improved significantly after surgery (P < 0.05). The mean ROM of the operated knee was 123.5 ± 2.8° at the last follow-up. The posterior slope of the tibial component was 3.9 ± 1.2°. A significant correlation was found between them according to the Pearson's correlation (r = 0.39, P = 0.03). There were 2 patients (7 %) with the complication of mobile bearing dislocation, and a second operation of replacing a thicker mobile bearing was performed for them. The early clinical data have shown that combined surgery of UKA and ACL reconstruction has revealed promising results. However, long-term follow-up studies should be done in these patients. Current trial ISRCTN24663935 (Retrospectively registered on 21 July 2016).

Long-term absorption of poly-L-lactic Acid interference screws.

PubMed

Barber, F Alan; Dockery, W Dee

2006-08-01

To evaluate the long term in vivo degradation of poly-L-lactic acid (PLLA) interference screws with computed tomography (CT) and radiography as used in patellar tendon autograft anterior cruciate ligament (ACL) reconstruction. A total of 20 patients who had undergone patellar tendon autograft ACL reconstruction fixed with PLLA screws at least 7 years earlier were evaluated by physical examination, radiography, and CT to determine whether PLLA screw reabsorption and bone ingrowth had occurred. This study was granted Institutional Review Board approval. Lysholm, Tegner, Cincinnati, and International Knee Documentation Committee (IKDC) scores were obtained. CT data were measured in Hounsfield units. In all, 15 men and 5 women were evaluated 104 months after surgery (range, 89 to 124 months). CT and radiography demonstrated that the bone plug had fused to the tunnel wall, and that no intact interference screw was left. A parallel, threaded, and corticated screw tract was visible adjacent to the bone plug. No bone ingrowth had occurred at the screw site, although, occasionally, minimal calcification was seen. This was never as dense as cancellous bone, and no trabeculae were ever present. No positive pivot-shift test results were obtained. Lysholm, Tegner, and Cincinnati scores were 83, 5.6, and 75, respectively, at follow-up. Average KT difference was 0.7 mm. PLLA interference screws completely degraded, and the resulting area demonstrated a low Hounsfield count, consistent with soft tissue 7 years after insertion. No significant bone ingrowth occurred at the screw site. Femoral and tibial ACL tunnels were absent of anything but fibrous tissue and usually had a sclerotic cortical lining. PLLA biodegradable ACL screws eventually disappear completely. PLLA material is not replaced by bone. ACL graft tunnels are filled with nonossified material. This study provides a baseline for comparison with other biodegradable interference screws that may encourage bone ingrowth as they degrade. Level IV (no or historical control).

Biodegradable screw versus a press-fit bone plug fixation for hamstring anterior cruciate ligament reconstruction: a prospective randomized study.

PubMed

Jagodzinski, Michael; Geiges, Bjoern; von Falck, Christian; Knobloch, Karsten; Haasper, Carl; Brand, Juergen; Hankemeier, Stefan; Krettek, Christian; Meller, Rupert

2010-03-01

Press-fit fixation of a tendon graft has been advocated to achieve tendon-to-bone healing. Fixation of hamstring tendon grafts with a porous bone scaffold limits bone tunnel enlargement compared with a biodegradable interference screw fixation. Randomized controlled trial; Level of evidence, 1. Methods Between 2005 and 2006, 20 patients (17 men, 3 women) with a primary reconstruction of the anterior cruciate ligament (ACL) were enrolled in this study. Patients were randomized to obtain graft fixation in the tibial tunnel either by means of an interference screw (I) or a press-fit fixation with a porous bone cylinder (P). At 3 months after surgery, a computed tomography (CT) scan of the knee was performed, and tunnel enlargement was analyzed in the coronal and sagittal planes for the proximal, middle, and distal thirds of the tunnel. After 6 months and 1 and 2 years, radiographs of the knee in the sagittal and coronal plane were analyzed for bone tunnel widening. The International Knee Documentation Committee (IKDC), Tegner, and Lysholm scores of both groups were compared after 1 and 2 years. The bone tunnel enlargement determined by CT was 106.9% + or - 10.9% for group P and 121.9% + or - 9.0% for group I (P < .02) in the anteroposterior (AP) plane and 102.8% + or - 15.2% versus 121.5% + or - 10.1% in the coronal plane (P <.01). The IKDC, Tegner, and Lysholm scores improved in both groups from preoperatively to postoperatively without significant differences between the 2 groups. There was a trend to higher knee stability in group P after 3 months (0.6 + or - 1.4 mm vs 1.8 + or - 1.5 mm; P = .08). Both interference screw and a press-fit fixation lead to a high number of good or very good outcomes after ACL reconstruction. Tibial press-fit fixation decreases the amount of proximal bone tunnel enlargement.

Magnetic Resonance Imaging and Functional Outcomes After a Polyurethane Meniscal Scaffold Implantation: Minimum 5-Year Follow-up.

PubMed

Monllau, Joan C; Poggioli, Francesco; Erquicia, Juan; Ramírez, Eduardo; Pelfort, Xavier; Gelber, Pablo; Torres-Claramunt, Raúl

2018-05-01

To report the magnetic resonance imaging (MRI) and clinical outcomes at a minimum 5-year follow-up in a series of patients with postmeniscectomy syndrome and treated with a polyurethane scaffold. All consecutive patients operated on from September 2008 to February 2011 for either persistent medial or lateral joint line compartmental pain receiving a polyurethane scaffold due to a previous partial meniscus resection with a minimum 5-year follow-up were included. Functional scores (Knee Injury and Osteoarthritis Outcomes Score, International Knee Documentation Committee, Lysholm, and Tegner) were assessed preoperatively and at the last follow-up. The state of the scaffold as well as postoperative scaffold extrusion and the total remaining meniscal volume was also evaluated in MRI. Thirty-two patients were included. The mean follow-up was 70.8 ± 7.5 months. The functionality of the knees improved in all the scores used (P < .001) except for the Tegner score that stayed steady. Most of meniscal implants showed extrusion of 2.4 mm (95% confidence interval [CI], 1.1-3.7) were smaller and a hyperintensity signal was seen in the MRI. Three scaffolds were resorbed at the last follow-up. The meniscal volume, determined by MRI, was 1.14 cm 3 (95% CI, 0.96-1.31) preoperatively and 1.61 cm 3 (95% CI, 1.43-1.7) at the last follow-up. No differences were presented. The use of a polyurethane meniscal scaffold in patients with a symptomatic meniscus deficit had a good functional outcome at 5 years after surgery. However, the implanted scaffolds did not present normal meniscal tissue with MRI, and the implant volume was considerably less than expected. The fact that most of patients included received different concomitant procedures during scaffold implantation introduces a degree of performance bias into the results. Level IV, case series. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma.

PubMed

Astur, Diego Costa; Xerez, Marcos; Rozas, João; Debieux, Pedro Vargas; Franciozi, Carlos Eduardo; Cohen, Moises

2016-01-01

To analyze the incidence of ACL and meniscal injuries in a population of recreational and elite athletes from Brazil and the relation of these injuries with their sports activities. This was a prospective observational study of 240 patients with ACL and/or meniscal injuries submitted to surgical treatment. Data of patients and sport modality, as well as Tegner score were registered in the first clinical evaluation. The patients were divided into three groups: (1) isolated rupture of the ACL; (2) ACL injury associated with meniscal injury; (3) isolated menisci injury. The majority of the patients belonged to group 1 (44.58%), followed by group 2 (30.2%) and 3 (25%). Most patients were soccer players. The mean time from sport practice to injury in group 1 was 17.81 years. In group 2, it was 17.3 years, and in group 3, 26.91 years. Soccer athletes presented ACL injury in 0.523/1000 h of practice and meniscal injury in 0.448/1000 h of practice. Before the injury, the mean Tegner score obtained for groups 1, 2, and 3 were 7.18, 7.34, and 6.53, respectively. After knee injury, those values were 3.07, 3.18, and 2.87, respectively. Soccer was the sport that caused the majority of lesions, regardless the group. Furthermore, patients from groups 1 and 2 had less time of practice prior to the injury (17.81 and 17.3 years) than the patients of group 3 (26.91 years). Women presented a higher risk to develop ACL and meniscal injuries in 1000 h of game/practice. Running, volleyball, and weightlifting are in ascending order of risk for ACL and/or meniscal injury. Regarding the return to sport practice, the efficiency of all athletes was impaired because of the injury.

Custom-Made Total Talonavicular Replacement in a Professional Rock Climber.

PubMed

Giannini, Sandro; Cadossi, Matteo; Mazzotti, Antonio; Ramponi, Laura; Belvedere, Claudio; Leardini, Alberto

Professional athletes are often eager to resume sporting activities at preinjury levels. When facing the challenge of restoring joint function after a complex articular fracture, innovative solutions must be explored. We describe the results of what we believe to be the first custom-made talonavicular prosthesis implanted in a professional rock climber who had developed post-traumatic ankle and talonavicular arthritis as sequelae of a complex talar and navicular fracture. Using computed tomography scan reconstruction of the contralateral healthy ankle and direct metal laser sintering, a custom-made talonavicular prosthesis was obtained and implanted using an anteromedial approach. The patient was clinically and radiographically evaluated every 6 months after surgery for 30 months. A 3-dimensional videofluoroscopic analysis was performed to assess the range of motion about the prosthesis. At the last follow-up visit, the functional scores were excellent (Tegner activity scale score of 9 of 10), and he had completely resumed his sporting activity. The American Orthopaedic Foot and Ankle Society score had increased from 36 to 81 points, and no signs of radiolucency were observed on the radiographs. The 3-dimensional videofluoroscopic analysis showed 15° of dorsiflexion and 4° of plantar flexion at the ankle. A customized solution is an option when the patient's expectations are not likely to be met by standard treatment, such as arthrodesis. A custom-made talonavicular prosthesis can be an effective solution for complex ankle injury sequelae in patients demanding high functionality. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Knee Dislocations

PubMed Central

Schenck, Robert C.; Richter, Dustin L.; Wascher, Daniel C.

2014-01-01

Background: Traumatic knee dislocation is becoming more prevalent because of improved recognition and increased exposure to high-energy trauma, but long-term results are lacking. Purpose: To present 2 cases with minimum 20-year follow-up and a review of the literature to illustrate some of the fundamental principles in the management of the dislocated knee. Study Design: Review and case reports. Methods: Two patients with knee dislocations who underwent multiligamentous knee reconstruction were reviewed, with a minimum 20-year follow-up. These patients were brought back for a clinical evaluation using both subjective and objective measures. Subjective measures include the following scales: Lysholm, Tegner activity, visual analog scale (VAS), Short Form–36 (SF-36), International Knee Documentation Committee (IKDC), and a psychosocial questionnaire. Objective measures included ligamentous examination, radiographic evaluation (including Telos stress radiographs), and physical therapy assessment of function and stability. Results: The mean follow-up was 22 years. One patient had a vascular injury requiring repair prior to ligament reconstruction. The average assessment scores were as follows: SF-36 physical health, 52; SF-36 mental health, 59; Lysholm, 92; IKDC, 86.5; VAS involved, 10.5 mm; and VAS uninvolved, 2.5 mm. Both patients had excellent stability and were functioning at high levels of activity for their age (eg, hiking, skydiving). Both patients had radiographic signs of arthritis, which lowered 1 subject’s IKDC score to “C.” Conclusion: Knee dislocations have rare long-term excellent results, and most intermediate-term studies show fair to good functional results. By following fundamental principles in the management of a dislocated knee, patients can be given the opportunity to function at high levels. Hopefully, continued advances in the evaluation and treatment of knee dislocations will improve the long-term outcomes for these patients in the future. PMID:26535332

Second-Look Arthroscopic Evaluation of Cartilage Lesions After Mesenchymal Stem Cell Implantation in Osteoarthritic Knees.

PubMed

Koh, Yong Gon; Choi, Yun Jin; Kwon, Oh Ryong; Kim, Yong Sang

2014-07-01

Cartilage regenerative procedures have been receiving increased interest because of their potential to alter the progression of osteoarthritis (OA). The application of mesenchymal stem cells (MSCs) has been proposed as a new treatment option for OA based on the ability of these cells to differentiate into chondrocytes. To investigate the clinical and second-look arthroscopic outcomes of MSC implantation and to identify prognostic factors associated with this treatment. Case series; Level of evidence, 4. This study retrospectively evaluated 37 knees examined using second-look arthroscopic surgery after MSC implantation for cartilage lesions in OA knees. Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and Tegner activity scale, and cartilage repair was assessed using International Cartilage Repair Society (ICRS) grading. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes. The mean patient age was 57.4 years (range, 48-69 years), the mean follow-up period was 26.5 months (range, 24-34 months), the mean body mass index (BMI) was 26.3 kg/m2 (range, 19.8-31.2 kg/m2), and the mean lesion size was 5.4 ± 2.9 cm2 (range, 2.3-8.9 cm2). The mean IKDC and Tegner activity scale scores were significantly improved from 38.0 ± 7.8 to 61.0 ± 11.0 and from 2.5 ± 0.5 to 3.6 ± 0.7, respectively (P < .001 for both). According to the ICRS overall repair grades at second-look arthroscopic surgery, 2 of the 37 lesions (5%) were grade I (normal), 7 (19%) were grade II (near normal), 20 (54%) were grade III (abnormal), and 8 (22%) were grade IV (severely abnormal). In terms of overall patient satisfaction with the operation, 33 (94%) patients reported good to excellent satisfaction. High BMI (≥27.5 kg/m2) and large lesion size (≥5.4 cm2) were found to be significant predictors of poor clinical and arthroscopic outcomes (P < .05 for both). Other prognostic factors, including patient age, sex, cartilage lesion location, and presence of subchondral cysts, did not significantly influence the outcomes (P > .05). The outcomes of MSC implantation for cartilage repair in OA knees seem encouraging; high BMI and large lesion size are important factors affecting outcomes. Although still in the early stages of application, MSC implantation for cartilage repair may have great potential for the treatment of OA knees. However, second-look arthroscopic findings revealed that 76% had the repair rated as abnormal or severely abnormal by ICRS standards. The development of an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions. © 2014 The Author(s).

Infra Patellar Branch of Saphenous Nerve Injury during Hamstring Graft Harvest: Vertical versus Oblique Incisions.

PubMed

Joshi, A; Kayasth, N; Shrestha, S; Kc, B R

2016-09-01

Autologous hamstring grafts are commonly used for anterior cruciate ligament reconstruction. The injury of infrapatellar branch of saphenous nerve is one of the concerns leading to various pattern of sensory loss in the operated leg. An oblique incision to harvest the graft has been reported to be better than the vertical one.The aim of this study was to compare the incidence, recovery of nerve injury and final outcome in patients with hamstring harvest of vertical or oblique incision. A total of 146 patients who underwent hamstring graft harvest for anterior cruciate ligament reconstruction, were included in the study. They were randomized into two (Vertical and Oblique) groups as per the incisions used. The sensory loss along the Infra Patellar Branch of Saphenous Nerve was documented on 3rd day. Recovery of the nerve injury was monitoredat three, six and 12 months follow-ups. At final follow up Tegner Lysholm score and scale was recorded to compare between two groups. The incidence of infrapatellar branch of saphenous nerve injury was 25% in vertical group and 16.36% in oblique group. Recovery of nerve injury started earlier in oblique group compared to vertical group. The mean TegnerLyshom score was not significantly different in both the groups. Oblique incision to harvest hamstring graft has lesser incidence of infrapatellar branch of saphenous nerve injury, recovers earlier and does not have any adverse effect on final outcome compared to the vertical incision.

Is Delayed Weightbearing After Matrix-Associated Autologous Chondrocyte Implantation in the Knee Associated With Better Outcomes? A Systematic Review of Randomized Controlled Trials.

PubMed

Kraeutler, Matthew J; Belk, John W; Carver, Trevor J; McCarty, Eric C

2018-05-01

Proper rehabilitation after matrix-associated autologous chondrocyte implantation (MACI) is essential to restore a patient's normal function without overloading the repair site. To evaluate the current literature to assess clinical outcomes of MACI in the knee based on postoperative rehabilitation protocols, namely, the time to return to full weightbearing (WB). Systematic review; Level of evidence, 1. A systematic review was performed to locate studies of level 1 evidence comparing the outcomes of patients who underwent MACI with a 6-week, 8-week, or 10/11-week time period to return to full WB. Patient-reported outcomes assessed included the Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner activity scale, Short Form Health Survey-36 (SF-36), and visual analog scale (VAS) for pain frequency and severity. Seven studies met the inclusion criteria, including a total of 136 patients (138 lesions) who underwent MACI. Treatment failure had occurred in 0.0% of patients in the 6-week group, 7.5% in the 8-week group, and 8.3% in the 10/11-week group at a mean follow-up of 2.5 years ( P = .46). KOOS, SF-36, and VAS scores in each group improved significantly from preoperatively to follow-up ( P < .001). Patients undergoing MACI in the knee can be expected to experience improvement in clinical outcomes with the rehabilitation protocols outlined in this work. No significant differences were seen in failure rates based on the time to return to full WB.

Use of cell-free collagen type I matrix implants for the treatment of small cartilage defects in the knee: clinical and magnetic resonance imaging evaluation.

PubMed

Schüttler, Karl F; Schenker, Hanno; Theisen, Christina; Schofer, Markus D; Getgood, Alan; Roessler, Philip P; Struewer, Johannes; Rominger, Marga B; Efe, Turgay

2014-06-01

Articular cartilage defects of the knee are a common condition for which several repair techniques have been described. The aim of the present study was to assess medium-term results of a one-step procedure using a cell-free collagen type I matrix. Fifteen patients with articular cartilage defects of the knee were treated with an 11-mm-diameter cell-free collagen type 1 matrix implant. The matrices were implanted in a press-fit manner into the defect after careful debridement down to the subchondral bone but without penetration of this margin. Follow-up examinations were carried out at 6 weeks, 6 months, and at 12, 24, 36, and 48 months after implantation. Clinical assessment included the visual analogue scale (VAS), the Tegner activity scale, and the International Knee Documentation Committee (IKDC) score. Radiological assessment for graft attachment and tissue regeneration was performed using the magnetic observation of cartilage repair tissue (MOCART) score. A total of 15 patients (males: n = 6 and females: n = 9) with a mean age of 26.4 years (range 19-40) were treated. The mean VAS improved significantly when compared to the preoperative values (P < 0.05). Six weeks after implantation, IKDC values were slightly lower than the preoperative values (n.s.), but increased significantly at final follow-up (P < 0.05). At 24 months, there were no significant differences in the median Tegner score between the post-operative values and the preoperative values (n.s.). However, after 36 months, a significant improvement was noted that lasted at least up to 48 months (P < 0.05). The MOCART score improved consistently up to 4 years after implantation, with significant improvements already observed after 12 months (P < 0.05). No correlation between the clinical scores and the MOCART score could be perceived. The present study showed that the use of cell-free collagen type I matrix implants led to a significant and durable improvement in all the clinical and imaging scores investigated 4 years after implantation. IV.

Long-Term Degradation of Self-Reinforced Poly-Levo (96%)/Dextro (4%)-Lactide/β-Tricalcium Phosphate Biocomposite Interference Screws.

PubMed

Barber, F Alan; Dockery, W D

2016-04-01

To evaluate the long-term in vivo degradation of biocomposite interference screws made with self-reinforced poly-levo (96%)/dextro (4%)-lactide/β-tricalcium phosphate [SR-PL(96)/D(4)LA/β-TCP]. A study of the in vivo biologic behavior of an SR-PL(96)/D(4)LA/β-TCP biocomposite interference screw was initiated in 2011 using an anterior cruciate ligament (ACL) reconstruction model. Eight patients undergoing a bone-patellar tendon-bone ACL reconstruction fixed at both the femur and tibia with an SR-PL(96)/D(4)LA/β-TCP screw at least 36 months earlier were evaluated by physical, radiographic, and computed tomography (CT) evaluations. Lysholm, Tegner, Cincinnati, and International Knee Documentation Committee scores were obtained. After incomplete degradation was observed in these 8 patients, a subsequent series of 17 patients were evaluated at a minimum of 48 months after surgery. By use of CT scans, Hounsfield unit (HU) data were obtained at the femoral and tibial screw and other bone sites. An ossification quality score (range, 1 to 4) was used to determine osteoconductivity at the screw sites. Eleven male and 6 female patients evaluated by CT scan and radiographs at a mean of 50 months (range, 48 to 61 months) after surgery showed bone plug healing to the tunnel wall and the SR-PL(96)/D(4)LA/β-TCP screws were replaced with material that was calcified and non-trabecular. Osteoconductivity was present in 24 of 34 tunnels (70.58%) and nearly complete or complete (type 3 or 4 ossification) in 11 of 34 (32.35%). Mean screw site densities (femoral, 242 HU; tibial, 240 HU) were consistent with cancellous bone density. One positive pivot-shift test was found. Lysholm, Cincinnati, Tegner, and International Knee Documentation Committee activity scores improved from 44.5, 40.7, 2.3, and 1.4, respectively, preoperatively to 92, 92.4, 5.7, and 3.3, respectively, at follow-up (P < .0001). The average postoperative Single Assessment Numeric Evaluation score was 92. The mean KT arthrometer (MEDmetric, San Diego, CA) difference was 1.25 mm. The SR-PL(96)/D(4)LA/β-TCP interference screw was replaced with calcified, non-trabecular material 4 years after implantation in a bone-patellar tendon-bone ACL reconstruction model. Osteoconductivity was confirmed in 24 of 34 screw sites (71%), with nearly complete or complete filling in 11 of 34 (33%). The SR-PL(96)/D(4)LA/β-TCP biocomposite interference screw is osteoconductive. Level IV, therapeutic case series. Copyright © 2016 The Arthroscopy Association of North America. All rights reserved.

Functional Outcome and Graft Retention in Patients With Septic Arthritis After Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Makhni, Eric C; Steinhaus, Michael E; Mehran, Nima; Schulz, Brian S; Ahmad, Christopher S

2015-07-01

To provide a comprehensive review of clinical and functional outcomes after treatment for septic arthritis after anterior cruciate ligament reconstruction. A systematic review of the literature was performed. Two reviewers assessed and confirmed the methodologic quality of each study. Studies that met the inclusion criteria were assessed for pertinent data, and when available, similar outcomes were combined to generate frequency-weighted means. Nineteen studies met the inclusion and exclusion criteria for this review, reporting on a total of 203 infected knees. The mean age was 27.5 years and the mean length of follow-up was 44.2 months, with male patients comprising 88% of the population. Hamstring and bone-patellar tendon-bone autografts were used in 63% and 33% of patients, respectively, with 78% of patients retaining their grafts. The studies reported mean flexion and extension deficits of 5.8° and 1.0°, respectively, and laxity testing showed a mean difference of 1.9 mm. The studies reported mean Lysholm, International Knee Documentation Committee, and Tegner scores of 82.1, 68.2, and 5.6, respectively. Of the patients, 83% reported an ability to return to activities of daily living whereas 67% reported a return to their preinjury level of athletics. Evidence of new degenerative changes was seen in 22% of patients. Septic arthritis after anterior cruciate ligament reconstruction remains a very infrequent event, affecting 0.5% of patients. On average, outcomes in these patients are comparable with those in patients in whom infection does not develop, including postoperative range of motion, residual instability, Lysholm scores, and return to preinjury level of activity. These patients do exhibit decreased International Knee Documentation Committee scores compared with patients without septic arthritis, however. The impact of this differential is not clear, but this scoring difference suggests that septic arthritis may be associated with more severe symptoms and reduced functional outcomes. In addition, there is limited evidence suggesting that septic arthritis leads to early degenerative changes found on imaging. Level IV, systematic review of Level III and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Medial unicondylar knee arthroplasty combined to anterior cruciate ligament reconstruction.

PubMed

Ventura, Alberto; Legnani, Claudio; Terzaghi, Clara; Iori, Stefano; Borgo, Enrico

2017-03-01

The purpose of the present study was to retrospectively evaluate the outcomes of patients who underwent combined medial unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament (ACL) reconstruction. The hypothesis was that this procedure would lead to a high success rate in patients affected by isolated medial unicompartmental osteoarthritis and concomitant ACL deficiency. Fourteen patients with primary ACL lesion and concomitant medial compartment symptomatic osteoarthritis treated from 2006 to 2010 were followed up for an average time of 26.7 months (SD 4.2). Assessment included KOOS score, Oxford Knee score, American Knee Society scores, WOMAC index of osteoarthritis, Tegner activity level and objective examination including instrumented laxity test with KT-1000 arthrometer. Radiological assessment was done with standard simple radiographs in order to get information about any presence of loosening of the components. KOOS score, OKS, WOMAC index and the AKSS improved significantly after surgery (p < 0.001). Regarding AKSS, improvement was noted both in the objective score and in the functional one (p < 0.001). There was no clinical evidence of instability in any of the knees as evaluated with clinical laxity testing. No pathologic radiolucent lines were observed around the components. In one patient signs of osteoarthritis in the lateral compartment were observed 28 months after surgery. UKA combined with ACL reconstruction is a valid therapeutic option for the treatment of combined medial unicompartmental knee osteoarthritis and ACL deficiency in young and active patients and confirms subjective and objective clinical improvement 2 years after surgery. The use of a fixed-bearing prosthesis represents a reliable feature as it allows to overcome problems of improper ligament tensioning during the implantation of the components. IV.

Treatment of patella baja by a modified Z-plasty.

PubMed

Guido, Wierer; Christian, Hoser; Elmar, Herbst; Elisabeth, Abermann; Christian, Fink

2016-09-01

The purpose of this study was to evaluate the efficiency of a modified Z-plasty for patellar tendon lengthening for the treatment of patella baja. Rather than adapting only two tendon reins according to the conventional Z-plasty method, the modified Z-plasty provides four reins to enable multifold overlapping of the tendon tissue. Between 2010 and 2012, a modified Z-plasty procedure was performed in four patients suffering from patella baja. Physical examinations and standardized scoring instruments served as the evaluation measures. The median preoperative CD ratio of 0.53 (range 0.43-0.62) was corrected to 1.03 (range 1-1.06) after a median follow-up of 34 months (range 23-41 months). The median preoperative flexion of 108° (range 80-135°) improved to 143° (range 110-145°) compared with the flexion of 145° (range 140-145°) of the unaffected knee. No patients showed any signs of extension lag. The median Lysholm score improved from 49 (range 22-80) to 91 (range 67-95), and the Tegner activity level improved from 2 (range 0-6) to 6 (range 2-6). The median VAS status for pain decreased from an average of 8.5 (range 4-10) to 1 (range 0-2). No complications were observed. The modified Z-plasty procedure is a valuable technique for the treatment of patella baja, especially if allografts are not available. This procedure allowed for early mobilization and achieved excellent clinical results. IV.

Assessing long-term return to play after hip arthroscopy in football players evaluating risk factors for good prognosis.

PubMed

Barastegui, D; Seijas, R; Alvarez-Diaz, P; Rivera, E; Alentorn-Geli, E; Steinbacher, G; Cuscó, X; Cugat, R

2018-03-01

Groin pain is the third most common disease in football players and has often been associated with hip pathology such as femoroacetabular impingement and labral lesions. Hip arthroscopy offers possibilities of function restoration via minimally invasive procedures. The aim of this study is to evaluate professional football player's injuries and their return to play after hip arthroscopy for FAI and labral injuries. Patients that underwent hip arthroscopy between 2009 and 2014 were selected retrospectively. From this population, only professional soccer players competing at national level were included (Tegner 10). Arthroscopic surgery was proposed in patients with persistent pain. All patients were assessed for VAS score preoperatively and at 3, 6, 12 and 24 months post-op. HOS (sport and DLA) and mHHS tests were performed at the same time periods. All patients were men with a mean age of 26.5 ± 7.1 years old. Preoperative VAS (7.4 ± 1.3), HOS ADL (67.7 ± 5.5), HOS sport (37.6 ± 18.7) and mHHS (72.5 ± 8.8) showed improved scores during long-term follow-up. Time to return to play was 10.8 months (SD ± 4.3), with range between 4 and 20 months. Mean follow-up was 45.4 ± 15.6 months (range from 26 to 72 months). No differences were observed between non-active and active patients at final follow-up with respect to chondral lesions, but significant differences were observed with reference to management of the labrum (p = 0.031), where a higher rate of labrectomies existed among inactive patients and a higher rate of suture among active patients. Hip arthroscopy is a safe procedure with very good return to play results, but for optimized return to football one should consider patient age at the time of surgery, the condition of the labrum and low scores on the Harris Hip Score (mHHS) and HOS (sport version) as predictive factors for poor prognosis. Level of evidence IV.

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

PubMed

Toole, Allison R; Ithurburn, Matthew P; Rauh, Mitchell J; Hewett, Timothy E; Paterno, Mark V; Schmitt, Laura C

2017-11-01

Study Design Prospective cohort study. Background While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. Objectives To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. Methods At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following return-to-sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. Results Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-to-sport clearance than those who did not (81.3% versus 60.2%, P = .02). Conclusion The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2017;47(11):825-833. Epub 7 Oct 2017. doi:10.2519/jospt.2017.7227.

Anteromedial portal versus transtibial drilling techniques in ACL reconstruction: a blinded cross-sectional study at two- to five-year follow-up

PubMed Central

Alentorn-Geli, Eduard; Samitier, Gonzalo; Álvarez, Pedro; Steinbacher, Gilbert

2010-01-01

Drilling of the femoral tunnel with the transtibial (TT) technique is widely used in bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction. Recent studies suggest higher knee stability with the use of the anteromedial portal (AMP). The purpose of this study was to compare functional and clinical outcomes of BPTB ACL reconstruction using the TT or the AMP technique for drilling the femoral tunnel. All ACL reconstructions between January 2003 and April 2006 were approached for eligibility. Forty-seven patients met inclusion criteria (21 TT group and 26 AMP group). Blinded assessments of IKDC score, knee stability and range of motion, one-leg hop test, mid-quadriceps circumference, VAS for satisfaction with surgery, Lysholm and Tegner scores, and SF-12 questionnaire were obtained for both groups. Data on preoperative and postoperative surgical timing were retrospectively reviewed through the charts. The AMP group demonstrated a significantly lower recovery time from surgery to walking without crutches (p < 0.01), to return to normal life (p < 0.03), to return jogging (p < 0.03), to return training (p < 0.03), and to return to play (p < 0.03). Knee stability values measured with KT-1000, Lachman test, pivot-shift sign, and objective IKDC score assessments were significantly better for the AMP compared to TT group (p < 0.002, p < 0.03, p < 0.02, p < 0.015, respectively). No differences were found for VAS for satisfaction with surgery, Lysholm, Tegner, and SF-12 between both groups. The use of the AMP technique significantly improved the anterior-posterior and rotational knee stability, IKDC scores, and recovery time from surgery compared to the TT technique. PMID:20401753

Outcomes of Patellofemoral Arthroplasty Based on Radiographic Severity.

PubMed

deDeugd, Casey M; Pareek, Ayoosh; Krych, Aaron J; Cummings, Nancy M; Dahm, Diane L

2017-04-01

Patellofemoral arthroplasty (PFA) is increasingly performed for symptomatic patellofemoral arthritis. The purpose of this study was to evaluate the outcomes of PFA based on preoperative radiographic severity of patellofemoral arthritis. All patients who underwent PFA for isolated patellofemoral arthritis between 2002 and 2013 and had undergone preoperative magnetic resonance imaging were identified. Radiographic severity of patellofemoral arthritis was classified according to the Iwano classification system. Groups were divided between mild (grade 0-I) and moderate to severe (grade II-IV) patellofemoral arthritis. Clinical outcomes were evaluated using the Knee Society scores (KSS), University of California at Los Angeles (UCLA) and Tegner scores. Seventy-five knees in 55 patients met inclusion criteria. Mean age was 51 years (range, 36 to 81), and mean follow-up was 3 years (range, 2 to 10). All patients had grade IV patellofemoral chondromalacia and/or significant subchondral cyst formation and edema on magnetic resonance imaging. On plain radiographs, there were no patients with Iwano grade 0, 21 grade I, 15 grade II, 21 grade III, and 18 grade IV patellofemoral arthritis. There was significantly more improvement in KSS pain (P = .046), KSS function (P = .02), University of California at Los Angeles (UCLA) (P = .046) and Tegner (P = .008) scores in the Iwano grade II-IV group vs the Iwano grade I group. Patient-reported pain quality improved significantly more following PFA in the grade II-IV group (P = .04). Patients with evidence of mild patellofemoral arthritis on plain radiographs demonstrated less improvement in pain and function after PFA than those with more advanced patellofemoral arthritis. Caution should be used when considering PFA for patients with minimal radiographic evidence of patellofemoral arthritis. Copyright © 2016 Elsevier Inc. All rights reserved.

Microfracture technique versus carbon fibre rod implantation for treatment of knee articular cartilage lesions.

PubMed

Dasar, U; Gursoy, S; Akkaya, M; Algin, O; Isik, C; Bozkurt, M

2016-08-01

To compare the microfracture technique with carbon fibre rod implantation for treatment of knee articular cartilage lesions. 10 men and 30 women aged 22 to 56 (mean, 37.4) years underwent microfracture (n=20) or carbon fibre rod implantation (n=20) for International Cartilage Repair Society grade 3 to 4 knee articular cartilage lesions after a mean of 12.2 months of viscosupplementation and physiotherapy. Clinical outcome at 6 and 12 months was assessed using the Tegner-Lysholm score and modified Cincinnati score. Magnetic resonance imaging (MRI) outcome at 12 months was assessed by a radiologist. The modified magnetic resonance observation of cartilage repair tissue (MOCART) score was evaluated. The 2 groups were comparable in terms of age, body mass index, lesion location, lesion size, duration of symptoms, and coexisting pathology. The microfracture group had a higher preoperative Tegner-Lysholm score (39.4±7.3 vs. 34.4±4.9, p=0.015) and modified Cincinnati score (36.4±7.2 vs. 30.4±4.0, p=0.002) than the carbon fibre rod group. At 12 months, change in both scores was significant within each group (p<0.001) and was higher in the microfracture than carbon fibre rod group (p<0.001). MRI showed minimal regenerative tissue. Lobulation, oedema, and hypertrophy were more commonly found in the regeneration tissue after carbon fibre rod implantation than microfracture. At 12 months, the MOCART score was higher in the microfracture than carbon fibre rod group (59 vs. 47, p<0.001). Microfracture is superior to carbon fibre rod implantation in terms of clinical and radiological outcome.

An anterior cruciate ligament injury does not affect the neuromuscular function of the non-injured leg except for dynamic balance and voluntary quadriceps activation.

PubMed

Zult, Tjerk; Gokeler, Alli; van Raay, Jos J A M; Brouwer, Reinoud W; Zijdewind, Inge; Hortobágyi, Tibor

2017-01-01

The function of the anterior cruciate ligament (ACL) patients' non-injured leg is relevant in light of the high incidence of secondary ACL injuries on the contralateral side. However, the non-injured leg's function has only been examined for a selected number of neuromuscular outcomes and often without appropriate control groups. We measured a broad array of neuromuscular functions between legs of ACL patients and compared outcomes to age, sex, and physical activity matched controls. Thirty-two ACL-deficient patients (208 ± 145 days post-injury) and active and less-active controls (N = 20 each) participated in the study. We measured single- and multi-joint neuromuscular function in both legs in each group and expressed the overall neuromuscular function in each leg by calculating a mean z-score across all neuromuscular measures. A group by leg MANOVA and ANOVA were performed to examine group and leg differences for the selected outcomes. After an ACL injury, duration (-4.3 h/week) and level (Tegner activity score of -3.9) of sports activity decreased and was comparable to less-active controls. ACL patients showed bilateral impairments in the star excursion balance test compared to both control groups (P ≤ 0.004) and for central activation ratio compared to active controls (P ≤ 0.002). There were between-leg differences within each group for maximal quadriceps and hamstring strength, voluntary quadriceps activation, star excursion balance test performance, and single-leg hop distance (all P < 0.05), but there were no significant differences in quadriceps force accuracy and variability, knee joint proprioception, and static balance. Overall neuromuscular function (mean z-score) did not differ between groups, but ACL patients' non-injured leg displayed better neuromuscular function than the injured leg (P < 0.05). Except for poorer dynamic balance and reduced quadriceps activation, ACL patients had no bilateral neuromuscular deficits despite reductions in physical activity after injury. Therapists can use the non-injured leg as a reference to assess the injured leg's function for tasks measured in the present study, excluding dynamic balance and quadriceps activation. Rehabilitation after an ACL injury should be mainly focused on the injured leg. III.

Press-fit fixation using autologous bone in the tibial canal causes less enlargement of bone tunnel diameter in ACL reconstruction--a CT scan analysis three months postoperatively.

PubMed

Akoto, Ralph; Müller-Hübenthal, Jonas; Balke, Maurice; Albers, Malte; Bouillon, Bertil; Helm, Philip; Banerjee, Marc; Höher, Jürgen

2015-08-19

Bone tunnel enlargement is a phenomenon present in all anterior cruciate ligament (ACL)- reconstruction techniques. It was hypothesized that press-fit fixation using a free autograft bone plug reduces the overall tunnel size in the tibial tunnel. In a prospective cohort study twelve patients who underwent primary ACL reconstruction using an autologous quadriceps tendon graft and adding a free bone block for press-fit fixation (PF) in the tibial tunnel were matched to twelve patients who underwent ACL reconstruction with a hamstring graft and interference screw fixation (IF). The diameters of the bone tunnels were analysed by a multiplanar reconstruction technique (MPR) in a CT scan three months postoperatively. Manual and instrumental laxity (Lachman test, Pivot-shift test, Rolimeter) and functional outcome scores (International Knee Documentation Committee sore, Tegner activity level) were measured after one year follow up. In the PF group the mean bone tunnel diameter at the level of the joint entrance was not significantly enlarged. One and two centimeter distal to the bone tunnel diameter was reduced by 15% (p = .001). In the IF group the bone tunnel at the level of the joint entrance was enlarged by 14% (p = .001). One and two centimeter distal to the joint line the IF group showed a widening of the bone tunnel by 21% (p < .001) One and two centimeter below the joint line the bone tunnel was smaller in the PF group when compared to the IF group (p < .001). No significant difference for laxity test and functional outcome scores could be shown. This study demonstrates that press-fit fixation with free autologous bone plugs in the tibial tunnel results in significantly smaller diameter of the tibial tunnel compared to interference screw fixation.

[What is hidden behind the Baking Tray Task? Study of sensibility and specificity in right-hemispheric stroke patients].

PubMed

Garcia-Fernandez, Juan; Garcia-Molina, Alberto; Aparicio-Lopez, Celeste; Sanchez-Carrion, Rocío; Ensenat, Antònia; Pena-Casanova, Jordi; Roig-Rovira, Teresa

2015-12-16

Tham and Tegner proposed the Baking Tray Task (BTT) as a fast simple assessment test for detecting spatial negligence. However, very few studies have examined its validity as a diagnostic test. To analyse the diagnostic validity of the BTT by measuring its specificity and sensitivity in a sample of subjects with right hemisphere strokes. Forty-eight patients with right hemisphere vascular lesions were distributed in two groups (negligence group, n = 35; non-negligence group, n = 13) according to the scores obtained in a battery of visuospatial examination tests. The participants' performance on the BTT was compared with that of a healthy control group (n = 12). The results showed a high level of sensitivity of the BTT, but low specificity. The performance on the BTT of eight of the 13 members of the non-negligence group was suggestive of negligence. The BTT has proved to be a sensitive test for the detection of spatial negligence. Yet, based on its low specificity, its use alone as a single diagnostic test is not recommended.

Landing mechanics during single hop for distance in females following anterior cruciate ligament reconstruction compared to healthy controls.

PubMed

Trigsted, Stephanie M; Post, Eric G; Bell, David R

2017-05-01

To determine possible differences in single-hop kinematics and kinetics in females with anterior cruciate ligament reconstruction compared to healthy controls. A second purpose was to make comparisons between the healthy and reconstructed limbs. Subjects were grouped based on surgical status (33 ACLR patients and 31 healthy controls). 3D motion capture synchronized with force plates was used to capture the landing phase of three successful trials of single hop for distance during a single data collection session. Peak values during the loading phase were analysed. Subjects additionally completed three successful trials of the triple hop for distance Tegner activity scale and International Knee Document Committee 2000 (IKDC). Controls demonstrated greater peak knee flexion and greater internal knee extension moment and hip extension moment than ACLR subjects. Within the ACLR group, the healthy limb exhibited greater peak knee flexion, hip flexion, hip extension moment, single hop and triple hops for distance and normalized quadriceps strength. Patients who undergo anterior cruciate ligament reconstruction land in a more extended posture when compared to healthy controls and compared to their healthy limb. III.

Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level.

PubMed

Novaretti, João Victor; Franciozi, Carlos Eduardo; Forgas, Andrea; Sasaki, Pedro Henrique; Ingham, Sheila Jean McNeill; Abdalla, Rene Jorge

There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR). Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not. Additionally, quadriceps strength deficit cutoff values of 80% and 90% would differentiate patients who returned to preinjury sports level from those who did not. Cohort study. Level 3. A retrospective search was conducted to identify all patients who underwent ACLR and completed isokinetic evaluation, postural stability analysis, and drop vertical jump testing at 6 months postoperatively. Patients were asked to complete 3 questionnaires at a minimum 1 year after surgery. Chi-square and logistic regression analyses were used for categorical dependent variables, while the Student t test, Pearson correlation, or analyses of variance with Bonferroni post hoc testing were used for continuous dependent variables. A post hoc power analysis was completed. Based on the results regarding correlations between return to preinjury level and all other variables, effect sizes from 0.24 to 3.03 were calculated. With these effect sizes, an alpha of 0.05 and sample size of 58, a power ranging from 0.15 to 0.94 was calculated. The rates of return to preinjury level and to any sports activity were 53.4% and 84.4%. Those who were able to return to their preinjury level of sport (n = 33) showed significantly higher Lysholm (91.6 ± 9.7 vs 76.7 ± 15.4) and International Knee Documentation Committee (IKDC) (83.6 ± 10.6 vs 69.8 ± 14.6) values compared with those who were unable to return to their preinjury level of sport (n = 25) ( P < 0.001). No significant differences were found for the clinical evaluations between those who were and those who were not able to return at the same level for the clinical evaluations (isokinetic evaluation, postural stability, drop vertical jump test) ( P > 0.05). No significant differences were found when comparing quadriceps strength deficit with cutoff values of 80% and 90% for return to preinjury activity level (Tegner), Lysholm, and IKDC scores. Quadriceps strength deficit, regardless of cutoff value (80% or 90%), at 6 months after ACLR does not predict return to preinjury level of sport. Patients who returned to sport at their preinjury level were more satisfied with their reconstruction compared with those who did not. Quadriceps strength deficit is not a reliable predictor of return to sports, and therefore it should not be used as the single criterion in such evaluations.

High Variability in Outcome Reporting Patterns in High-Impact ACL Literature.

PubMed

Makhni, Eric C; Padaki, Ajay S; Petridis, Petros D; Steinhaus, Michael E; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2015-09-16

ACL (anterior cruciate ligament) reconstruction is one of the most commonly performed and studied procedures in modern sports medicine. A multitude of objective and subjective patient outcome measures exists; however, nonstandardized reporting patterns of these metrics may create challenges in objectively analyzing pooled results from different studies. The goal of this study was to document the variability in outcome reporting patterns in high-impact orthopaedic studies of ACL reconstruction. All clinical studies pertaining to ACL reconstruction in four high-impact-factor orthopaedic journals over a five-year period were reviewed. Biomechanical, basic science, and imaging studies were excluded, as were studies with fewer than fifty patients, yielding 119 studies for review. Incorporation of various objective and subjective outcomes was noted for each study. Substantial variability in reporting of both objective and subjective measures was noted in the study cohort. Although a majority of studies reported instrumented laxity findings, there was substantial variability in the type and method of laxity reporting. Most other objective outcomes, including range of motion, strength, and complications, were reported in <50% of all studies. Return to pre-injury level of activity was infrequently reported (24% of studies), as were patient satisfaction and pain assessment following surgery (8% and 13%, respectively). Of the patient-reported outcomes, the International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were most often reported (71%, 63%, and 42%, respectively). Substantial variability in outcome reporting patterns exists among high-impact studies of ACL reconstruction. Such variability may create challenges in interpreting results and pooling them across different studies. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Evaluation and comparison of clinical results of femoral fixation devices in arthroscopic anterior cruciate ligament reconstruction.

PubMed

Aydin, Deniz; Ozcan, Mert

2016-03-01

Several femoral fixation devices are available for hamstring tendon autograft in anterior cruciate ligament (ACL) reconstruction, but the best technique is debatable. We hypothesised that different suspensory femoral fixation techniques have no superiority over each other. The aim of this study was to evaluate and compare the clinical results of different suspensory femoral fixation devices in arthroscopic ACL reconstruction. This was a Level III, retrospective, comparative study. A total of 100 consecutive patients who underwent arthroscopic ACL reconstruction in a single institution with a mean follow-up time of 40 months (12-67 months) were divided into three groups according to femoral fixation devices as 'Endobutton' (n=34), 'Transfix' (n=35) and 'Aperfix' (n=31). The length of painful period after surgery, time to return to work and sporting activities, final range of motion, anterior drawer and Lachman tests, knee instability symptoms, International Knee Documentation Committee (IKDC) subjective knee evaluation score, Short Form 36 (SF-36) score, Lysholm knee score and Tegner point of the patients were evaluated and compared between groups. There were no significant differences between the groups. All techniques led to significant recovery in knee instability tests and symptoms. In this study, the clinical results of different suspensory femoral fixation techniques were found to be similar. We believe that different femoral fixation techniques have no effect on clinical results provided that the technique is correctly applied. The surgeon must choose a technique appropriate to his or her experience. Copyright © 2015 Elsevier B.V. All rights reserved.

Autograft Versus Allograft Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Clinical Study With a Minimum 10-Year Follow-up.

PubMed

Bottoni, Craig R; Smith, Eric L; Shaha, James; Shaha, Steven S; Raybin, Sarah G; Tokish, John M; Rowles, Douglas J

2015-10-01

The use of allografts for anterior cruciate ligament (ACL) reconstruction in young athletes is controversial. No long-term results have been published comparing tibialis posterior allografts to hamstring autografts. To evaluate the long-term results of primary ACL reconstruction using either an allograft or autograft. Randomized controlled trial; Level of evidence, 1. From June 2002 to August 2003, patients with a symptomatic ACL-deficient knee were randomized to receive either a hamstring autograft or tibialis posterior allograft. All allografts were from a single tissue bank, aseptically processed, and fresh-frozen without terminal irradiation. Graft fixation was identical in all knees. All patients followed the same postoperative rehabilitation protocol, which was blinded to the therapists. Preoperative and postoperative assessments were performed via examination and/or telephone and Internet-based questionnaire to ascertain the functional and subjective status using established knee metrics. The primary outcome measures were graft integrity, subjective knee stability, and functional status. There were 99 patients (100 knees); 86 were men, and 95% were active-duty military. Both groups were similar in demographics and preoperative activity level. The mean and median ages of both groups were identical at 29 and 26 years, respectively. Concomitant meniscal and chondral pathologic abnormalities, microfracture, and meniscal repair performed at the time of reconstruction were similar in both groups. At a minimum of 10 years (range, 120-132 months) from surgery, 96 patients (97 knees) were contacted (2 patients were deceased, and 1 was unable to be located). There were 4 (8.3%) autograft and 13 (26.5%) allograft failures that required revision reconstruction. In the remaining patients whose graft was intact, there was no difference in the mean Single Assessment Numeric Evaluation, Tegner, or International Knee Documentation Committee scores. At a minimum of 10 years after ACL reconstruction in a young athletic population, over 80% of all grafts were intact and had maintained stability. However, those patients who had an allograft failed at a rate over 3 times higher than those with an autograft. © 2015 The Author(s).

Long-term degradation of a poly-lactide co-glycolide/β-tricalcium phosphate biocomposite interference screw.

PubMed

Barber, F Alan; Dockery, W D; Hrnack, Scott A

2011-05-01

To evaluate the long-term in vivo degradation of biodegradable interference screws made of poly-L-lactide co-glycolide (poly-L-lactic acid [PLLA]/polyglycolic acid [PGA]) and β-tricalcium phosphate (β-TCP). To study in vivo the biological behavior of a PLLA/PGA/β-TCP biocomposite screw (Milagro; DePuy Mitek, Raynham, MA), an institutional review board-approved program using anterior cruciate ligament (ACL) interference fixation screws was initiated in 2005. Thirteen patients who had bone-patellar tendon-bone ACL reconstruction fixed at both the femur and tibia with PLLA/PGA/β-TCP screws at least 24 months earlier were evaluated by physical, radiographic, and computed tomography (CT) evaluations. Lysholm, Tegner, Cincinnati, and International Knee Documentation Committee scores were also obtained. Radiographs and CT scans of the operated knee were obtained. CT scan data measured in Hounsfield units (HU) evaluated the material density at the screw and bone plug sites. Soft-tissue and cancellous and cortical bone site readings were also taken. Osteoconductivity scores were determined at the screw sites by use of an ossification quality score (range, 1 to 4). Eleven men and two women were evaluated at a mean of 38 months after surgery (range, 24 to 49 months). CT scans and radiographs showed the bone plug fused to the tunnel wall with no PLLA/PGA/β-TCP screw remaining. The screws were replaced with material that was calcified and non-trabecular. Osteoconductivity was present in 21 of 26 tunnels (81%) and complete (type 4 ossification) in 5 of 26 (19%). Mean screw site densities (femoral, 159 HU; tibial, 157 HU) were not different from the mean cancellous bone density (femoral, 146 HU; tibial, 140 HU). No positive pivot-shift tests were found. Lysholm, Tegner, and Cincinnati scores improved from 44, 3.7, and 37 preoperatively to 93, 6, and 87 at follow-up, respectively. The mean KT arthrometer (MEDmetric, San Diego, CA) difference was 0.8 mm. The PLLA/PGA/β-TCP interference screw completely degraded, and no remnant was present 3 years after implantation for a bone-patellar tendon-bone graft ACL reconstruction. Osteoconductivity was confirmed in 21 of 26 screw sites (81%) and completely filled the site in 5 of 26 (19%). The PLLA/PGA/β-TCP biocomposite interference screw is osteoconductive. Level IV, therapeutic case series. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Relationship between quadriceps strength and patellofemoral joint chondral lesions after anterior cruciate ligament reconstruction.

PubMed

Wang, Hai-Jun; Ao, Ying-Fang; Jiang, Dong; Gong, Xi; Wang, Yong-Jian; Wang, Jian; Yu, Jia-Kuo

2015-09-01

The incidence of the patellofemoral joint chondral lesions after anterior cruciate ligament reconstruction (ACLR) is disturbingly high. Few studies have assessed the factors affecting patellofemoral joint chondral lesions postoperatively. The recovery of quadriceps strength after ACLR could be associated with patellofemoral joint cartilage damage. Cohort study; Level of evidence, 3. A total of 88 patients who underwent arthroscopic anatomic double-bundle ACLR with hamstring autografts received second-look arthroscopy at the time of metal staple removal at an average of 24.1 months (range, 12-51 months) postoperatively. All patients underwent standardized isokinetic strength testing for bilateral quadriceps and hamstrings 1 to 2 days before second-look arthroscopy. The patients were divided into 2 groups: Patients in group 1 had a ≥20% deficit on the peak torque measures for quadriceps compared with that of the contralateral knee, whereas those in group 2 had a <20% deficit on peak torque. Cartilage status at the patellofemoral joint and tibiofemoral joint were evaluated by second-look arthroscopy and the Outerbridge classification. Other assessments included the International Knee Documentation Committee (IKDC) score, Tegner and Lysholm scores, side-to-side difference on KT-2000 arthrometer, and range of motion. There were 42 patients included in group 1 and 46 patients in group 2. The mean postoperative quadriceps peak torque of the involved knee compared with the contralateral knee was 70% (range, 57%-80%) in group 1 and 95% (range, 81%-116%) in group 2. For all patients, a significant worsening was seen in the patellar and trochlear cartilage (P = .030 and <.001, respectively) but not at the medial or lateral tibiofemoral joint after ACLR. A significant worsening in the status of both patellar and trochlear cartilage was seen after ACLR in group 1 (P = .013 and =.011, respectively) and of trochlear cartilage in group 2 (P = .006). Significantly fewer severe chondral lesions of the patella were found in group 2 than in group 1 (proportion of patients whose cartilage grade worsened: 26% vs 48%, P < .05; difference in cartilage grade: 0.09 vs 0.62, P < .05). There was no significant difference for trochlear chondral worsening between the 2 groups. No significant differences were detected between the 2 groups in terms of hamstring strength; Lysholm, Tegner, and IKDC scores; KT-2000 arthrometer anterior laxity; or range of motion. Greater than 80% recovery of quadriceps strength after ACLR is associated with less severe patellar cartilage damage at short-term follow-up. © 2015 The Author(s).

Partial meniscectomy provides no benefit for symptomatic degenerative medial meniscus posterior root tears.

PubMed

Krych, Aaron J; Johnson, Nick R; Mohan, Rohith; Dahm, Diane L; Levy, Bruce A; Stuart, Michael J

2018-04-01

Medial meniscus posterior root tears (MMPRTs) are recognized as a source of pain and dysfunction, but treatment options remain a challenge. The purpose of the study was to determine (1) the efficacy of partial meniscectomy to treat MMPRTs compared to a matched group of non-operatively treated MMPRTs, and (2) risk factors for worse clinical and radiographic outcome. This retrospective comparative study was performed to include patients with complete, isolated MMPRTs with documented clinical symptoms and were treated with arthroscopic partial meniscectomy (PMM) and a minimum 2-year follow-up. These patients were then matched by age, gender, and BMI to patients with the same diagnosis who were treated non-operatively. Clinical and radiographic outcomes were compared between the two groups. Analysis was performed to determine risk factors for worse clinical and radiographic outcome in the PMM group alone. Overall, 52 patients were included in the study. Twenty-six patients (9M:17F) with a mean age of 55 ± 9 and a mean BMI of 32.8 ± 5.3 were treated with PMM and followed for 5.5 ± 2.0 years (range 2.3-9.3 years). In the PMM group, final median Tegner score was 3, mean IKDC score was 67.8 ± 20, and more patients had grade II or higher arthritis at final follow-up than baseline (91.3 vs. 36%, p < 0.01). Overall, 14 of the 26 patients (54%) treated operatively progressed to total knee arthroplasty at a mean of 54.3 months. There was no significant difference in final Tegner scores, IKDC, K-L grades, progression to arthroplasty, or overall failure rate between the PMM group and non-operative group. Following PMM, female patients had lower final IKDC scores (44.0 ± 2.8 vs. 74.6 ± 16.7, p = 0.02) compared to males, as well as a higher rate of arthroplasty (70.6 vs. 20.0%, p = 0.009). Higher BMI correlated with lower IKDC scores (r = -0.91, p = 0.01) and meniscal extrusion was associated with higher rate of arthritis at final follow-up (p = 0.02). Partial meniscectomy for a complete MMPRT provides no benefit in halting arthritic progression. Patients who undergo PMM for MMPRTs still progress to significant arthritis, poor clinical outcomes and a high arthroplasty rate (54%) at over 5-year follow-up. Female gender, increased BMI, and meniscus extrusion were associated with worse outcome. Level III.

Return to sport after the surgical management of articular cartilage lesions in the knee: a meta-analysis.

PubMed

Krych, Aaron J; Pareek, Ayoosh; King, Alexander H; Johnson, Nick R; Stuart, Michael J; Williams, Riley J

2017-10-01

Optimal surgical treatment of chondral defects in an athletic population remains highly controversial and has yet to be determined. The purpose of this review was to (1) report data on return to sport and (2) compare activity and functional outcome measures following various cartilage restoration techniques. A comprehensive review was performed for studies with return-to-sport outcomes after microfracture (MFX), osteochondral autograft transfer (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI). All studies containing return-to-sport participation with minimum 2-year post-operative activity-based outcomes were included. A meta-analysis comparing rate of return to sport between each surgical intervention was conducted using a random-effects model. Forty-four studies met inclusion criteria (18 Level I/II, 26 Level III/IV). In total, 2549 patients were included (1756 M, 793 F) with an average age of 35 years and follow-up of 47 months. Return to sport at some level was 76 % overall, with highest rates of return after OAT (93 %), followed by OCA (88 %), ACI (82 %), and MFX (58 %). Osteochondral autograft transfer showed the fastest return to sports (5.2 ± 1.8 months) compared to 9.1 ± 2.2 months for MFX, 9.6 ± 3.0 months for OCA and 11.8 ± 3.8 months for ACI (P < 0.001). A meta-regression was conducted due to heterogeneity in preoperative factors such as patient age, lesion size, and preoperative Tegner score. None of these factors were found to be significant determinants for rate of return to sport. In conclusion, in this meta-analysis of 2549 athletes, cartilage restoration surgery had a 76 % return to sport at mid-term follow-up. Osteochondral autograft transfer offered a faster recovery and appeared to have a higher rate of return to preinjury athletics, but heterogeneity in lesion size, athlete age, and concomitant surgical procedures are important factors to consider when assessing individual athletes. This study reports on the rate of return to sport in athletes undergoing various procedures for symptomatic chondral defects. IV.

Single-stage in situ suture repair of multiple-ligament knee injury: a retrospective study of 17 patients (18 knees).

PubMed

Hua, Xingyi; Tao, Hui; Fang, Wang; Tang, Jian

2016-01-22

Multiple-ligament injured knee (MLIK) is a rare but severe injury. Although the principles of MLIK management have progressed over the past 40 years, there is a paucity of high-quality evidence upon which to base the management of MLIK. Treatment strategies for MLIK are challenging for most orthopedic surgeons, and the optimal treatment remains controversial, especially with regard to repair vs. reconstruction of the ligaments. The aim of the present study was to observe clinical outcomes of single-stage in situ suture repair of knee dislocation with multiple-ligament injury using nonabsorbable suture material. Consecutive patients with MLIK between 2002 and 2010 were included, for a total of 25 patients with knee dislocation. 17 patients (18 knees) with closed knee dislocation with a mean follow-up of 4.8 ± 1.3 years were retrospective analyzed. All patients were treated surgically with single-stage in situ suture repair for all injured ligaments and followed a standardized postoperative rehabilitation protocol. The VAS score, satisfactory score, total SF-36 score, Lysholm score, Tegner score, the Meyers functional rating and the ranges of motion and knee stability were used to evaluate outcomes. At final follow-up, mean visual analog scale score was 2.4 ± 0.9, patient satisfaction score was 8.0 ± 1.1, 36-item Short-Form Health Survey total score was 85.5 ± 10.4, and mean Lysholm score was 87.5 ± 7.7. There were significant differences between mean preinjury and postoperative Tegner activity scores (5.6 ± 1.4 and 3.4 ± 1.7, respectively; P < 0.01) and in mean range of motion between the injured and contralateral knees (112.5 ± 8.4° and 129.6 ± 10.3°, respectively; P < 0.01). At final follow-up, no patient demonstrated obvious ligamentous laxity, and only one patient was unable to return to work. Three patients had knee joint stiffness, two had wound problems (infection or fat liquefaction), and two had heterotopic bone formation. Single-stage in situ suture repair of injured ligaments confers advantages of reliable fixation and early exercise. It could be considered as an alternate and effective option in the dislocation knee with multiple-ligament injury.

Osteoarthritis prevalence following anterior cruciate ligament reconstruction: a systematic review and numbers-needed-to-treat analysis.

PubMed

Luc, Brittney; Gribble, Phillip A; Pietrosimone, Brian G

2014-01-01

To determine the prophylactic capability of anterior cruciate ligament (ACL) reconstruction in decreasing the risk of knee osteoarthritis (OA) when compared with ACL-deficient patients, as well as the effect of a concomitant meniscectomy. We also sought to examine the influence of study design, publication date, and graft type as well as the magnitude of change in physical activity from preinjury Tegner scores in both cohorts. We searched Web of Science and PubMed databases from 1960 through 2012 with the search terms osteoarthritis, meniscectomy, anterior cruciate ligament, anterior cruciate ligament reconstruction, and anterior cruciate ligament deficient. Articles that reported the prevalence of tibiofemoral or patellofemoral OA based on radiographic assessment were included. We calculated numbers needed to treat and relative risk reduction with associated 95% confidence intervals for 3 groups (1) patients with meniscal and ACL injury, (2) patients with isolated ACL injury, and (3) total patients (groups 1 and 2). A total of 38 studies met the criteria. Of these, 27 assessed the presence of tibiofemoral osteoarthritis in patients treated with anterior cruciate ligament reconstruction. Overall, ACL reconstruction (ACL-R) yielded a numbers needed to treat to harm of 16 with a relative risk increase of 16%. Anterior cruciate ligament reconstruction along with meniscectomy yielded a numbers needed to treat to benefit of 15 and relative risk reduction of 11%. Isolated ACL-R showed a numbers needed to treat to harm of 8 and relative risk increase of 43%. Activity levels were decreased in both ACL-R (d = -0.90; 95% confidence interval = 0.77, 1.13) and ACL-deficient (d = -1.13; 95% confidence interval = 0.96, 1.29) patients after injury. The current literature does not provide substantial evidence to suggest that ACL-R is an adequate intervention to prevent knee osteoarthritis. With regard to osteoarthritis prevalence, the only patients benefiting from ACL-R were those undergoing concomitant meniscectomy with reconstruction.

[Biodegradable screw versus a press-fit bone plug fixation for ACL reconstruction: a prospective randomized study].

PubMed

Geiges, B; von Falck, C; Knobloch, K; Haasper, C; Meller, R; Krettek, C; Hankemeier, S; Brand, J; Jagodzinski, M

2013-02-01

Press-fit fixation of a tendon graft has been advocated in order to achieve tendon to bone healing. Fixation of a tendon graft with a porous bone scaffold limits bone tunnel enlargement compared with a biodegradable interference screw fixation. Between 2005 and 2006, 20 patients (17 men, 3 women) were enrolled in this study for primary reconstruction of the ACL. Patients were randomized to either obtain graft fixation in the tibial tunnel by means of an interference screw (I) or a press-fit fixation with a porous bone cylinder (P). Three months after surgery, a CT scan of the knee was performed and tunnel enlargement was analysed in the coronal and sagittal planes for the proximal, middle and distal thirds of the tunnel. After 6 months, 1 and 2 years, International Knee Documentation Committee (IKDC), Tegner and Lysholm scores of both groups were compared. The bone tunnel enlargement was 106.9±10.9% for group P and 121.9±9.0% for group I (P<0.02) in the AP plane and 102.8±15.2% vs 121.5±10.1% in the coronal plane (P<0.01). IKDC, Tegner, and Lysholm scores improved in both groups from pre- to postoperative assessment without significant differences between the two groups. There was a trend to higher knee stability in group P after 3 months (0.6±1.4 mm vs 1.81±.5 mm, P=0.08). Both interference screw and a press-fit fixation lead to a high number of good or very good outcomes after ACL reconstruction. Tibial press-fit fixation decreases the amount of proximal bone tunnel enlargement. Press-fit fixation decreases the amount of proximal bone tunnel enlargement and improves bone to tendon contact.

Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function.

PubMed

Frings, Jannik; Krause, Matthias; Akoto, Ralph; Wohlmuth, Peter; Frosch, Karl-Heinz

2018-06-04

Valgus deformities of the lower extremity influence patellofemoral joint kinematics. However, studies examining the clinical outcome after treatment of patellar instability and maltracking due to valgus deformity are rare in recent literature. This study's purpose is to analyze the clinical results after combined distal femoral osteotomy (DFO) for treatment of patellar instability. From 2010 to 2016, 406 cases of patellofemoral instability and maltracking were treated. Twenty cases of recurring (≥ 2) patellar dislocations with genu valgum and unsuccessful conservative treatment were included in the study. A radiological analysis was performed, and anteroposterior (AP), lateral and long leg standing radiographs were analyzed, and the leg axis was pre- and postoperatively measured. At least 12 months postoperatively, the clinical leg axis, range of motion (ROM), apprehension sign, Zohlen sign, and J-sign were physically examined. Pain level and knee function were objectified on a visual analogue scale (VAS). The Lysholm, Kujala, and Tegner scores, re-dislocation rate, and patient satisfaction were also examined. 20 combined DFOs on 18 patients with a median age of 23 years (15-55 years) were performed. The preoperative mechanical leg axis was 6.5° ± 2.0° valgus, and the mean tibial tuberosity to trochlear groove (TT-TG) distance was 19.1 ± 4.8 mm. All patients reported multiple dislocations. Intraoperatively, 71% presented III°-IV° cartilage lesions, located retropatellarly in 87% and correlating negatively with the postoperative Lysholm score (r = - 0.462, p = 0.040). The leg axis was corrected by 7.1° ± 2.6°, and in 17 cases, the tibial tubercle was additionally medialized by 10 ± 3.1 mm. All patellae were re-stabilized with medial patellofemoral ligament reconstruction. After a median period of 16 (12-64) months, the pain level decreased from 8.0 ± 1.4 to 2.3 ± 2.1 (VAS p ≤ 0.001) and knee function improved from 40.1 ± 17.9 to 78.5 ± 16.6 (Kujala p ≤ 0.001), 36.1 ± 19.5 to 81.6 ± 11.7 (Lysholm p ≤ 0.001), and 2.0 (1-5) to 4.0 (3-6) (median Tegner p ≤ 0.001). No re-dislocation was observed. Combined DFO is a suitable treatment for patellar instability and maltracking due to genu valgum, as it leads to very low re-dislocation rates, a significant reduction of pain, and a significant increase of knee function with good-to-excellent results in the short-term follow-up. However, a high prevalence of substantial cartilage lesions is observed, causing postoperative limitations of knee function. IV, retrospective cohort study.

Systemic Review of Anatomic Single- Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: Does Femoral Tunnel Drilling Technique Matter?

PubMed

Zhang, Yang; Xu, Caiqi; Dong, Shiqui; Shen, Peng; Su, Wei; Zhao, Jinzhong

2016-09-01

To provide an up-to-date assessment of the difference between anatomic double-bundle anterior cruciate ligament (ACL) reconstruction (DB-ACLR) and anatomic single-bundle ACL reconstruction (SB-ACLR). We hypothesized that anatomic SB-ACLR using independent femoral drilling technique would be able to achieve kinematic stability as with anatomic DB-ACLR. A comprehensive Internet search was performed to identify all therapeutic trials of anatomic DB-ACLR versus anatomic SB-ACLR. Only clinical studies of Level I and II evidence were included. The comparative outcomes were instrument-measured anterior laxity, Lachman test, pivot shift, clinical outcomes including objective/subjective International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner activity scale and complication rates of extension/flexion deficits, graft failure, and early osteoarthritis. Subgroup analyses were performed for femoral tunnel drilling techniques including independent drilling and transtibial (TT) drilling. Twenty-two clinical trials of 2,261 anatomically ACL-reconstructed patients were included in the meta-analysis. Via TT drilling technique, anatomic DB-ACLR led to improved instrument-measured anterior laxity with a standard mean difference (SMD) of -0.42 (95% confidence interval [CI] = -0.81 to -0.02), less rotational instability measured by pivot shift (SMD = 2.76, 95% CI = 1.24 to 6.16), and higher objective IKDC score with odds ratio (OR) of 2.28 (95% CI = 1.19 to 4.36). Via independent drilling technique, anatomic DB-ACLR yielded better pivot shift (SMD = 2.04, 95% CI = 1.36 to 3.05). Anatomic DB-ACLR also revealed statistical significance in subjective IKDC score compared with anatomic SB-ACLR (SMD = 0.27, 95% CI = 0.05 to 0.49). Anatomic DB-ACLR showed better anterior and rotational stability and higher objective IKDC score than anatomic SB-ACLR via TT drilling technique. Via independent drilling technique, however, anatomic DB-ACLR only showed superiority of rotational stability. All clinical function outcomes except subjective IKDC score were not significantly different between anatomic DB-ACLR and SB-ACLR. Level II, meta-analysis of Level I and II studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Repair of insertional achilles tendinosis with a bone-quadriceps tendon graft.

PubMed

Philippot, Rémi; Wegrzyn, Julien; Grosclaude, Sophie; Besse, Jean Luc

2010-09-01

While conservative treatment may be successful in most cases, partial rupture at the calcaneal insertion point is a significant concern with insertional Achilles tendinopathy. We report on the outcomes of a surgical technique for Achilles tendon augmentation using a bone-tendon graft harvested from the knee extensor system. Our retrospective case series includes 25 surgical procedures performed in 24 patients, 19 males and five females, with a mean age of 47 (range, 30 to 59) years, 18 of whom were athletes. The mean followup period was 52 (range, 12 to 156) months. All patients underwent MRI examination prior to surgery which showed partial Achilles tendon rupture. The Achilles tendon was debrided through a posterolateral approach. The bone-quadriceps tendon graft was harvested, then the bone plug of the graft was inserted into a blind tunnel drilled into the calcaneus and fixed with an interference screw. The fibers of the quadriceps tendon were sutured to the residual part of the Achilles tendon with the foot at an angle of 90 degrees. Patients were able to resume their sporting activity after an average of 6.7 months. At last followup examination, physical activity was scored 5.2 on the 10-point Tegner Scale; the mean AOFAS score was 98.4. MRI examination showed good graft integration 1 year postoperatively. The bone-quadriceps tendon grafting technique was a good alternative for the insertional Achilles lesions with partial detachment which we felt required augmentation.

Restoring tibiofemoral alignment during ACL reconstruction results in better knee biomechanics.

PubMed

Zampeli, Frantzeska; Terzidis, Ioannis; Espregueira-Mendes, João; Georgoulis, Jim-Dimitris; Bernard, Manfred; Pappas, Evangelos; Georgoulis, Anastasios D

2018-05-01

Anterior cruciate ligament (ACL) reconstruction (ACLR) aims to restore normal knee joint function, stability and biomechanics and in the long term avoid joint degeneration. The purpose of this study is to present the anatomic single bundle (SB) ACLR that emphasizes intraoperative correction of tibiofemoral subluxation that occurs after ACL injury. It was hypothesized that this technique leads to optimal outcomes and better restoration of pathological tibiofemoral joint movement that results from ACL deficiency (ACLD). Thirteen men with unilateral ACLD were prospectively evaluated before and at a mean follow-up of 14.9 (SD = 1.8) months after anatomic SB ACLR with bone patellar tendon bone autograft. The anatomic ACLR replicated the native ACL attachment site anatomy and graft orientation. Emphasis was placed on intraoperative correction of tibiofemoral subluxation by reducing anterior tibial translation (ATT) and internal tibial rotation. Function was measured with IKDC, Lysholm and the Tegner activity scale, ATT was measured with the KT-1000 arthrometer and tibial rotation (TR) kinematics were measured with 3Dmotion analysis during a high-demand pivoting task. The results showed significantly higher TR of the ACL-deficient knee when compared to the intact knee prior to surgery (12.2° ± 3.7° and 10.7° ± 2.6° respectively, P = 0.014). Postoperatively, the ACLR knee showed significantly lower TR as compared to the ACL-deficient knee (9.6°±3.1°, P = 0.001) but no difference as compared to the control knee (n.s.). All functional scores were significantly improved and ATT was restored within normal values (P < 0.001). Intraoperative correction of tibiofemoral subluxation that results after ACL injury is an important step during anatomic SB ACLR. The intraoperative correction of tibiofemoral subluxation along with the replication of native ACL anatomy results in restoration of rotational kinematics of ACLD patients to normal levels that are comparable to the control knee. These results indicate that the reestablishment of tibiofemoral alignment during ACLR may be an important step that facilitates normal knee kinematics postoperatively. Level II, prospective cohort study.

Osteoarthritis Prevalence Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Numbers-Needed-to-Treat Analysis

PubMed Central

Luc, Brittney; Gribble, Phillip A.; Pietrosimone, Brian G.

2014-01-01

Objective: To determine the prophylactic capability of anterior cruciate ligament (ACL) reconstruction in decreasing the risk of knee osteoarthritis (OA) when compared with ACL-deficient patients, as well as the effect of a concomitant meniscectomy. We also sought to examine the influence of study design, publication date, and graft type as well as the magnitude of change in physical activity from preinjury Tegner scores in both cohorts. Data Sources: We searched Web of Science and PubMed databases from 1960 through 2012 with the search terms osteoarthritis, meniscectomy, anterior cruciate ligament, anterior cruciate ligament reconstruction, and anterior cruciate ligament deficient. Study Selection: Articles that reported the prevalence of tibiofemoral or patellofemoral OA based on radiographic assessment were included. We calculated numbers needed to treat and relative risk reduction with associated 95% confidence intervals for 3 groups (1) patients with meniscal and ACL injury, (2) patients with isolated ACL injury, and (3) total patients (groups 1 and 2). Data Extraction: A total of 38 studies met the criteria. Of these, 27 assessed the presence of tibiofemoral osteoarthritis in patients treated with anterior cruciate ligament reconstruction. Data Synthesis: Overall, ACL reconstruction (ACL-R) yielded a numbers needed to treat to harm of 16 with a relative risk increase of 16%. Anterior cruciate ligament reconstruction along with meniscectomy yielded a numbers needed to treat to benefit of 15 and relative risk reduction of 11%. Isolated ACL-R showed a numbers needed to treat to harm of 8 and relative risk increase of 43%. Activity levels were decreased in both ACL-R (d = −0.90; 95% confidence interval = 0.77, 1.13) and ACL-deficient (d = −1.13; 95% confidence interval = 0.96, 1.29) patients after injury. Conclusions: The current literature does not provide substantial evidence to suggest that ACL-R is an adequate intervention to prevent knee osteoarthritis. With regard to osteoarthritis prevalence, the only patients benefiting from ACL-R were those undergoing concomitant meniscectomy with reconstruction. PMID:25232663

First-generation autologous chondrocyte implantation in patients with cartilage defects of the knee: 7 to 14 years' clinical and magnetic resonance imaging follow-up evaluation.

PubMed

Moradi, Babak; Schönit, Eva; Nierhoff, Corinna; Hagmann, Sébastien; Oberle, Doris; Gotterbarm, Tobias; Schmitt, Holger; Zeifang, Felix

2012-12-01

The purpose of this study was to evaluate the overall long-term improvement of autologous chondrocyte implantation (ACI) treatment in terms of patient satisfaction, clinical assessment, and magnetic resonance imaging (MRI) evaluation. Furthermore, we aimed to assess the impact of independent variables on clinical outcomes and patient satisfaction. We evaluated 23 patients (mean age, 30.5 ± 8.2 years) with full-thickness chondral lesions of the distal femur who underwent first-generation ACI with periosteum between 1997 and 2004. The Lysholm score, Tegner activity score, subjective International Knee Documentation Committee score, numeric rating scale score, and Short Form 36 score were used for clinical assessment preoperatively, at 1 year postoperatively, and at 7 to 14 years (mean, 9.9 years) after surgery. MRI was performed to evaluate the cartilage preoperatively and at final follow-up, by use of the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. ACI resulted in a substantial improvement in all clinical outcome parameters, even as much as 14 years after implantation, although a small deterioration was noticed between intermediate and final evaluations in some outcome parameters. Of the patients, 73.1% stated that they would undergo the operation again. Younger patients with a shorter duration of preoperative symptoms and smaller defect sizes benefited most. MRI findings confirmed complete defect filling in 52.3% of the patients at final follow-up. Our long-term results confirm that first-generation ACI is an effective treatment for large full-thickness chondral and osteochondral lesions of the knee joint. Younger patients with a shorter duration of preoperative symptoms and smaller defect size benefited most in our study. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Clinical, radiological, and morphological evaluations of posterior horn tears of the lateral meniscus left in situ during anterior cruciate ligament reconstruction.

PubMed

Lee, Dhong Won; Jang, Hyoung Won; Lee, Sung Rak; Park, Jung Ho; Ha, Jeong Ku; Kim, Jin Goo

2014-02-01

Recent studies have shown that lateral menisci have a higher healing potential and that they can be treated successfully without symptoms by being left in situ during anterior cruciate ligament (ACL) reconstruction. However, few studies have reported morphological results. Stable posterior horn tears of the lateral meniscus left in situ during ACL reconstruction could be healed spontaneously and would result in not only successful clinical outcomes but also morphological restoration. Cohort study; Level of evidence, 3. Among 367 patients who underwent primary ACL reconstruction between 2008 and 2010, 53 patients who had lateral meniscus tears that were left in situ were analyzed. These patients were evaluated subjectively and radiologically and compared with a matched control group that underwent ACL reconstruction without any other structural disorders. Of the 53 patients with stable posterior horn tears of the lateral meniscus left in situ, 28 patients were assessed by second-look arthroscopic surgery and magnetic resonance imaging (MRI). The mean follow-up of the study group and the control group was 36.47 and 37.26 months, respectively. There were no statistical differences in postoperative clinical outcomes between the 2 groups. Clinical results of both groups including the Lysholm score, Tegner activity score, and International Knee Documentation Committee (IKDC) score significantly improved. In the subgroup composed of 28 patients, follow-up MRI showed 25 (89%) and 24 (86%) healed menisci in sagittal and coronal views, respectively. Twenty-one (75%) were considered to be completely healed, and 5 (18%) were incompletely healed on second-look arthroscopic surgery. Stable posterior horn tears of the lateral meniscus left in situ at the time of ACL reconstruction revealed successful clinical outcomes compared with isolated ACL injuries and showed considerable healing and functional restoration of tears with repeat MRI and second-look arthroscopic surgery. Therefore, leaving stable posterior horn tears of the lateral meniscus in situ during ACL reconstruction should be considered.

The importance of early diagnosis in spontaneous osteonecrosis of the knee - A case series with six year follow-up.

PubMed

Jordan, Robert W; Aparajit, Prasad; Docker, Charles; Udeshi, Umesh; El-Shazly, Mohi

2016-08-01

Spontaneous osteonecrosis of the knee has an unknown aetiology. Management options include conservative, surgical and pharmacological interventions. The aim of this study was to report the experience of the authors in conservative management of SONK using non-operative measures by analysing the functional outcome and need for surgical intervention. All patients treated for SONK between 1st August 2001 and 1st April 2014 were retrospectively reviewed. Treatment consisted of touch-down weight bearing for around six weeks. MR imaging was evaluated for size of lesion, the condyles involved and the time taken for resolution. Tegner Activity Scale, VAS pain, Lysholm, WOMAC and IKDC scores were recorded at presentation and final follow-up (mean six years, range six months to 13years). Forty cases were included; the mean age of the group was 55.3years and 67.5% were male. The medial femoral condyle was the most commonly affected (52.5%). A statistically significant improvement was reported in all functional outcome measures (p<0.001). Only one patient required arthroscopic surgical intervention and no patients required arthroplasty during the follow-up period. Early stage spontaneous osteonecrosis of the knee can be managed successfully without surgery if diagnosed early. Thus early investigation of acute knee pain with MRI scanning is recommended. Copyright © 2016 Elsevier B.V. All rights reserved.

Hip external rotation strength predicts hop performance after anterior cruciate ligament reconstruction.

PubMed

Kline, Paul W; Burnham, Jeremy; Yonz, Michael; Johnson, Darren; Ireland, Mary Lloyd; Noehren, Brian

2018-04-01

Quadriceps strength and single-leg hop performance are commonly evaluated prior to return to sport after anterior cruciate ligament reconstruction (ACLR). However, few studies have documented potential hip strength deficits after ACLR, or ascertained the relative contribution of quadriceps and hip strength to hop performance. Patients cleared for return to sports drills after ACLR were compared to a control group. Participants' peak isometric knee extension, hip abduction, hip extension, and hip external rotation (HER) strength were measured. Participants also performed single-leg hops, timed hops, triple hops, and crossover hops. Between-limb comparisons for the ACLR to control limb and the non-operative limb were made using independent two-sample and paired sample t tests. Pearson's correlations and stepwise multiple linear regression were used to determine the relationships and predictive ability of limb strength, graft type, sex, and limb dominance to hop performance. Sixty-five subjects, 20 ACLR [11F, age 22.8 (15-45) years, 8.3 ± 2 months post-op, mass 70.47 ± 12.95 kg, height 1.71 ± 0.08 m, Tegner 5.5 (3-9)] and 45 controls [22F, age 25.8 (15-45) years, mass 74.0 ± 15.2 kg, height 1.74 ± 0.1 m, Tegner 6 (3-7)], were tested. Knee extension (4.4 ± 1.5 vs 5.4 ± 1.8 N/kg, p = 0.02), HER (1.4 ± 0.4 vs 1.7 ± 0.5 N/kg, p = 0.04), single-leg hop (146 ± 37 vs 182 ± 38% limb length, p < 0.01), triple hop (417 ± 106 vs 519 ± 102% limb length, p < 0.01), timed hop (3.3 ± 2.0 vs 2.3 ± 0.6 s, p < 0.01), and crossover hop (364 ± 107 vs 446 ± 123% limb length, p = 0.01) were significantly impaired in the operative versus control subject limbs. Similar deficits existed between the operative and non-operative limbs. Knee extension and HER strength were significantly correlated with each of the hop tests, but only HER significantly predicted hop performance. After ACLR, patients have persistent HER strength, knee extension strength, and hop test deficits in the operative limb compared to the control and non-operative limbs, even after starting sport-specific drills. Importantly, HER strength independently predicted hop performance. Based on these findings, to resolve between-limb deficits in strength and hop performance clinicians should include HER strengthening exercises in post-operative rehabilitation. Prognostic Study, Level II.

[Application of pie-crusting the medial collateral ligament release in arthroscopic surgery for posterior horn of 
medial meniscus in knee joint].

PubMed

Zhu, Weihong; Tang, Qi; Liao, Lele; Li, Ding; Yang, Yang; Chen, You

2017-09-28

To explore the effectiveness and safety of pie-crusting the medial collateral ligament release (MCL) in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.
 Methods: Thirty-two consecutive patients with PHMM tear in tight medial tibiofemoral compartment of knee joint were admitted to our department from January, 2013 to December, 2014. All patients were performed pie-crusting the MCL release at its tibial insertion with 18-gauge intravenous needle. All patients were evaluated by valgus stress test and bilateral valgus stress radiograph at postoperative 1st day, 4th week and 12th week. Visual Analogue Scales (VAS), Lysholm scores, Tegner scores and International Knee Documentation Committee (IKDC) scores were recorded at the 1st, 3th, 6th month follow-up, then follow-up every 6 months.
 Results: The mean follow-up was 28 (24-36) months. All cases were negative in valgus stress test. MCL rupture, femoral fracture, articular cartilage lesion and neurovascular injury were not found at the last follow-up. The median medial joint space width of affected side and unaffected side for valgus stress radiographs were 6.8 mm and 4.3 mm (P<0.05) at the 1st day, 5.5 mm and 4.2 mm 
(P<0.05) in the 4th week and 4.8 mm and 4.3 mm (P>0.05) at the 12th week, respectively. VAS scores was changed from 4.5±1.5 preoperatively to 1.7±1.0 at the final follow-up (t=16.561, P<0.05). Lysholm scores was changed from 52.3±5.8 preoperatively to 93.2±6.3 at the final follow-up (t=-41.353, P<0.05). Tegner scores was changed from 4.1±1.1 preoperatively to 5.5±0.6 at the final follow-up (t=-18.792, P<0.05). IKDC scores was changed from 54.5±6.2 preoperative to 93.8±4.5 at the final follow-up (t=-38.253, P<0.05).
 Conclusion: Pie-crusting the medial collateral ligament release is a safe, minimal invasive and effective surgical option for posterior horn of medial meniscus tear in tight medial tibiofemoral compartment of knee joint.

Can Competitive Athletes Return to High-Level Play After Osteochondral Allograft Transplantation of the Knee?

PubMed

McCarthy, Mark A; Meyer, Maximilian A; Weber, Alexander E; Levy, David M; Tilton, Annemarie K; Yanke, Adam B; Cole, Brian J

2017-09-01

To investigate functional outcomes among competitive athletes undergoing osteochondral allograft (OCA) transplantation of the knee, including rates of return to play (RTP), and factors preventing RTP. A retrospective review identified all competitive athletes (high school, intercollegiate, professional) undergoing isolated femoral condyle OCA from 2004 to 2013. Patient-reported outcome (PRO) questionnaires (Lysholm, International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMasters Universities Arthritis Index [WOMAC], 12-Item Short Form Health Survey [SF-12], Tegner, and Marx) and custom RTP surveys were administered. All subsequent reoperations were documented. Thirteen athletes (4 intercollegiate, 9 high-school) were identified with an average follow-up of 5.9 ± 2.5 years. Seven athletes (54%) returned to competitive sport at an average of 7.9 ± 3.5 months, 5 of whom returned to preinjury functional levels. Of the 8 athletes who either did not return to competitive sport or failed to sustain their high level of play, the most common reasons cited were graduation from high school or college (4 patients, 50%) or fear of reinjury (3 patients, 38%). All 4 patients citing graduation as the primary factor preventing return to preinjury level of competitive sport resumed recreational sport without limitations, yielding an adjusted RTP rate of 10 patients (77%) who either returned to competitive play or believed they could return if they had not graduated. At final follow-up, athletes reported significant improvements in all PRO scores except for KOOS-Sport, WOMAC-Stiffness, and SF-12 Mental subscales. There were 3 reoperations at an average of 3.8 ± 3.3 years after the index OCA. There were no instances of graft failure. OCAs provide an adjusted RTP rate of 77% for high-level adolescent athletes. Social factors may be more likely than persistent pain to prevent return to sport. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Synthetic devices for reconstructive surgery of the cruciate ligaments: a systematic review.

PubMed

Batty, Lachlan M; Norsworthy, Cameron J; Lash, Nicholas J; Wasiak, Jason; Richmond, Anneka K; Feller, Julian A

2015-05-01

The role of synthetic devices in the management of the cruciate ligament-injured knee remains controversial. The aim of this systematic review was to assess the safety and efficacy of synthetic devices in cruciate ligament surgery. A systematic review of the electronic databases Medline, Embase, and The Cochrane Library (issue 1, 2014) on January 13, 2014, was performed to identify controlled and uncontrolled trials. Trials that assessed the safety and efficacy of synthetic devices for cruciate ligament surgery were included. The main variables assessed included rates of failure, revision, and noninfective effusion and synovitis. Patient-reported outcome assessments and complications were also assessed where reported. From 511 records screened, we included 85 articles published between 1985 and 2013 reporting on 6 synthetic devices (ligament augmentation and reconstruction system [Ligament Augmentation and Reconstruction System (LARS; Surgical Implants and Devices, Arc-sur-Tille, France)]; Leeds-Keio [Xiros (formerly Neoligaments), Leeds, England]; Kennedy ligament augmentation device [3M, St Paul, MN]; Dacron [Stryker, Kalamazoo, MI]; Gore-Tex [W.L. Gore and Associates, Flagstaff, AZ]; and Trevira [Telos (limited liability company), Marburg, Germany]). The heterogeneity of the included studies precluded meta-analysis. The results were analyzed by device and then type of reconstruction (anterior cruciate ligament [ACL]/posterior cruciate ligament [PCL]/combined ACL and PCL). The lowest cumulative rates of failure were seen with the LARS device (2.6% for ACL and 1% for PCL surgery). The highest failure rate was seen in the Dacron ACL group (cumulative rate, 33.6%). Rates of noninfective synovitis and effusion ranged from 0.2% in the LARS ACL group to 27.6% in the Gore-Tex ACL group. Revision rates ranged from 2.6% (LARS) to 11.8% (Trevira-Hochfest; Telos). Recent designs, specifically the LARS, showed good improvement in the outcome scores. The mean preoperative and postoperative Lysholm knee scores were 54 and 88, respectively; the mean preoperative and postoperative Tegner activity scale scores were 3.3 and 6, respectively. Preliminary results for newer-generation devices, specifically the LARS, show lower reported rates of failure, revision, and sterile effusion/synovitis when compared with older devices. Level IV, systematic review of Level II through IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

PubMed Central

Brusalis, Christopher M.; Lakomkin, Nikita; Suryavanshi, Joash R.; Cruz, Aristides I.; Green, Daniel W.; Jones, Kristofer J.; Fabricant, Peter D.

2017-01-01

Background: Advances in anterior cruciate ligament (ACL) reconstruction procedures in pediatric and adolescent patients have resulted in an increase in recent clinical studies on this topic. However, the consistency with which outcome measures are reported in this demographic is unknown. Purpose: To document outcome reporting patterns of youth ACL reconstruction studies in high-impact journals. Study Design: Systematic review; Level of evidence, 4. Methods: All articles published in 5 high-impact orthopaedic journals from 2010 to 2016 were reviewed to identify those reporting clinical outcomes of young patients who underwent ACL reconstruction. Studies that were nonclinical, reported on patients older than 18 years, or included fewer than 10 patients were excluded. Outcome measures used in all included studies were recorded. Results: Seventeen studies encompassing 772 subjects (mean age, 14.3 years; range, 6.3-18.0 years) were analyzed. Eight studies (47%) reported on Tanner stage of subjects, while 1 study reported skeletal age. Ten studies (59%) clearly documented the presence or absence of surgical complications. Range of motion was reported in 65% of studies. Leg-length discrepancy and angular deformity were each reported in 76% of studies, with 12% quantifying results through radiographic measurements. Ligament testing was variably defined by inclusion of instrumented testing (65%), Lachman test (53%), and pivot-shift test (53%). Fourteen studies (82%) explicitly reported on the rate of ACL rerupture, while 71% reported on the rate of revision surgery. Rate of return to preinjury activity was reported in 8 studies (47%), of which 2 defined criteria for return to sport and 3 defined the level of competitive sport. Patient-reported outcome measures (PROMs) were used variably. For the 3 most commonly reported PROMs (Lysholm, International Knee Documentation Committee, and Tegner), 24% of studies reported all 3 PROMs, 35% of studies reported 2 PROMs, and 6% of studies reported 1 PROM in isolation. A pediatric-specific PROM was reported in 1 of the 17 studies. Conclusion: Studies on pediatric ACL reconstruction published in high-impact journals unreliably defined subjects’ skeletal maturity, inconsistently reported on objective outcome measures, and used disparate adult-validated PROMs to assess subjective outcomes. These findings highlight the need for standardized, pediatric-specific outcome measures to be applied in future studies evaluating ACL reconstruction in children and adolescents. PMID:28840156

Outcome of opening wedge high tibial osteotomy augmented with a Biosorb® wedge and fixed with a plate and screws in 124 patients with a mean of ten years follow-up.

PubMed

Saragaglia, Dominique; Blaysat, Marc; Inman, Dominic; Mercier, Numa

2011-08-01

The objective of this work was firstly to evaluate the long-term results of medial opening wedge high tibial osteotomy (HTO) and secondly to evaluate the tolerance and integration of a Biosorb® wedge (β Tricalcium Phosphate, SBM Company, Lourdes, France). The series consisted of 124 knees in 110 patients, 74 men and 36 women, with mean age of 53.23±10.68 years (range 32-74) and treated between June 1995 and November 2000 for medial compartment knee osteoarthritis by the senior author. The mean preoperative Lysholm and Tegner functional score was 65.44±13.32 (range 27-80) and the preoperative HKA angle was 172.51°±3.8° (range 162-179°). According to the modified Ahlbäck classification there were 27 stage I, 42 stage II, 44 stage III and 11 stage IV knees. All patients were reviewed clinically and radiologically with a mean follow-up of 10.39±1.98 years (range 8-14 years). Immediate postoperative complications consisted of nine undisplaced lateral tibial plateau fractures of no clinical significance, two deep vein thromboses and three pulmonary emboli which resolved with appropriate treatment. At a later stage, there were seven delayed unions without development of pseudarthrosis, and three screw breakages when the AO T-plate was used, leading to a secondary angulation in one case, requiring revision by femoral osteotomy. Postoperative mean weightbearing HKA angle was 182°±1.8° (range 178-186°) and 73.4% of axes were 184°±2°. Fifteen knees (12.1%) underwent total knee arthroplasty (TKA) after a mean delay of 8.87±3.04 years and were excluded from the final analysis. Concerning the long-term results (n = 107 knees), the mean Lysholm-Tegner score was 88±12.7 points (51-100) and the KOOS score was 86±14.6 points (25-100) with 94 patients satisfied or very satisfied (87.85%). In terms of the HTO survivorship curve, with failure consisting of revision to TKA or another operation, survival was 88.8% at five years and 74% at ten years. Concerning Biosorb®, this was completely integrated in 100% of cases and there was complete resorption in 12.1% of cases and greater than 50% resorption in 52.3% of cases.

The necessity of clinical application of tibial reduction for detection of underestimated posterolateral rotatory instability in combined posterior cruciate ligament and posterolateral corner deficient knee.

PubMed

Lee, Han-Jun; Park, Yong-Beom; Ko, Young-Bong; Kim, Seong-Hwan; Kwon, Hyeok-Bin; Yu, Dong-Seok; Jung, Young-Bok

2015-10-01

The purpose of this study was to evaluate the usefulness of tibial reduction during dial test for clinical detection of underestimated posterolateral rotatory instability (PLRI) in combined posterior cruciate ligament (PCL)-posterolateral corner (PLC) deficient knee in terms of external rotation laxity and clinical outcomes. Twenty-one patients who classified as grade I PLRI using dial test with subluxated tibia, but classified as grade II with tibial reduction evaluated retrospectively. The mean follow-up was 39.3 months (range 24-61 months). Each patient was evaluated by the following variables: posterior translation and varus laxity on radiograph, KT-1000 arthrometer, dial test (reduced and subluxated position), International Knee Documentation Committee, Orthopädische Arbeitsgruppe Knie scoring system and Tegner activity scale. There were significant improvements in posterior tibial translation (8.6 ± 2.0 to 2.1 ± 1.0 mm; P < 0.001), varus laxity (3.3 ± 1.3 to 1.4 ± 0.5 mm; P < 0.001) and external rotation (13.2° ± 0.8° to 3.6° ± 1.1° at 30°, 13.3° ± 0.9° to 3.6° ± 0.9° at 90°; P < 0.001). The clinical scores were improved significantly at the last follow-up (P < 0.001). The external tibial rotation during dial test with tibial reduction increased from 6.8° ± 0.9 to 13.2° ± 0.8° at 30° of knee flexion, from 7.0° ± 0.8° to 13.3° ± 0.9° at 90° (P < 0.001). The clinical application of reduction of posteriorly subluxated tibia during the dial test was essential for an appropriate treatment of underestimated PLRI in combined PCL-PLC deficient knee. Retrospective case series, Level IV.

Clinical results of hamstring autografts in anterior cruciate ligament reconstruction: a comparison of femoral knot/press-fit fixation and interference screw fixation.

PubMed

Ho, Wei-Pin; Lee, Chian-Her; Huang, Chang-Hung; Chen, Chih-Hwa; Chuang, Tai-Yuan

2014-07-01

To compare the clinical outcomes of femoral knot/press-fit anterior cruciate ligament (ACL) reconstruction with conventional techniques using femoral interference screws. Among patients who underwent arthroscopic ACL reconstruction with hamstring autografts, 73 were treated with either a femoral knot/press-fit technique (40 patients, group A) or femoral interference screw fixation (33 patients, group B). The clinical results of the 2 groups were retrospectively compared. The inclusion criteria were primary ACL reconstruction in active patients. The exclusion criteria were fractures, multiligamentous injuries, patients undergoing revision, or patients with contralateral ACL-deficient knees. In the femoral knot/press-fit technique, semitendinosus and gracilis tendons were prepared as 2 loops with knots. After passage through a bottleneck femoral tunnel, the grafts were fixed with a press-fit method (grafts' knots were stuck in the bottleneck of the femoral tunnel). A tie with Mersilene tape (Ethicon, Somerville, NJ) over a bone bridge for each tendon loop and an additional bioabsorbable interference screw were used for tibial fixation. The mean follow-up period was 38 months (range, 24 to 61 months). A significant improvement in knee function and symptoms was reported in most patients, as shown by improved Tegner scores, Lysholm knee scores, and International Knee Documentation Committee assessments (P < .01). The results of instrumented laxity testing, thigh muscle assessment, and radiologic assessment were clearly improved when compared with the preoperative status (P < .01). No statistically significant difference in outcomes could be observed between group A and group B (P = not significant). In this nonrandomized study, femoral knot/press-fit ACL reconstruction did not appear to provide increased anterior instability compared with that of conventional femoral interference screw ACL reconstruction. Favorable outcomes with regard to knee stability and patient satisfaction were achieved in most of our ACL-reconstructed patients using femoral knot/press-fit fixation with hamstring tendon autograft. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Suture versus FasT-Fix all-inside meniscus repair at time of anterior cruciate ligament reconstruction.

PubMed

Choi, Nam-Hong; Kim, Byeong-Yeon; Hwang Bo, Byung-Hun; Victoroff, Brian N

2014-10-01

To compare meniscal healing and functional outcomes after all-inside meniscal repair between sutures and meniscal fixation devices. Sixty patients with a tear within the red-red or red-white zones of the posterior horn of the medial or lateral meniscus in conjunction with an anterior cruciate ligament (ACL) tear were included in this study. Meniscal repairs were performed with sutures in 35 patients and the FasT-Fix device (Smith & Nephew Endoscopy, Andover, MA) in 25 patients concomitantly with hamstring ACL reconstruction. Postoperative evaluations included Lysholm knee score, Tegner activity scale, Lachman and pivot-shift tests, and KT-1000 arthrometer (MEDmetric, San Diego, CA) testing. Follow-up magnetic resonance imaging (MRI) scans were obtained postoperatively for all patients to evaluate meniscal healing. The mean follow-up period was 47.2 months. In the suture group, 31 patients (86.1%) were asymptomatic and 4 (13.9%) were symptomatic. In the FasT-Fix group, 20 patients (80%) were asymptomatic and 5 (20%) were symptomatic. Postoperative functional evaluation and knee stability showed no statistically significant difference between the 2 groups. Follow-up MRI showed that 26 menisci (74.3%) were healed, 3 menisci (8.6%) were partially healed, and 6 menisci (17.1%) were not healed in the suture group. In the FasT-Fix group, 15 menisci (64%) were healed, 7 menisci (24%) were partially healed, and 3 menisci (12%) were not healed. Follow-up MRI showed no statistically significant difference between the 2 groups. In the FasT-Fix group, follow-up MRI showed a newly developed cyst posterior to the medial meniscus in 2 patients. A new tear anterior to the previous tear was found in 1 patient. In the suture group, follow-up MRI showed no cysts or new tears. All-inside meniscal repairs using either sutures or the FasT-Fix device showed satisfactory results in patients with concomitant hamstring ACL reconstruction. There was no statistically significant difference in meniscal healing evaluated by MRI and functional outcomes between the 2 techniques. Level III, retrospective comparative study. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Capsulodesis Versus Bone Trough Technique in Lateral Meniscal Allograft Transplantation: Graft Extrusion and Functional Results.

PubMed

Masferrer-Pino, Angel; Monllau, Joan C; Ibáñez, Maximiliano; Erquicia, Juan I; Pelfort, Xavier; Gelber, Pablo E

2018-06-01

To compare the radiographic results (in terms of graft extrusion) and the functional results of lateral meniscus allograft transplantations (MAT) performed with a bony fixation technique or with a soft tissue fixation technique after capsulodesis. A prospective series of 29 consecutive lateral MAT was analyzed. The inclusion criterion for MAT was lateral joint line pain due to a previous meniscectomy. Malalignment, patients who had an Ahlback grade greater than II, and patients with a body mass index over 30 were considered as the exclusion criterion to prevent confounding results. Fifteen of the grafts were fixed with a bony fixation technique (group A). The remaining 14 cases (group B) were fixed with sutures through bone tunnels after lateral capsular fixation (capsulodesis). All patients were studied with magnetic resonance imaging to determine the degree of meniscal extrusion at an average of 18 months of surgery (range, 12-48 months). Meniscal extrusion was measured on coronal magnetic resonance imaging. To standardize the results, the percentage of meniscus extruded for each group was also calculated and compared. The functional results were analyzed by means of standard knee scores (Lysholm, Tegner, and visual analog scale). If we consider the first 4 cases of group B as the learning curve of the new technique, we observe that group A had 8 cases (53.3%) of major extrusion, whereas group B had 1 case (7.1%) (P = .02). When comparing the degree of meniscal extrusion with the type of fixation employed, an even lower percentage of extruded menisci was found in group B (P = .01). The final follow-up Lysholm score in group A was 94.33 ± 5.96 (P < .001) and 91.43 ± 6.19 (P < .001) in group B. The median follow-up Tegner score significantly improved from 4 (range, 2-5) to 7 (range, 6-9) in group A (P < .001) and from 4 (range, 3-5) to 7 (range, 6-8) in group B (P < .001). The average visual analog scale score dropped down 5.87 and 7.29 points in groups A and B, respectively (P < .001). The Knee Injury and Osteoarthritis Outcome Score improved from 51.98 ± 2.84 to 90.88 ± 7.53 in group A (P < .001) and from 50.44 ± 2.32 to 92.01 ± 6.71 in group B (P < .001). Patient satisfaction with regard to the procedure stood at a mean of 3.6 ± 0.2 points out of a maximum of 4 in group A and 3.8 ± 0.4 in group B. There were no complications in this series. The capsulodesis technique in lateral MAT proved not to be statistically different at decreasing the degree of meniscal extrusion with respect to the bone-bridge fixation. If the first 4 cases using the new capsulodesis technique had not included in the results, the capsulodesis technique would have effectively presented better results relative to the degree of meniscal extrusion compared with the bone-bridge fixation technique. In addition, the functional results were similar. Level II, prospective comparative study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Healing of the Acutely Injured Anterior Cruciate Ligament: Functional Treatment with the ACL-Jack, a Dynamic Posterior Drawer Brace

PubMed Central

Reischl, Nikolaus; Rönn, Karolin; Magnusson, Robert A.; Gautier, Emanuel; Jakob, Roland P.

2016-01-01

Background. The injured anterior cruciate ligament (ACL) has a limited healing capacity leading to persisting instability. Hypothesis/Purpose. To study if the application of a brace, producing a dynamic posterior drawer force, after acute ACL injury reduces initial instability. Study Design. Cohort study. Methods. Patients treated with the ACL-Jack brace were compared to controls treated with primary ACL reconstruction und controls treated nonsurgically with functional rehabilitation. Measurements included anterior laxity (Rolimeter), clinical scores (Lysholm, Tegner, and IKDC), and MRI evaluation. Patients were followed up to 24 months. Results. Patients treated with the ACL-Jack brace showed a significant improvement of anterior knee laxity comparable to patients treated with ACL reconstruction, whereas laxity persisted after nonsurgical functional rehabilitation. The failure risk (secondary reconstruction necessary) of the ACL-Jack group was however 21% (18 of 86) within 24 months. Clinical scores were similar in all treatment groups. Conclusion. Treatment of acute ACL tears with the ACL-Jack brace leads to improved anterior knee laxity compared to nonsurgical treatment with functional rehabilitation. PMID:28053787

Reference values for fatigued versus non-fatigued limb symmetry index measured by a newly designed single-leg hop test battery in healthy subjects: a pilot study.

PubMed

Leister, Iris; Mattiassich, Georg; Kindermann, Harald; Ortmaier, Reinhold; Barthofer, Jürgen; Vasvary, Imre; Katzensteiner, Klaus; Stelzhammer, Christine; Kulnik, Stefan Tino

2018-01-01

There is sparse evidence for return to sport criteria after knee injury. Functional performance deficits, particularly in fatigued muscular condition, should be verified prior to the attempt to return to high-risk pivoting sports. The purpose of this study was to generate reference values for the limb symmetry index (LSI) of healthy subjects in fatigued and non-fatigued muscular condition in a newly designed test battery. Forty-two healthy subjects [22 females, 20 males; mean (SD) age 30.4 (6.6) years] were evaluated using a test battery consisting of an isometric strength test, a series of five single-leg hop tests and an integrated fatigue protocol. Subjective physical activity was assessed with the Tegner Activity Scale (TAS). The cut-off values for healthy subjects were calculated considering the fifth percentile as the minimum reference value for the LSI and single-leg hop distance. The mean (SD) overall LSI was 98.8% (4.6). No significant gender or age specific differences in limb symmetry were observed. The comparison of the non-fatigued LSI with the overall LSI revealed no clinically relevant change due to muscular fatigue. Repeated measures ANOVA revealed a significant within effect on fatigue/non-fatigue condition ( F (1,38)  = 18.000; p  < 0.001, η 2  = 0.321) on absolute single-leg hop distance. Moreover, a significant between effect on the TAS-parameter ( F (1,38)  = 5.928; p  = 0.020, η 2  = 0.135 between: TAS ≤ 5/TAS > 5) and on gender ( F (1,38)  = 23.956; p  < 0.001, η 2  = 0.387) could be detected. The absolute jumping distance in the single-leg hop for distance was significantly reduced due to fatigue. No clinically relevant effect of muscular fatigue was observed on limb symmetry in our study sample. Gender and physical activity are important factors to be considered when interpreting reference values.

Autologous Dual-Tissue Transplantation for Osteochondral Repair

PubMed Central

Foldager, Casper Bindzus; Jensen, Jonas; Lind, Martin

2015-01-01

Background Numerous treatment methods for osteochondral repair have been implemented, including auto- and allogeneic osteochondral transplantations, combined bone and chondrocyte transplantations, and synthetic implants, but no gold standard treatment has been established. We present preliminary data on a combined autologous bone and cartilage chips: autologous dual-tissue transplantation (ADTT); an easily applicable, low-cost treatment option for osteochondral repair. The aim of this study was to investigate the early biological and clinical outcome of ADTT. Materials Eight patients (age 32 ± 7.5 years) suffering from osteochondritis dissecans (OCD) in the knee were enrolled. The OCD lesion was debrided and the osteochondral defect was filled with autologous bone, to a level at the base of the adjacent cartilage. Cartilage biopsies from the intercondylar notch were chipped and embedded within fibrin glue in the defect. Evaluation was performed using magnetic resonance imaging, computed tomography, and clinical scores, preoperative and 1 year postoperative. Results Cartilage tissue repair evaluated using MOCART score improved from 22.5 to 52.5 (P < 0.01). Computed tomography imaging demonstrated very good subchondral bone healing with all 8 patients having a bone filling of >80%. We found improvements 1 year postoperative in the International Knee Documentation Committee score (from 35.9 to 68.1, P < 0.01), Tegner score (from 2.6 to 4.7, P < 0.05), and Knee injury and Osteoarthritis Outcome Score pain, symptoms, sport/recreation and quality of life (P < 0.05). Conclusion Treatment of OCD with ADTT resulted in very good subchondral bone restoration and good cartilage repair. Significant improvements in patient reported outcome was found at 1 year postoperative. This study suggests ADTT as a promising, low-cost, treatment option for osteochondral injuries. PMID:26175862

Combined injuries of the medial collateral ligament and the anterior cruciate ligament. Early ACL reconstruction versus late ACL reconstruction.

PubMed

Petersen, W; Laprell, H

1999-01-01

Aim of this retrospective study is to evaluate the effect of acute and late anterior cruciate ligament (ACL) reconstruction in patients with a combined injury of the ACL and the medial collateral ligament (MCL). All MCL injuries were treated non-operatively. In 27 patients (group I) we performed early ACL reconstruction (within the first 3 weeks after injury). The postoperative rehabilitation protocol included brace treatment for all patients over a period of 6 weeks. In 37 patients we performed late ACL reconstruction (after a minimum of 10 weeks). In this group initial non-operative MCL treatment (6 weeks brace treatment) was followed by a period of accelerated rehabilitation. Patients with late ACL reconstruction had a lower rate of loss of motion after finishing the postoperative rehabilitation programme and a lower rate of re-arthroscopies for a loss of extension (group I: 4 patients, group II: 1 patient). The difference in the mean quadriceps muscle strength (group I: 83.3%, group II: 86.3%) was not statistically significant. After a mean interval of 22 months, we saw no difference in the frequency of anterior or medial instabilities or in the loss of motion. The Lysholm score was significantly better in the group with late ACL reconstruction (group I: 85.3, group II: 89.9). The position on the Tegner activity scale decreased in both groups, to 5.5 in group I (preoperatively: 6.0) and to 5.6 in group II (preoperatively: 5.9). With regard to the lower rate of motion complications in the early postoperative period, the lower rate of re-arthroscopies, and the significantly better results in the Lysholm score, we prefer late ACL reconstruction in the treatment of combined injuries of the ACL and the MCL.

Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root.

PubMed

Neogi, Devdatta Suhas; Kumar, Ashok; Rijal, Laxman; Yadav, Chandra Shekhar; Jaiman, Ashish; Nag, Hira Lal

2013-09-01

Tears of the medial meniscus posterior root can lead to progressive arthritis, and its management has no consensus. The aim of our study was to evaluate the effect of supervised exercise therapy on patients with medial meniscus posterior root tears. Between January 2005 and May 2007, 37 patients with this tear verified by magnetic resonance imaging (MRI) and osteoarthritis grade 1-2 by radiographic examination were treated by a short course of analgesics daily for up to 6 weeks and then as required during follow-up, as well as a 12-week supervised exercise program followed by a home exercise program. Final analysis was performed for 33 patients, average age 55.8 (range 50-62) years and average follow-up of 35 (range 26-49) months. Patients were followed up at 3, 6, and 12 months and yearly thereafter using the Lysholm Knee Scoring Scale, Tegner Activity Scale (TAS), and visual analog scale (VAS). The analysis was performed using one-way analysis of variance (ANOVA) and Pearson's correlation coefficient to determine the relationship between Lysholm score and body mass index (BMI). Patients showed an improvement in Lysholm score, TAS, and VAS, which reached maximum in 6 months and later was accompanied by a decline. However, scores at the final follow-up were significantly better than the pretherapy scores. There was also a progression in arthritis as per Kellgren and Lawrence radiographic classification from median 1 preintervention to median 2 at the final follow-up. A correlation between BMI and Lysholm scores was seen (r = 0.47). Supervised physical therapy with a short course of analgesics followed by a home-based program results in symptomatic and functional improvement over a short-term follow-up; however, osteoarthritis progression continues and is related to BMI.

Assessment of clinical and MRI outcomes after mesenchymal stem cell implantation in patients with knee osteoarthritis: a prospective study.

PubMed

Kim, Y S; Choi, Y J; Lee, S W; Kwon, O R; Suh, D S; Heo, D B; Koh, Y G

2016-02-01

Cartilage regenerative procedures using the cell-based tissue engineering approach involving mesenchymal stem cells (MSCs) have been receiving increased interest because of their potential for altering the progression of osteoarthritis (OA) by repairing cartilage lesions. The aim of this study was to investigate the clinical and magnetic resonance imaging (MRI) outcomes of MSC implantation in OA knees and to determine the association between clinical and MRI outcomes. Twenty patients (24 knees) who underwent arthroscopic MSC implantation for cartilage lesions in their OA knees were evaluated at 2 years after surgery. Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed according to the MRI Osteoarthritis Knee Score (MOAKS) and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. The clinical outcomes significantly improved (P < 0.001 for both). The cartilage lesion grades (as described in MOAKS [grades for size of cartilage-loss area and percentage of full-thickness cartilage loss]) at follow-up MRI were significantly better than the preoperative values (P < 0.001 for both). The clinical outcomes at final follow-up were significantly correlated with the MOAKS and MOCART score at follow-up MRI (P < 0.05 for all). Considering the encouraging clinical and MRI outcomes obtained and the significant correlations noted between the clinical and MRI outcomes, MSC implantation seems to be useful for repairing cartilage lesions in OA knees. However, a larger sample size and long-term studies are needed to confirm our findings. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The Top 100 Cited Articles in Clinical Orthopedic Sports Medicine.

PubMed

Nayar, Suresh K; Dein, Eric J; Spiker, Andrea M; Bernard, Johnathan A; Zikria, Bashir A

2015-08-01

Orthopedic sports medicine continues to evolve, owing much of its clinical management and practice to rigorous academic research. In this review, we identify and describe the top 100 cited articles in clinical sports medicine and recognize the authors and institutions driving the research. We collected articles (excluding basic science, animal, and cadaveric studies) from the 25 highest-impact sports medicine journals and analyzed them by number of citations, journal, publication date, institution, country, topic, and author. Mean number of citations was 408 (range, 229-1629). The articles were published in 7 journals, most in the 1980s to 2000s, and represented 15 countries. Thirty topics were addressed, with a heavy emphasis on anterior cruciate ligament injury and reconstruction, knee rating systems, rotator cuff reconstruction, and chondrocyte transplantation. The 3 most cited articles, by Insall and colleagues, Constant and Murley, and Tegner and Lysholm, addressed a knee, a shoulder, and another knee rating system, respectively. Several authors contributed multiple articles. The Hospital for Special Surgery and the University of Bern contributed the most articles (5 each). This study provides a comprehensive list of the past century's major academic contributions to sports medicine. Residents and fellows may use this list to guide their scholarly investigations.

Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction: Midterm Clinical Outcomes.

PubMed

Tian, Shaoqi; Wang, Bin; Liu, Lun; Wang, Yuanhe; Ha, Chengzhi; Li, Qicai; Yang, Xu; Sun, Kang

2016-10-01

Most studies on grafts for anterior cruciate ligament (ACL) reconstruction (ACLR) have been of autografts or nonirradiated allografts with a single-bundle (SB) technique. Outcome reports evaluating anatomic double-bundle (DB) ACLR with a hamstring tendon autograft versus irradiated allograft are rare. To compare the clinical outcomes of arthroscopic anatomic DB ACLR with a hamstring tendon autograft versus irradiated allograft. Randomized controlled trial; Level of evidence, 2. Between 2008 and 2009, a total of 107 patients undergoing arthroscopic DB ACLR were prospectively randomized consecutively into 1 of 2 groups (autograft [Auto] group and irradiated allograft [Ir-Allo] group). All the surgical procedures were performed by the same senior surgeon using the DB reconstruction technique. All irradiated hamstring tendon allografts were sterilized with 2.5 Mrad of irradiation before distribution and were obtained from a single certified tissue bank. Graft fixation on the femoral side was by an Endobutton, and on the tibial side by a bioabsorbable interference screw augmented with a staple. The same rehabilitation protocol was applied to all patients. Before surgery and at a mean of 6.9 years of follow-up, patients were evaluated by the same observer according to objective and subjective clinical evaluations including detailed history, physical examination, radiography, functional knee ligament testing, KT-2000 arthrometer testing, Harner vertical jump and Daniel 1-legged hop tests, Lysholm score, Tegner score, International Knee Documentation Committee (IKDC) standard evaluation form, and Cincinnati knee score. A total of 83 patients (Auto: n = 40 [mean age, 29.2 ± 6.9 years]; Ir-Allo: n = 43 [mean age, 28.6 ± 7.2 years]) fulfilled follow-up and clinical evaluations. No significant differences were found between the 2 groups according to the overall IKDC functional and subjective evaluations as well as testing of activity levels. Significant between-group differences were found when comparing the results at final follow-up according to the Lachman test, anterior drawer test, pivot-shift test, and KT-2000 arthrometer measurements (P < .001). Most importantly, 87.5% of patients in the Auto group and 34.9% in the Ir-Allo group had a side-to-side difference <3 mm. The rate of laxity (side-to-side difference >5 mm) with an irradiated allograft (30.2%) was higher than that with an autograft (7.5%) (P < .001). The failure rate in the Ir-Allo group (30.2%) was higher than that in the Auto group (7.5%) (P < .001). Anterior and rotational stability decreased significantly in the Ir-Allo group; patients in the Ir-Allo group also had a shorter operation time. There were 10.0% (4/40) of patients in the Auto group and 32.6% (19/43) of patients in the Ir-Allo group who had arthritic progression (P < .05). There were no significant differences in postoperative activity levels and functional outcomes between the Auto and Ir-Allo groups. However, a significant increase in anterior and rotational laxity in the Ir-Allo group was found according to evaluations. We do not advocate an irradiated hamstring tendon allograft for DB ACLR. Clinical Trial Register System of The Affiliated Hospital of Qingdao University (qdfy-ky2008-12). © 2016 The Author(s).

Arthroscopic Repair of the Medial Meniscus Radial/Oblique Tear Prevents the Progression of Meniscal Extrusion in Mildly Osteoarthritic Knees.

PubMed

Furumatsu, Takayuki; Kodama, Yuya; Kamatsuki, Yusuke; Hino, Tomohito; Ozaki, Toshifumi

2017-10-01

Extrusion of the medial meniscus (MM) is associated with knee joint pain in osteoarthritic knees. The relationships among MM radial/oblique tears, MM extrusion (MME), and the effect of arthroscopic meniscal repair are not established. Here we evaluated the effects of arthroscopic all-inside MM repair on MME and the clinical outcomes in patients with radially oriented MM tears and mildly osteoarthritic knees. Twenty patients with a symptomatic radial or oblique tear of the MM posterior segment, MME ≥2.5 mm, and mildly osteoarthritic knees were treated using FasT-Fix 360 All-inside Meniscal Suture devices. We used magnetic resonance imaging (MRI) to measure the patients' MM body width (MMBW), absolute MME, and relative MME. The Japanese Knee Injury and Osteoarthritis Outcome Score, Lysholm, Tegner, IKDC Subjective Knee Evaluation, and Visual Analogue Scale scores were obtained. Arthroscopic all-inside MM repair prevented increases of absolute and relative MME. The preoperative and 3- and 12-month MRI-based MMBW values were similar. Over a 24-month follow-up after the MM repairs, the clinical scores showed significant improvements. Our results suggest that all-inside meniscal repairs would be useful in preventing the progression of MME in patients suffering from symptomatic MM radial/oblique tears associated with mildly osteoarthritic knees.

The effect and safety of highly standardized Ginger (Zingiber officinale) and Echinacea (Echinacea angustifolia) extract supplementation on inflammation and chronic pain in NSAIDs poor responders. A pilot study in subjects with knee arthrosis.

PubMed

Rondanelli, Mariangela; Riva, Antonella; Morazzoni, Paolo; Allegrini, Pietro; Faliva, Milena Anna; Naso, Maurizio; Miccono, Alessandra; Peroni, Gabriella; Degli Agosti, Irene; Perna, Simone

2017-06-01

The study aimed to evaluate the effect of Zingiber officinale and Echinacea angustifolia extract supplementation (25 mg of ginger and 5 mg of Echinacea) for 30 days on inflammation and chronic pain in knee osteoarthritis (OA). Consecutive nonsteroidal anti-inflammatory-drugs (NSAIDs) poor responders with chronic inflammation and pain due to knee arthrosis were assessed (15 subjects, age: 67.2 ± 7.9, body mass index: 30.6 ± 7.1, men/women:2/13). The primary endpoint was to determine pain improvement from baseline to Day 30 by Tegner Lysholm Knee Scoring. The secondary endpoints were the assessment of Visual Analog Scale for Pain, health-related quality of life, by the ShortForm36 (SF-36), anthropometric parameters, hydration. After supplementation, a significant improvement of 12.27 points was observed for Lysholm scale score (p < 0.05), SF-36 (p < 0.05), and a decrease in -0.52 cm in knee circumference (left) (p < 0.01). This pilot study provides feasibility and safety data for the use of highly standardised ginger and Echinacea extract supplementation in people with knee OA.

Clinical and radiological outcomes after a quasi-anatomical reconstruction of medial patellofemoral ligament with gracilis tendon autograft.

PubMed

Monllau, Joan C; Masferrer-Pino, Àngel; Ginovart, Gerard; Pérez-Prieto, Daniel; Gelber, Pablo E; Sanchis-Alfonso, Vicente

2017-08-01

To analyse the clinical and radiological outcomes of a quasi-anatomical reconstruction of the medial patellofemoral ligament (MPFL) with a gracilis tendon autograft. Patients with objective recurrent patellar instability that were operated on from 2006 to 2012 were included. A quasi-anatomical surgical technique was performed using a gracilis tendon autograft. It was anatomically attached at the patella, and the adductor magnus tendon was also used as a pulley for femoral fixation (non-anatomical reconstruction). The IKDC, Kujala and Lysholm scores as well as Tegner and VAS for pain were collected preoperatively and at final follow-up. Radiographic measurements of patellar position tilt and signs of osteoarthritis (OA) as well as trochlear dysplasia were also recorded. Thirty-six patients were included. The mean age at surgery was 25.6 years. After a minimum 27 months of follow-up, all functional scores significantly improved (p < 0.001) with respect to the preoperative values. The VAS dropped from 6 (SD 2.48) to 2 (SD 1.58). No recurrence of dislocation was observed in this series. The apprehension sign was still apparent in one patient. The CT scan evaluation showed a significant decrease in patellar tilt (p < 0.001). On the Crosby and Insall grading scale, there were no changes in the radiological signs of OA. This specific MPFL reconstruction gives good clinical results and corrects patellar tilt. It did not affect the patellofemoral surfaces at the short term, as shown by the absence of radiological signs of OA in the CT scan. The procedure has been shown to be safe and suitable for the treatment of chronic patellar instability, including in adolescents with open physis. A new effective, inexpensive and easy-to-perform technique is described to reconstruct MPFL in the daily clinical practice. Therapeutic case series, Level IV.

“Basket weave technique” for medial patellofemoral ligament reconstruction: Clinical outcome of a prospective study

PubMed Central

Kodkani, Pranjal S

2016-01-01

Background: Bone tunneling and implants with rigid fixations for medial patellofemoral ligament (MPFL) reconstruction are known to compromise results and are avoidable, especially in skeletally immature subjects. This study was to assess if these deficiencies were overcome with the technique devised by the author which avoids implants and bone tunnels. Results were assessed for complication rate and outcome. Materials and Methods: Fifty six knees of recurrent lateral patellar dislocation were treated in the past 49 months by MPFL reconstruction. Thirty nine were female and 17 male knees. The mean age was 20.6 years (range 9-48 years). Mean followup was 26 months. Five knees had previously failed stabilization procedures. Thirty one cases had Dejours Type A or B and 12 had Type C trochlear dysplasia. Arthroscopy was performed for associated injuries and loose bodies. Seven knees required loose body removal. Five knees underwent lateral retinacular release. Four knees had tibial tuberosity transfer. One knee had an associated anterior cruciate ligament reconstruction. An anatomical MPFL reconstruction was performed using hamstring autograft without the need for intraoperative fluoroscopy. Only soft tissue fixation was necessary with this newly devised technique and suturing. A rapid rehabilitation protocol was implemented with monthly followup until normalcy and 6 monthly thereafter. Results: All achieved full range of motion and normal mediolateral stability. There was no recurrence of dislocation. No major surgery related complications. One patella fracture at 8 months was due to a fall developed terminal restriction of flexion. Those in sports could return to their sporting activities (Tegner 1–9). Cases with osteochondral fractures had occasional pain that subsided in 1 year. Mean Kujala score improved from 64.3 to 99.69 with KOOS score near normal in all. Conclusion: This new method of MPFL reconstruction gives excellent results. It avoids complications related to bone tunneling and implants. It is a safe, effective, reliable and reproducible technique. PMID:26952121

Perioperative Testosterone Supplementation Increases Lean Mass in Healthy Men Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

PubMed

Wu, Brian; Lorezanza, Dan; Badash, Ido; Berger, Max; Lane, Christianne; Sum, Jonathan C; Hatch, George F; Schroeder, E Todd

2017-08-01

Rehabilitation after repair of the anterior cruciate ligament (ACL) is complicated by the loss of leg muscle mass and strength. Prior studies have shown that preoperative rehabilitation may improve muscle strength and postoperative outcomes. Testosterone supplementation may likewise counteract this muscle loss and potentially improve clinical outcomes. The purpose was to investigate the effect of perioperative testosterone administration on lean mass after ACL reconstruction in men and to examine the effects of testosterone on leg strength and clinical outcome scores. It was hypothesized that testosterone would increase lean mass and leg strength and improve clinical outcome scores relative to placebo. Randomized controlled trial; Level of evidence, 1. Male patients (N = 13) scheduled for ACL reconstruction were randomized into 2 groups: testosterone and placebo. Participants in the testosterone group received 200 mg of intramuscular testosterone weekly for 8 weeks beginning 2 weeks before surgery. Participants in the placebo group received saline following the same schedule. Both groups participated in a standard rehabilitation protocol. The primary outcome was the change in total lean body mass at 6 and 12 weeks. Secondary outcomes were extensor muscle strength, Tegner activity score, and Knee injury and Osteoarthritis Outcome Score. There was an increase in lean mass of a mean 2.7 ± 1.7 kg at 6 weeks postoperatively in the testosterone group compared with a decrease of a mean 0.1 ± 1.5 kg in the placebo group ( P = .01). Extensor muscle strength of the uninjured leg also increased more from baseline in the testosterone group (+20.8 ± 25.6 Nm) compared with the placebo group (-21.4 ± 36.7 Nm) at 12 weeks ( P = .04). There were no significant between-group differences in injured leg strength or clinical outcome scores. There were no negative side effects of testosterone noted. Perioperative testosterone supplementation increased lean mass 6 weeks after ACL reconstruction, suggesting that this treatment may help minimize the effects of muscle atrophy associated with ACL injuries and repair. This study was not powered to detect differences in strength or clinical outcome scores to assess the incidence of testosterone-related adverse events. Supraphysiological testosterone supplementation may be a useful adjunct therapy for counteracting muscle atrophy after ACL reconstruction. Further investigation is necessary to determine the safety profile and effects of perioperative testosterone administration on leg strength and clinical outcomes after surgery. NCT01595581 (ClinicalTrials.gov).

Extra-articular tenodesis combined with an anterior cruciate ligament reconstruction in acute anterior cruciate ligament tear in elite female football players.

PubMed

Guzzini, Matteo; Mazza, Daniele; Fabbri, Mattia; Lanzetti, Riccardo; Redler, Andrea; Iorio, Carlo; Monaco, Edoardo; Ferretti, Andrea

2016-10-01

The growing popularity of elite soccer among female participants has led to increased incidents of anterior cruciate ligament (ACL) ruptures. Many authors underline a positive glide after ACL reconstruction (ACLR), especially in women. In fact, an isolated intra-articular ACLR may be inadequate to control rotational instability after a combined injury of the ACL and the peripheral structures of the knee. Extra-articular procedures are sometimes used in primary cases displaying excessive antero-lateral rotatory instability. The purpose of this case series was to report subjective and objective outcomes after combined ACL and lateral extra-articular tenodesis (LET) with a minimum 4-year follow-up in a selected high-risk population of elite female football players. Between January 2007 and December 2010, 16 elite Italian female football players were included in the study. All patients underwent the same surgical technique: anatomical ACLR with autogenous semitendinosus and gracilis tendons. After the intra-articular reconstruction was performed, an additional extra-articular MacIntosh modified Coker-Arnold procedure was carried out. Patients were assessed pre- and post-operatively with the subjective and objective International Knee Documentation Committee (IKDC) evaluation form, Tegner activity scale (TAS) and Lysholm score. Joint laxity was assessed with KT-1000 by measuring the side-to-side (S/S) differences in displacement at manual maximum (mm) testing. At a mean follow-up of 72.6 ± 8.1 months, two independent examiners reviewed all players. All of the patients had a fully recovered range of motion. Lachman test was negative in all patients (100 %). The evaluation of joint laxity and clinical evaluation showed a statistically significant improvement. No patients experienced complication or a re-rupture. The rationale of combining extra-articular procedures with ACLR is to restrict the internal rotation of the reconstructed knee, taking advantage of its long lever arm and thus providing more stability in the rotational axis and preventing the ACL graft from undergoing further excessive strain. The combination of an LET with ACLR in elite female football players demonstrated excellent results in terms of subjective scales, post-operative residual laxity and re-rupture rate with no complication, and a complete return to sport activity.

The Effect of Sagittal Plane Deformities after Tibial Plateau Fractures to Functions and Instability of Knee Joint.

PubMed

Erdil, M; Yildiz, F; Kuyucu, E; Sayar, Ş; Polat, G; Ceylan, H H; Koçyiğit, F

2016-01-01

The objective of this study is to evaluate the effect of posterior tibial slope after fracture healing on antero-posterior knee laxity, functional outcome and patient satisfaction. 126 patients who were treated for tibial plateau fractures between 2008-2013 in the orthopedics and traumatology department of our institution were evaluated for the study. Patients were treated with open reduction and internal fixation, arthroscopy assisted minimally invasive osteosynthesis or conservative treatment. Mean posterior tibial slope after the treatment was 6.91 ± 5.11 and there was no significant difference when compared to the uninvolved side 6.42 ± 4,21 (p = 0.794). Knee laxity in anterior-posterior plane was 6.14 ± 2.11 and 5.95 ± 2.25 respectively on healthy and injured side. The difference of mean laxity in anterior-posterior plane between two sides was statistically significant. In this study we found no difference in laxity between the injured and healthy knees. However Tegner score decreased significantly in patients who had greater laxity difference between the knees. We did not find significant difference between fracture type and laxity, IKDC functional scores independent of the ligamentous injury. In conclusion despite coronal alignment is taken into consideration in treatment of tibial plateau fractures, sagittal alignment is reasonably important for stability and should not be ignored.

One-Step Treatment for Patellar Cartilage Defects With a Cell-Free Osteochondral Scaffold: A Prospective Clinical and MRI Evaluation.

PubMed

Perdisa, Francesco; Filardo, Giuseppe; Sessa, Andrea; Busacca, Maurizio; Zaffagnini, Stefano; Marcacci, Maurilio; Kon, Elizaveta

2017-06-01

The treatment of symptomatic cartilage defects of the patella is particularly challenging, and no gold standard is currently available. To evaluate the clinical results of a biphasic cell-free collagen-hydroxyapatite scaffold and to evaluate osteochondral tissue regeneration with magnetic resonance imaging (MRI). Case series; Level of evidence, 4. Thirty-four patients (18 men and 16 women; mean ± SD: age, 30.0 ± 10 years) were treated by scaffold implantation for knee chondral or osteochondral lesions of the patella (area, 2.1 ± 1 cm 2 ). The clinical evaluation was performed prospectively at 12 and 24 months via the IKDC (International Knee Documentation Committee; objective and subjective) and Tegner scores. MRI evaluation was performed at both follow-ups in 18 lesions through the MOCART score (magnetic resonance observation of cartilage repair tissue) and specific subchondral bone parameters. A statistically significant improvement in all the scores was observed at 12- and 24-month follow-up as compared with the basal evaluation. The IKDC subjective score improved from 39.5 ± 14.5 to 61.9 ± 14.5 at 12 months ( P > .0005) with a further increase to 67.6 ± 17.4 at 24 months of follow-up (12-24 months, P = .020). The MRI evaluation showed a stable value of the MOCART score between 12 and 24 months, with a complete filling of the cartilage in 87.0% of the lesions, complete integration of the graft in 95.7%, and intact repair tissue surface in 69.6% at final follow-up. The presence of osteophytes or more extensive bony overgrowth was documented in 47.8% of the patients of this series, but no correlation was found between MRI findings and clinical outcome. The implantation of a cell-free collagen-hydroxyapatite osteochondral scaffold provided a clinical improvement at short-term follow-up for the treatment of patellar cartilage defects. Women had lower outcomes, and the need for realignment procedures led to a slower recovery. MRI evaluation showed some abnormal findings with the presence of bone overgrowth, but no correlation has been found with the clinical outcome.

A multilayer biomaterial for osteochondral regeneration shows superiority vs microfractures for the treatment of osteochondral lesions in a multicentre randomized trial at 2 years.

PubMed

Kon, Elizaveta; Filardo, Giuseppe; Brittberg, Mats; Busacca, Maurizio; Condello, Vincenzo; Engebretsen, Lars; Marlovits, Stefan; Niemeyer, Philipp; Platzer, Patrik; Posthumus, Michael; Verdonk, Peter; Verdonk, Renè; Victor, Jan; van der Merwe, Willem; Widuchowski, Wojciech; Zorzi, Claudio; Marcacci, Maurilio

2017-09-14

The increasing awareness on the role of subchondral bone in the etiopathology of articular surface lesions led to the development of osteochondral scaffolds. While safety and promising results have been suggested, there are no trials proving the real potential of the osteochondral regenerative approach. Aim was to assess the benefit provided by a nanostructured collagen-hydroxyapatite (coll-HA) multilayer scaffold for the treatment of chondral and osteochondral knee lesions. In this multicentre randomized controlled clinical trial, 100 patients affected by symptomatic chondral and osteochondral lesions were treated and evaluated for up to 2 years (51 study group and 49 control group). A biomimetic coll-HA scaffold was studied, and bone marrow stimulation (BMS) was used as reference intervention. Primary efficacy measurement was IKDC subjective score at 2 years. Secondary efficacy measurements were: KOOS, IKDC Knee Examination Form, Tegner and VAS Pain scores evaluated at 6, 12 and 24 months. Tissue regeneration was evaluated with MRI MOCART scoring system at 6, 12 and 24 months. An external independent agency was involved to ensure data correctness and objectiveness. A statistically significant improvement of all clinical scores was obtained from basal evaluation to 2-year follow-up in both groups, although no overall statistically significant differences were detected between the two treatments. Conversely, the subgroup of patients affected by deep osteochondral lesions (i.e. Outerbridge grade IV and OCD) showed a statistically significant better IKDC subjective outcome (+12.4 points, p = 0.036) in the coll-HA group. Statistically significant better results were also found for another challenging group: sport active patients (+16.0, p = 0.027). Severe adverse events related to treatment were documented only in three patients in the coll-HA group and in one in the BMS group. The MOCART score showed no statistical difference between the two groups. This study highlighted the safety and potential of a biomimetic implant. While no statistically significant differences were found compared to BMS for chondral lesions, this procedure can be considered a suitable option for the treatment of osteochondral lesions. I.

No degeneration found in focal cartilage defects evaluated with dGEMRIC at 12-year follow-up.

PubMed

Engen, Cathrine Nørstad; Løken, Sverre; Årøen, Asbjørn; Ho, Charles; Engebretsen, Lars

2017-02-01

Background and purpose - The natural history of focal cartilage defects (FCDs) is still unresolved, as is the long-term cartilage quality after cartilage surgery. It has been suggested that delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a biomarker of early OA. We aimed to quantitatively evaluate the articular cartilage in knees with FCDs, 12 years after arthroscopic diagnosis. Patients and methods - We included 21 patients from a cohort of patients with knee pain who underwent arthroscopy in 1999. Patients with a full-thickness cartilage defect, stable knees, and at least 50% of both their menisci intact at baseline were eligible. 10 patients had cartilage repair performed at baseline (microfracture or autologous chondrocyte implantation), whereas 11 patients had either no additional surgery or simple debridement performed. Mean follow-up time was 12 (10-13) years. The morphology and biochemical features were evaluated with dGEMRIC and T2 mapping. Standing radiographs for Kellgren and Lawrence (K&L) classification of osteoarthritis (OA) were obtained. Knee function was assessed with VAS, Tegner, Lysholm, and KOOS. Results - The dGEMRIC showed varying results but, overall, no increased degeneration of the injured knees. Degenerative changes (K&L above 0) were, however, evident in 13 of the 21 knees. Interpretation - The natural history of untreated FCDs shows large dGEMRIC variations, as does the knee articular cartilage of surgically treated patients. In this study, radiographic OA changes did not correlate with cartilage quality, as assessed with dGEMRIC.

Platelet-rich plasma: does it help reduce tunnel widening after ACL reconstruction?

PubMed

Vadalà, Antonio; Iorio, Raffaele; De Carli, Angelo; Ferretti, Matteo; Paravani, Daniele; Caperna, Ludovico; Iorio, Carlo; Gatti, Andrea; Ferretti, Andrea

2013-04-01

The purpose of this study was to evaluate the efficacy of platelet-rich plasma (PRP) in reducing femoral and tibial tunnel enlargement in patients operated on for anterior cruciate ligament reconstruction with hamstrings. Forty male patients, in which both femoral and tibial 9-mm tunnels were performed because of the graft size, were enrolled in this prospective study. They were randomly assigned to group A (20 patients, PRP group) and group B (20 patients, control group). All patients were followed up at a median of 14.7 months (range 10-16 months), with a physical examination, the Tegner, Lysholm and objective IKDC scoring scales, and with the KT-1000 arthrometer. Moreover, they underwent a CT evaluation in order to assess the amount of tunnel enlargement. Femoral tunnel diameter increased from 9.0 ± 0.1 mm to 9.8 ± 0.3 mm in group A (p = 0.032) and from 9.0 ± 0.1 mm to 9.4 ± 0.5 mm in group B (p = 0.043). Tibial tunnel diameter increased from 9.0 ± 0.2 mm to 10.9 ± 0.2 mm in group A (p = 0.029) and from 9.1 ± 0.1 mm to 10.1 ± 0.4 mm in group B (p = 0.028). Physical examination as well as the evaluation scales used showed no differences between the two groups. The use of PRP does not seem to be effective in preventing tunnel enlargement.

Single-stage cartilage repair in the knee with microfracture covered with a resorbable polymer-based matrix and autologous bone marrow concentrate.

PubMed

Enea, D; Cecconi, S; Calcagno, S; Busilacchi, A; Manzotti, S; Kaps, C; Gigante, A

2013-12-01

Different single-stage surgical approaches are currently under evaluation to repair focal cartilage lesions. This study aims to analyze the clinical and histological results after treatment of focal condylar articular lesions of the knee with microfracture and subsequent covering with a resorbable polyglycolic acid/hyaluronan (PGA -HA) matrix augmented with autologous bone marrow concentrate (BMC). Nine patients with focal lesions of the condylar articular cartilage were consecutively treated with arthroscopic PGA -HA-covered microfracture and bone marrow concentrate (PGA -HA-CMBMC). Patients were retrospectively assessed using standardized assessment tools and magnetic resonance imaging (MRI). Five patients consented to undergo second look arthroscopy and 2 consented biopsy harvest. All the patients but one showed improvement in clinical scoring from the pre-operative situation to the latest follow-up (average 22±2months). The mean IKDC subjective score, Lysholm score, VAS and the median Tegner score significantly increased from baseline to the latest follow-up. Cartilage macroscopic assessment at 12months revealed that one repair appeared normal, three almost normal and one appeared abnormal. Histological analysis proofed hyaline-like cartilage repair tissue formation in one case. MRI at 8 to 12months follow-up showed complete defect filling. The first clinical experience with single-stage treatment of focal cartilage defects of the knee with microfracture and covering with the PGA -HA matrix augmented with autologous BMC (PGA -HA-CMBMC) suggests that it is safe, it improves knee function and has the potential to regenerate hyaline-like cartilage. IV, case series. Copyright © 2013 Elsevier B.V. All rights reserved.

Testing the feasibility and safety of the Nintendo Wii gaming console in orthopedic rehabilitation: a pilot randomized controlled study

PubMed Central

Stapf, Jonas; Meissner, Kay Michael; Niethammer, Thomas; Lahner, Matthias; Wagenhäuser, Markus; Müller, Peter E.; Pietschmann, Matthias F.

2016-01-01

Introduction The Nintendo Wii game console is already used as an additional training device for e.g. neurological wards. Still there are limited data available regarding orthopedic rehabilitation. The authors’ objective was to examine whether the Nintendo Wii is an appropriate and safe tool in rehabilitation after orthopedic knee surgery. Material and methods A prospective, randomized, controlled study comparing standard physiotherapy vs. standard physiotherapy plus game console training (Wii group) in patients having anterior cruciate ligament (ACL) repair or knee arthroplasty was conducted. The subjects of the Wii group (n = 17; mean age: 54 ±19 years) performed simple knee exercises daily under the supervision of a physiotherapist in addition to the normal rehabilitation program. The patients of the control group (n = 13; 52 ±18 years) were treated with physiotherapy only. The participants of both groups completed a questionnaire including the International Knee Documentation Committee (IKDC) score, the Modified Cincinnati Rating System and the Tegner Lysholm Knee Score prior to the operation, before discharge from hospital and four weeks after treatment. Results There was no significant difference in the score results between the Wii and the control group (p > 0.05). Conclusions We demonstrated that physiotherapy using the Nintendo Wii gaming console after ACL reconstruction and knee arthroplasty does not negatively influence outcome. Because training with the Wii device was highly accepted by patients, we see an opportunity whereby additional training with a gaming console for a longer period of time could lead to even better results, regarding the training motivation and the outcome after orthopedic surgery. PMID:27904518

Evaluation of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee: a systematic review.

PubMed

Howe, Tracey E; Dawson, Lesley J; Syme, Grant; Duncan, Louise; Reid, Judith

2012-04-01

This systematic review reported on the clinimetric properties of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee. A systematic search was performed in Medline, EMBASE, Cinahl and AMED to identify studies examining the clinimetric properties of outcome measures for adults undergoing conservative treatment of ligament injuries, meniscal lesions, patellofemoral pain and osteoarthritis of the knee. Outcomes measures taking less than 20 min to administer and requiring minimal equipment and space were included. Pairs of authors used a checklist to record the characteristics of the outcome measures, their reported clinimetric properties and the demographics of the study populations. The OMERACT filters of 'truth' and 'discrimination' were applied to the data for each outcome measure by an expert panel. Forty-seven studies were included evaluating 37 outcome measures. Ten outcome measures had adequate supporting evidence for 'truth' and 'discrimination': AAOS, AKPS, goniometer measurement, IKDC, KOOS, LEFS, Lysholm, Tegner, WOMAC and WOMET. However none of the outcome measures had been comprehensively tested across all clinimetric properties. Despite the widespread use of some outcome measures in clinical practice and primary research, data on the clinimetric properties were available for only 37 and of these only 10 had adequate supporting evidence for use in this population. However, before a core set of outcome measures can be recommended use in clinical practice, for adults with musculoskeletal conditions of the knee, consensus should be obtained on 'feasibility' in terms of burden on the clinician and the participant. Copyright © 2011 Elsevier Ltd. All rights reserved.

Testing the feasibility and safety of the Nintendo Wii gaming console in orthopedic rehabilitation: a pilot randomized controlled study.

PubMed

Ficklscherer, Andreas; Stapf, Jonas; Meissner, Kay Michael; Niethammer, Thomas; Lahner, Matthias; Wagenhäuser, Markus; Müller, Peter E; Pietschmann, Matthias F

2016-12-01

The Nintendo Wii game console is already used as an additional training device for e.g. neurological wards. Still there are limited data available regarding orthopedic rehabilitation. The authors' objective was to examine whether the Nintendo Wii is an appropriate and safe tool in rehabilitation after orthopedic knee surgery. A prospective, randomized, controlled study comparing standard physiotherapy vs. standard physiotherapy plus game console training (Wii group) in patients having anterior cruciate ligament (ACL) repair or knee arthroplasty was conducted. The subjects of the Wii group ( n = 17; mean age: 54 ±19 years) performed simple knee exercises daily under the supervision of a physiotherapist in addition to the normal rehabilitation program. The patients of the control group ( n = 13; 52 ±18 years) were treated with physiotherapy only. The participants of both groups completed a questionnaire including the International Knee Documentation Committee (IKDC) score, the Modified Cincinnati Rating System and the Tegner Lysholm Knee Score prior to the operation, before discharge from hospital and four weeks after treatment. There was no significant difference in the score results between the Wii and the control group ( p > 0.05). We demonstrated that physiotherapy using the Nintendo Wii gaming console after ACL reconstruction and knee arthroplasty does not negatively influence outcome. Because training with the Wii device was highly accepted by patients, we see an opportunity whereby additional training with a gaming console for a longer period of time could lead to even better results, regarding the training motivation and the outcome after orthopedic surgery.

Clinician-Friendly Physical Performance Tests for the Hip, Ankle, and Foot.

PubMed

Vogler, Joseph H; Csiernik, Alexander J; Yorgey, Marissa K; Harrison, Jerrod J; Games, Kenneth E

2017-09-01

Reference:  Hegedus EJ, McDonough SM, Bleakley C, Baxter D, Cook CE. Clinician-friendly lower extremity physical performance tests in athletes: a systematic review of measurement properties and correlation with injury. Part 2: the tests for the hip, thigh, foot, and ankle including the Star Excursion Balance Test. Br J Sports Med. 2015;49(10):649-656.   Do individual physical performance tests (PPTs) for the lower extremity have any relation to injury in athletes 12 years of age and older?   The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to locate articles. Three databases were searched from inception to January 13, 2014: PubMed, CINAHL, and SPORTDiscus. Search phrases were sport, athletics, athletes, and injuries combined with strength, power, endurance, agility, and function. Reference lists of all remaining articles and personal collections of the authors were then reviewed for any missing articles.   Studies were included according to the following criteria: (1) published in English, (2) presented as complete articles (ie, no abstracts or posters), and (3) involved human participants. Studies were excluded on the following criteria: (1) a combination of PPTs was examined, (2) the results were measured using equipment that was expensive or not readily available to the average clinician, (3) the PPTs examined impairment-level data, (4) the PPTs examined tasks not relevant to the lower extremity, or (5) the participants scored 4 or less on the Tegner Activity Scale. The final analysis involved 31 studies.   The name of the PPT and methods were extracted. Each PPT was then critiqued using the Consensus-Based Standards for the Selection of Health Measurement Instruments, a 4-point Likert scale. Data were also summarized using a score of unknown, strong, moderate, limited, or conflicting for the best evidence synthesis.   A total of 14 PPTs were examined; however, names and methods of the PPTs were inconsistent throughout the literature. In descending order, based on frequency of appearance in the literature, the PPTs were (1) 1-legged hop for distance, (2) vertical jump, (3) Star Excursion Balance Test, (4) shuttle run, (5) 6-m timed hop, (6) triple hop, (7) 40-yd sprint, (8) triple crossover hop for distance, (9) 6-m timed crossover hop, (10) T-agility, (11) hexagon hop, (12) medial hop, (13) lateral hop, and (14) multi-stage fitness (beep test). The Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions was the only test that could help identify injury risk. The 1-legged hop for distance and hexagon hop showed a moderate ability to differentiate between normal and unstable ankles. In dancers, the medial hop in dancers differentiated between painful and normal hips with moderate evidence.   Very little evidence supports the use of PPTs for athletes with lower extremity injuries. A panel of experts needs to standardize the names and methods of widely accepted tests.

Do Tibial Plateau Fractures Worsen Outcomes of Knee Ligament Injuries? A Matched Cohort Analysis

PubMed Central

Cinque, Mark E.; Godin, Jonathan A.; Moatshe, Gilbert; Chahla, Jorge; Kruckeberg, Bradley M.; Pogorzelski, Jonas; LaPrade, Robert F.

2017-01-01

Background: Tibial plateau fractures account for a small portion of all fractures; however, these fractures can pose a surgical challenge when occurring concomitantly with ligament injuries. Purpose/Hypothesis: The purpose of this study was to compare 2-year outcomes of soft tissue reconstruction with or without a concomitant tibial plateau fracture and open reduction internal fixation. We hypothesized that patients with a concomitant tibial plateau fracture at the time of soft tissue surgery would have inferior outcomes compared with patients without an associated tibial plateau fracture. Study Design: Cohort study; Level of evidence, 3. Methods: Forty patients were included in this study: 8 in the fracture group and 32 in the matched control group. Inclusion criteria for the fracture group included patients who were at least 18 years old at the time of surgery and sustained a tibial plateau fracture and a concomitant injury of the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, or fibular collateral ligament in isolation or any combination of cruciate or collateral ligaments and who subsequently underwent isolated or combined ligament reconstruction. Patients were excluded if they underwent prior ipsilateral knee surgery, sustained additional bony injuries, or sustained an isolated extra-articular ligament injury at the time of injury. Each patient with a fracture was matched with 4 patients from a control group who had no evidence of a tibial plateau fracture but underwent the same soft tissue reconstruction procedure. Results: Patients in the fracture group improved significantly from preoperatively to postoperatively with respect to Short Form–12 (P < .05) and Western Ontario and McMaster Universities Osteoarthritis Index total scores (P < .05). The Lysholm (P = .075) and Tegner scores (P = .086) also improved, although this was not statistically significant. Patients in the control group improved significantly from preoperatively to postoperatively across all measured scores. A comparison of the postoperative results between the 2 groups showed no statistically significant difference. Conclusion: The presence of a tibial plateau fracture in conjunction with a ligamentous knee injury did not have a negative effect on postoperative patient-reported outcomes. Patient-reported outcome scores after surgery in both the fracture and control groups improved beyond the minimally clinically important difference, indicating that the presence of a fracture did not detract from the outcomes observed in patients without fractures undergoing concomitant ligament reconstruction. PMID:28840154

The value of arthroscopy in the treatment of complex ankle fractures - a protocol of a randomised controlled trial.

PubMed

Braunstein, Mareen; Baumbach, Sebastian F; Regauer, Markus; Böcker, Wolfgang; Polzer, Hans

2016-05-12

An anatomical reconstruction of the ankle congruity is the important prerequisite in the operative treatment of acute ankle fractures. Despite anatomic restoration patients regularly suffer from residual symptoms after these fractures. There is growing evidence, that a poor outcome is related to the concomitant traumatic intra-articular pathology. By supplementary ankle arthroscopy anatomic reduction can be confirmed and associated intra-articular injuries can be treated. Nevertheless, the vast majority of complex ankle fractures are managed by open reduction and internal fixation (ORIF) only. Up to now, the effectiveness of arthroscopically assisted fracture treatment (AORIF) has not been conclusively determined. Therefore, a prospective randomised study is needed to sufficiently evaluate the effect of AORIF compared to ORIF in complex ankle fractures. We perform a randomised controlled trial at Munich University Clinic enrolling patients (18-65 years) with an acute ankle fracture (AO 44 A2, A3, B2, B3, C1 - C3 according to AO classification system). Patients meeting the inclusion criteria are randomised to either intervention group (AORIF, n = 37) or comparison group (ORIF, n = 37). Exclusion criteria are fractures classified as AO type 44 A1 or B1, pilon or plafond-variant injury or open fractures. Primary outcome is the AOFAS Score (American Orthopaedic Foot and Ankle Society). Secondary outcome parameter are JSSF Score (Japanese Society of Surgery of the Foot), Olerud and Molander Score, Karlsson Score, Tegner Activity Scale, SF-12, radiographic analysis, arthroscopic findings of intra-articular lesions, functional assessments, time to return to work/sports and complications. This study protocol is accordant to the SPIRIT 2013 recommendation. Statistical analysis will be performed using SPSS 22.0 (IBM). The subjective and functional outcome of complex ankle fractures is regularly unsatisfying. As these injuries are very common it is essential to improve the postoperative results. Potentially, arthroscopically assisted fracture treatment can significantly improve the outcome by addressing the intra-articular pathologies. Given the absolute lack of studies comparing AORIF to ORIF in complex ankle fractures, this randomised controlled trail is urgently needed to evaluate the effectiveness of additional arthroscopy. ClinicalTrials.gov reference: NCT02449096 (Trial registration date: April 7th, 2015).

Mid-term results of lateral unicondylar mobile bearing knee arthroplasty: a multicentre study of 363 cases.

PubMed

Walker, T; Zahn, N; Bruckner, T; Streit, M R; Mohr, G; Aldinger, P R; Clarius, M; Gotterbarm, T

2018-01-01

The aim of this independent multicentre study was to assess the mid-term results of mobile bearing unicondylar knee arthroplasty (UKA) for isolated lateral osteoarthritis of the knee joint. We retrospectively evaluated 363 consecutive, lateral UKAs (346 patients) performed using the Oxford domed lateral prosthesis undertaken in three high-volume knee arthroplasty centres between 2006 and 2014. Mean age of the patients at surgery was 65 years (36 to 88) with a mean final follow-up of 37 months (12 to 93) RESULTS: A total of 36 (10.5%) patients underwent revision surgery, giving a survival rate of 90.1% at three years (95% confidence intervals (CI) 86.1 to 93.1; number at risk: 155) and 85.0% at five years (95% CI 77.9 to 89.9; number at risk: 43). Dislocation of the mobile bearing occurred in 18 patients (5.6%) at three years (95% CI 1.0 to 16.4; number at risk: 154) and in 20 patients (8.5%) at five years (95% CI 1.0 to 27.0; number at risk: 42). There were no significant differences in the dislocation rate between the participating centres or the surgeons. We were not able to identify an effect of each surgeon's learning curve on the dislocation rate of the mobile bearing. The clinical outcome in patients without revision surgery at final follow-up was good to excellent, with a mean Oxford knee score of 40.3 (95% CI 39.4 to 41.2), a mean Tegner activity score of 3.2 (95% CI 3.1 to 3.3) and a mean University of California, Los Angeles score of 5.7 (95% CI 5.5 to 5.9). Our data, which consists of a high number of patients treated with mobile bearing UKA in the lateral compartment, indicates a high revision rate of 15% at five years with dislocation of the mobile bearing being the main reason for implant failure. Despite the good functional and clinical results and the high patient satisfaction in our study group, we therefore discontinued using mobile-bearing lateral UKA in favour of a fixed-bearing component. Cite this article: Bone Joint J 2018;100-B:42-9. ©2018 The British Editorial Society of Bone & Joint Surgery.

Total resection of any segment of the lateral meniscus may cause early cartilage degeneration: Evaluation by magnetic resonance imaging using T2 mapping.

PubMed

Murakami, Koji; Arai, Yuji; Ikoma, Kazuya; Kato, Kammei; Inoue, Hiroaki; Nakagawa, Shuji; Fujii, Yuta; Ueshima, Keiichiro; Fujiwara, Hiroyoshi; Kubo, Toshikazu

2018-06-01

The aim of this study was to perform quantitative evaluation of degeneration of joint cartilage using T2 mapping in magnetic resonance imaging (MRI) after arthroscopic partial resection of the lateral meniscus.The subjects were 21 patients (23 knees) treated with arthroscopic partial resection of the lateral meniscus. MRI was performed for all knees before surgery and 6 months after surgery to evaluate the center of the lateral condyle of the femur in sagittal images for T2 mapping. Ten regions of interest (ROIs) on the articular cartilage were established at 10-degree intervals, from the point at which the femur shaft crossed the lateral femoral condyle joint to the articular cartilage 90° relative to the femur shaft. Preoperative and postoperative T2 values were evaluated at each ROI. Age, sex, body mass index, femorotibial angle, Tegner score, and amount of meniscal resection were evaluated when the T2 value increased more than 6% at 30°.T2 values at approximately 10 °, 20 °, 30 °, 40 °, 50 °, and 60 ° degrees relative to the anatomical axis of the femur were significantly greater postoperatively (3.1, 3.6, 5.5, 4.4, 5.0, 6.4%, respectively) than preoperatively. A >6% increase at 30° was associated with total resection of any segment of the meniscus.Degeneration of the articular cartilage, as shown by the disorganization of collagen arrays at positions approximately 10 °, 20 °, 30 °, 40 °, 50 °, and 60 ° relative to the anatomical axis of the femur, may start soon after arthroscopic lateral meniscectomy. Total resection of any segment of the lateral meniscus may cause T2 elevation of articular cartilage of lateral femoral condyle.

Posterior root tear of the medial meniscus in multiple knee ligament injuries.

PubMed

Kim, Young Jae; Kim, Jin Goo; Chang, Seok Hwan; Shim, Jae Chan; Kim, Sang Bum; Lee, Mi Young

2010-10-01

The purposes of the present study were to examine the frequency and characteristics of root tears of the medial meniscus associated with ligament injuries of the knee and to evaluate the effectiveness of pull-out repair for restoring meniscus function. We retrospectively analyzed the 9 patients (10 knees) with posterior root tears of the medial meniscus and ligament injuries of the knee treated between August 2004 and February 2007. All the patients were male, with average age of 29.8 years, and the mean follow-up period was 29.7 months. The pull-out suture technique was used to repair the root tears. Clinical outcomes were evaluated using the Lysholm, IKDC, and Tegner scores, as well as the McMurray and Apley tests. The mean follow-up period was 41.1 months (range, 30 to 63 months). The incidence of root tears of the medial meniscus with ligament injuries was 2.74% (10 cases in 365 ligament surgeries). All clinical results showed significant improvement. At the final follow-up, McMurray test showed one positive and nine negative cases, and the Apley test revealed two positive and eight negative cases. There were no positive findings in anterior drawer test, posterior drawer test, valgus and varus stress test, and posterolateral instability test. Healing of the root tear was confirmed by arthroscopy in five patients and by MR in four patients. Root tears of the medial meniscus may occur in multiple knee ligament injuries. It is important not to miss them. Our results indicate that pull-out repair provides satisfactory results and evidence of healing. Copyright 2009 Elsevier B.V. All rights reserved.

Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures.

PubMed

Koch, Matthias; Matteo, Berardo Di; Eichhorn, Jürgen; Zellner, Johannes; Mayr, Felix; Krutsch, Werner; Achenbach, Leonard; Woehl, Rebecca; Nerlich, Michael; Angele, Peter

2018-05-01

Conservative treatment of partial ACL ruptures is associated with a high failure rate, and often patients undergo ACL reconstruction. ACL preservation by trephination of the ACL origin and application of Autologous Conditioned Plasma (ACP) seems to be an intriguing new treatment option to favour ACL tissue healing and avoid traditional reconstruction. The aim of this study was to describe the mid-term outcomes of this new ACL preserving technique. Twenty-four patients (mean age 41.8 years) affected by partial rupture of one or both ACL bundles were included in the present trial. The partial ACL tears were arthroscopically assessed and classified according to a new five step grading system. All patients were treated by trephination of the femoral ACL stump and intra-ligamentary application of ACP. The postoperative outcome was evaluated by both subjective scores and stability testing up to a mean of 25.1 months' follow-up. Adverse events and failure rate were also documented. Clinical outcome was good to excellent with IKDC subjective 82.7 (SD 11.8), Lysholm 87.6 (SD 8.1), Tegner 5.3 (SD 2.1), Cincinnati 88.7 (SD 14.8). The failure rate (i.e. persisting knee instability assessed clinically or by rolimeter) was 12.5%. At objective measurements, knee joints showed a firm endpoint in Lachman test, negative pivot shift phenomenon and a significant reduction in AP-laxity compared to pre-operative status by rolimeter testing (p = 0.002). Return to sport practice was achieved after mean 4.8 months (SD 4.1). ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.

Clinical and radiographical ten years long-term outcome of microfracture vs. autologous chondrocyte implantation: a matched-pair analysis.

PubMed

Ossendorff, Robert; Franke, Kilian; Erdle, Benjamin; Uhl, Markus; Südkamp, Norbert P; Salzmann, Gian M

2018-06-16

To compare the clinical and radiographical long-term outcome of microfracture (MFX) and first-generation periosteum-covered autologous chondrocyte implantation (ACI-P). All subjects (n = 86) who had been treated with knee joint ACI-P or microfracture (n = 76) with a post-operative follow-up of at least ten years were selected. Clinical pre- and post-operative outcomes were analyzed by numeric analog scale (NAS) for pain, Lysholm, Tegner, IKDC, and KOOS score. Radiographical evaluation was visualized by magnetic resonance imaging (MRI). Assessment of the regenerate quality was performed by the magnetic resonance observation of cartilage repair tissue (MOCART) and modified knee osteoarthritis scoring system (mKOSS). Relaxation time (RT) of T2 maps enabled a microstructural cartilage analysis. MFX and ACI of 44 patients (24 females, 20 males; mean age 38.9 ± 12.1 years) resulted in a good long-term outcome with low pain scores and significant improved clinical scores. The final Lysholm and functional NAS scores were significantly higher in the MFX group (Lysholm: MFX 82 ± 15 vs. ACI-P 71 ± 18 p = 0.027; NAS function: MFX 8.1 ± 3.5 vs. ACI-P 6.0 ± 2.5; p = 0.003). The MOCART score did not show any qualitative differences. KOSS analysis demonstrated that cartilage repair of small defects resulted in a significant better outcome. T2-relaxation times were without difference between groups at the region of the regenerate tissue. This study did not demonstrate coherent statistical differences between both cartilage repair procedures. MFX might be superior in the treatment of small cartilage defects.

Is Quadriceps Tendon Autograft a Better Choice Than Hamstring Autograft for Anterior Cruciate Ligament Reconstruction? A Comparative Study With a Mean Follow-up of 3.6 Years.

PubMed

Cavaignac, Etienne; Coulin, Benoit; Tscholl, Philippe; Nik Mohd Fatmy, Nik; Duthon, Victoria; Menetrey, Jacques

2017-05-01

The quadriceps tendon (QT) autograft is known as an effective graft for anterior cruciate ligament (ACL) reconstruction and shows a similar functional outcome to the bone-patellar tendon-bone (BPTB) in randomized controlled trials, with a lesser incidence of complications. Up until now, only 2 studies have compared QT to hamstring tendon (HT) autograft. The functional outcomes of the QT technique are at least as good as those of the HT technique, with the same morbidity. Cohort study; Level of evidence, 3. Ninety-five patients underwent isolated ACL reconstruction between January 1 and December 31, 2012. Fifty underwent ACL reconstruction with the QT and 45 with the HT. The same surgical technique, fixation method, and postoperative protocol were used in both groups. The following parameters were evaluated: surgical revisions, functional outcome (Lysholm, Knee injury and Osteoarthritis Outcome Score [KOOS], Tegner, subjective International Knee Documentation Committee), joint stability (KT-1000, Lachman, pivot shift), anterior knee pain (Shelbourne-Trumper score), and isokinetic strength. Descriptive statistics are presented for these variables using the Student t test. Eighty-six patients (45 QT, 41 HT) were reviewed with a mean follow-up of 3.6 ± 0.4 years; minimum follow-up was 3 years. There were 4 reoperations in the QT group (including 1 ACL revision) and 3 in the HT group (including 2 ACL revisions) ( P > .05). The Lysholm (89 ± 6.9 vs 83.1 ± 5.3), KOOS Symptoms (90 ± 11.2 vs 81 ± 10.3), and KOOS Sport (82 ± 11.3 vs 67 ± 12.4) scores were significantly better in the QT group than in the HT group. In terms of stability, the mean side-to-side difference was 1.1 ± 0.9 mm for the QT group and 3.1 ± 1.3 mm for the HT group based on KT-1000 measurements ( P < .005). The negative Lachman component was higher in the QT group than in the HT group (90% vs 46%, P < .005). There was a trend for the negative pivot-shift component to be higher in the QT group than in the HT group (90% vs 64%, P = .052). The Shelbourne-Trumper score was the same in both groups. There was no difference between groups in terms of isokinetic strength. The use of a QT graft in ACL reconstruction leads to equal or better functional outcomes than does the use of an HT graft, without affecting morbidity.

Weak associations between body mass index and self-reported disability in people with unilateral anterior cruciate ligament reconstruction.

PubMed

Pietrosimone, Brian; Kuenze, Christopher; Hart, Joseph M; Thigpen, Charles; Lepley, Adam S; Blackburn, J Troy; Padua, Darin A; Grindstaff, Terry; Davis, Hope; Bell, David

2018-05-01

Individuals with an anterior cruciate ligament reconstruction (ACLR) are susceptible to persistent disability, weight gain and the development of knee osteoarthritis. It remains unclear whether body mass index (BMI) is a factor that influences disability following ACLR. The purpose of this study was to determine the association between BMI and self-reported disability [International Knee Documentation Committee (IKDC) Index] in individuals with a unilateral ACLR. We hypothesized that lower BMI would associate with higher IKDC. BMI and IKDC were measured in 668 individuals with a unilateral ACLR (60.9% female, BMI 24.4 ± 3.7 kg/m 2 , IKDC 84.7 ± 11.9%). Bivariate associations were conducted between BMI and IKDC for the entire sample and selected subsets (gender, ACLR graft type and history of meniscal injury). Multiple regression analyses were used to determine the impact of potential covariates (Tegner score, age and months since ACLR) for significant bivariate associations. After accounting for covariates, there were no significant associations between BMI and IKDC when separately evaluating the cohort based on either gender or history of a concomitant meniscal injury. The odds of achieving age- and gender-matched healthy population average IKDC scores for those with low (<25) and high (≥25) BMI were determined. Lower BMI associated with higher IKDC (r = -0.08, P = 0.04). For the entire sample, BMI did not uniquely predict variance in IKDC (ΔR 2  > 0.001, n.s.) after accounting for covariates. BMI uniquely predicted a significant but negligible amount of variance in IKDC in individuals with a patellar tendon autograft (ΔR 2  = 0.015, n.s.). Individuals with low BMI demonstrated higher odds (odds ratio = 1.45; 1.05-1.99) of achieving population average IKDC scores compared to participants with high BMI. There was a significant but negligible correlation between lower BMI and lesser disability in individuals with unilateral ACLR and individuals who are underweight or of normal BMI demonstrated higher odds of achieving population average IKDC scores compared to overweight or obese individuals. While an overall association was found between lower BMI and lesser disability, the magnitude of the association remains negligible; therefore, BMI was not a strong clinical predictor of successful ACLR outcomes in this cohort of patients with unilateral ACLR. Cross-sectional prognostic study, Level II.

Repair of meniscal tears with the absorbable Clearfix screw: results after 1-3 years.

PubMed

Frosch, K H; Fuchs, M; Losch, A; Stürmer, K M

2005-11-01

Total meniscus resection usually leads to osteoarthritis of the knee joint. Preservation and refixation of the injured menisci are therefore of great clinical importance. The present study examines 40 meniscal injuries in 37 patients that were arthroscopically treated with Clearfix meniscal screws (Mitek, Norderstedt, Germany) in the period from August 1999 to December 2002. The mean patient age was 27.7 (range 16-62) years. Nine patients were female. A total of 24 patients (27 meniscal tears) also had an anterior cruciate ligament (ACL) lesion, and 5 patients had cartilage injuries. Twenty-two patients were treated within the first 2 weeks following the trauma, 10 patients within 8 weeks, and 5 patients after 8 weeks. The lesions were a bucket-handle tear of the medial meniscus in 11 cases and a bucket-handle tear of the lateral meniscus in 2 cases. The posterior horn of the medial meniscus was torn in 13 cases, and the pars intermedia in 3 cases. The posterior horn of the lateral meniscus was torn in 8 cases, and the pars intermedia in 3 cases. The mean tear length was 2.9 (+/- 1.5) cm and was fixed with an average of 1.8 (+/- 0.7) screws. In 7 cases, the anterior horn was treated with an additional meniscal suture. A total of 35 patients were examined after an average of 18 (range 7-45) months. In the event of a moderate outcome, MRI was performed as part of the follow-up investigation. The average Lysholm score was 93 (+/- 7.4), the Tegner activity index was 6.3 (+/- 2.0) before the accident and 5.8 (+/- 2.0) at the follow-up, the Marshall knee score was 47 (+/- 3.8). The VAS pain assessment was 1.6 (+/- 1.3) and the VAS function assessment was 7.9 (+/- 1.6). Of the 7 patients with a moderate result, 2 patients without additional ligament lesions suffered re-ruptures after and 13 months, respectively. The other 5 patients with a moderate result each had multiple accompanying injuries or pre-existing damage to the affected knee joint. The Clearfix screws achieved a clinical success rate of 82% in isolated meniscal tears in stable knee joints and a clinical success rate of 100% with additional ACL reconstruction. In view of the good clinical results and the simple procedure for use, the implant should be recommended for meniscal refixation.

Bioabsorbable versus metallic interference screws for graft fixation in anterior cruciate ligament reconstruction.

PubMed

Debieux, Pedro; Franciozi, Carlos E S; Lenza, Mário; Tamaoki, Marcel Jun; Magnussen, Robert A; Faloppa, Flávio; Belloti, João Carlos

2016-07-24

Anterior cruciate ligament (ACL) tears are frequently treated with surgical reconstruction with grafts, frequently patella tendon or hamstrings. Interference screws are often used to secure the graft in bone tunnels in the femur and tibia. This review examines whether bioabsorbable interference screws give better results than metal interference screws when used for graft fixation in ACL reconstruction. To assess the effects (benefits and harms) of bioabsorbable versus metallic interference screws for graft fixation in ACL reconstruction. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (the Cochrane Library), MEDLINE, Embase, LILACS, trial registers and reference lists of articles. Date of search: January 2016. We included randomised controlled trials and quasi-randomised trials comparing bioabsorbable with metallic interferences screws in ACL reconstruction. The main outcomes sought were subjective-rated knee function, failure of treatment, and activity level. At least two review authors selected eligible trials, independently assessed risk of bias, and cross-checked data. Data were pooled whenever relevant and possible. Requests for further information were sent to the original study authors. We included 12 trials (11 randomised and one quasi-randomised) involving a total of 944 participants, and reporting follow-up results for 774. Participants in the 12 trials underwent ACL reconstruction with either hamstring tendon grafts (five trials) or patellar tendon grafts (seven trials). Trials participants were randomly allocated to bioabsorbable or metallic interference screws for graft fixation in both femur and tibia (seven trials); femur only (three trials); tibia only (one trial); location was not reported in the remaining trial. A variety of materials was used for the bioabsorbable screws, Poly-L-lactic acid (PLLA) being the most common. The metallic screws, where reported, were titanium.All trials were at high risk of bias, which invariably included performance bias. Seven trials were at high risk of attrition bias and eight at high risk of reporting bias. The quasi-randomised trial was assessed as being at high risk for selection bias. Based on these study limitations and insufficiency of the available data, we judged the quality of evidence for all outcomes was very low.The majority of the available data for patient-reported knee function was presented as Lysholm scores (0 to 100; higher scores = better function). There was very low quality but consistent evidence of no clinically important differences between the two groups in Lysholm scores at 12 months follow-up (mean difference (MD) -0.08, 95% confidence interval (CI) -1.48 to 1.32; three trials, 168 participants); 24 months (MD 0.35, 95% CI -1.27 to 1.98; three trials, 113 participants) or five or more years follow-up (MD 1.23, 95% CI -2.00 to 4.47; two trials, 71 participants). This lack of between-group differences was also reported for Lysholm scores in several trials that did not provide sufficient data for pooling as well as for other self-reported knee function scores reported in several trials.Treatment failure was represented by the summed data for implant breakage during surgery and major postoperative complications (implant failure, graft rupture, symptomatic foreign body reactions, effusion and treated arthrofibrosis and related conditions) that were usually described in the trial reports as requiring further substantive treatment. There is very low-quality evidence of greater treatment failure in the bioabsorbable screw group (60/451 versus 29/434; risk ratio (RR) 1.94 favouring metallic screw fixation, 95% CI 1.29 to 2.93; 885 participants, 11 studies). In a population with an assumed risk (based on the median control group risk) of 56 participants per 1000 having treatment failure after metallic screw fixation, this equates to 53 more (95% CI 17 to 108 more) per 1000 participants having treatment failure after bioabsorbable screw fixation. All 16 intraoperative complications in the bioabsorbable screw group were implant breakages upon screw insertion. Treatment failure defined as postoperative complications only still favoured the metallic screw group but the 95% CI also included the potential for a greater risk of treatment failure after metallic screw fixation: 44/451 versus 29/434; RR 1.44, 95% CI 0.93 to 2.23. Based on the assumed risk of 56 participants per 1000 having postoperative treatment failure after metallic screw fixation, this equates to 25 more (95% CI 4 fewer and 69 more) per 1000 participants having this outcome after bioabsorbable screw fixation.There was very low-quality evidence of very similar activity levels in the two groups at 12 and 24 months follow-up measured via the Tegner score (0 to 10; higher scores = greater activity): 12 months (MD 0.08, 95% CI -0.39 to 0.55; 122 participants, two studies); 24 months (MD 0.01, 95% CI -0.54 to 0.57; 72 participants, two studies). There is very low-quality evidence of no difference in self-reported knee function and levels of activity between bioabsorbable and metallic interference screws for graft fixation in ACL reconstruction. There is very low-quality evidence that bioabsorbable screws may be associated with more overall treatment failures, including implant breakage during surgery. Further research does not appear to be a priority, but if undertaken, should also examine costs.

Treating patella fractures with a fixed-angle patella plate-A prospective observational study.

PubMed

Wild, Michael; Fischer, Kai; Hilsenbeck, Florian; Hakimi, Mohssen; Betsch, Marcel

2016-08-01

Anterior tension wiring using Kirschner wires (K-wires) is still considered the standard treatment for patella fractures, despite its high complication rate. The objective of this prospective clinical study was to evaluate intra- and perioperative complications as well as the clinical outcome of patients with patella fracture treated with a new developed bilateral, polyaxial, fixed-angle 2.7mm patella plate. Between 2011 and 2014 all patients with a patella fracture were included in this prospective study and treated with a fixed-angle patella plate. Avulsion fractures of the inferior or superior pole of the patella were excluded. All fractures were classified according to the AO/OTA fracture classification. During a twelve-month follow up period all intra- and postoperative complications were recorded as well as the time until fracture healing. One year postoperatively the Lysholm Score, the pre- and postoperative Tegner Score, the Hospital for Special Surgery Knee Score (HSS), the Turba Score, the Oxford Knee Score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the Bostman Score and the Iowa Knee Score were surveyed. Altogether, 20 patella fractures in 19 patients were included in this prospective study. The most frequent type of fracture, n=10, was a simple transverse patella fracture (C1), followed by 7 comminuted patella fractures (C3) and 3 T-shaped patella fractures (C2). During the 12-month follow up period two patients treated with the patella plate had a complication. In one patient a superficial wound infection occurred, which was treated successfully with hardware removal and in one patient a fracture dislocation due to an implant failure occurred. X-rays demonstrated complete bony healing in all fractures on average 3.2 months postoperatively. All knee scores showed good to excellent clinical results one year postoperatively. The results of this first clinical study indicate that the fixed-angle patella plate is an effective and safe treatment option for patella fractures with a short operative learning curve. The treatment of communited patella fractures (C3) with a fixed-angle patella plate should be well-considered to avoid distending the indication and biomechanical properties. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adult-Supplied Structure and Children's Activity Levels.

ERIC Educational Resources Information Center

Carpenter, C. J.; And Others

This study investigated the relationship between preschool children's participation in play activities structured by adults and the level of motor activity children exhibited while in those activities, to test the hypothesis that children's motor activity levels vary according to the level of structure imposed on activities by adults. Subjects…

Adult attachment and approaches to activity engagement in chronic pain

PubMed Central

Andrews, Nicole E; Meredith, Pamela J; Strong, Jenny; Donohue, Genevieve F

2014-01-01

BACKGROUND: The way in which individuals with chronic pain habitually approach activity engagement has been shown to impact daily functioning, with both avoidance of one’s daily activities and overactivity (activity engagement that significantly exacerbates pain) associated with more pain, higher levels of physical disability and poorer psychological functioning. OBJECTIVE: To provide insight into the development of maladaptive habitual approaches to activity engagement in chronic pain by applying an attachment theory framework. METHODS: A sample of 164 adults with chronic pain completed selfreport measures of attachment, approach to activity and pain cognitions. Mediation analyses were undertaken to examine the direct association between attachment variables and maladaptive approaches to activity, and to test for the mediating role of pain cognitions (catastrophizing and thought suppression). RESULTS: Results demonstrated that higher levels of secure attachment were associated with lower levels of activity avoidance, which was fully mediated by lower levels of pain catastrophizing; higher levels of preoccupied or fearful attachment were directly associated with higher levels overactivity; higher levels of preoccupied attachment were associated with higher levels of activity avoidance, which was partially mediated by higher levels of pain catastrophizing; and higher levels of fearful attachment were indirectly associated with higher levels of activity avoidance through higher levels of catastrophizing. CONCLUSIONS: These results provide preliminary support for the suggestion that insecure attachment may be a source of vulnerability to the development of disabling activity patterns in chronic pain. PMID:25337857

Serum paraoxonase activity and oxidative stress levels in patients with cutaneous anthrax.

PubMed

Karadas, S; Aslan, M; Ceylan, M R; Sunnetcioglu, M; Bozan, N; Kara, H; Demir, H

2017-07-01

Anthrax is a bacterial disease caused by the aerobic sporeforming bacterium Bacillus anthracis. It has been suggested that oxidative stress plays an important role in the pathogenesis of B. anthracis. The aim of this study was to investigate serum paraoxonase 1 (PON1) activity, catalase activity, malondialdehyde (MDA) levels, and superoxide dismutase (SOD) levels in patients with cutaneous anthrax. Fifteen patients with cutaneous anthrax and 15 healthy controls were enrolled in this study. The serum MDA levels, SOD levels, paraoxonase, arylesterase, and catalase activities were measured using a spectrophotometer. The serum SOD levels, paraoxonase, arylesterase, and catalase activities were significantly lower in patients with cutaneous anthrax than in controls (for all, p < 0.001), whereas MDA levels were significantly higher ( p < 0.001). No significant correlation was found between serum paraoxonase activity, arylesterase activity, SOD levels, and MDA levels (all, p > 0.05) in patients with cutaneous anthrax. The current study was the first to show decreased antioxidant levels and increased oxidant levels in patients with cutaneous anthrax. Therefore, decreased PON1 activity may play a role in the pathogenesis of cutaneous anthrax.

Friendship networks and physical activity and sedentary behavior among youth: a systematized review.

PubMed

Sawka, Keri Jo; McCormack, Gavin R; Nettel-Aguirre, Alberto; Hawe, Penelope; Doyle-Baker, Patricia K

2013-12-01

Low levels of physical activity and increased participation in sedentary leisure-time activities are two important obesity-risk behaviors that impact the health of today's youth. Friend's health behaviors have been shown to influence individual health behaviors; however, current evidence on the specific role of friendship networks in relation to levels of physical activity and sedentary behavior is limited. The purpose of this review was to summarize evidence on friendship networks and both physical activity and sedentary behavior among children and adolescents. After a search of seven scientific databases and reference scans, a total of thirteen articles were eligible for inclusion. All assessed the association between friendship networks and physical activity, while three also assessed sedentary behavior. Overall, higher levels of physical activity among friends are associated with higher levels of physical activity of the individual. Longitudinal studies reveal that an individual's level of physical activity changes to reflect his/her friends' higher level of physical activity. Boys tend to be influenced by their friendship network to a greater extent than girls. There is mixed evidence surrounding a friend's sedentary behavior and individual sedentary behavior. Friends' physical activity level appears to have a significant influence on individual's physical activity level. Evidence surrounding sedentary behavior is limited and mixed. Results from this review could inform effective public health interventions that harness the influence of friends to increase physical activity levels among children and adolescents.

Impact of parents’ physical activity on preschool children’s physical activity: a cross-sectional study

PubMed Central

Quan, Minghui; Zhang, Hanbin; Zhou, Chenglin

2018-01-01

Purpose This study examined the associations of physical activity levels between parents and their pre-school children based on gender and weekday/weekend. Method A total of 247 parent-preschool child triads from Shanghai, China were analyzed. The children had a mean age of 57.5 ± 5.2 months. Both sedentary behavior and physical activity were measured in all participants using an ActiGraph GT3X+ accelerometer over seven consecutive days from Monday through the following Sunday. A multivariate regression model was derived to identify significant relationships between parental and child physical activity according to gender and weekday/weekend. Results There was a significant correlation between mothers’ and girls’ moderate-to-vigorous physical activity (MVPA) and total physical activity (TPA) on weekdays. Fathers’ MPVA levels correlated significantly with those of boys and girls, with paternal influence appearing to be stronger than maternal influence. However, there was not a significant correlation between fathers’ and children’s TPA. TPA levels of both mothers and fathers correlated with those of girls, but not with those of boys. Parental sedentary levels on the weekend correlated significantly with girls’ levels, but not with boys’ levels. Children’s physical activity levels on weekends were influenced more by fathers’ activity levels than by mothers’, while the opposite was observed on weekdays. Conclusion Sedentary behavior and physical activity levels of parents can strongly influence those of their preschool children, with maternal influence stronger during the weekdays and paternal influence stronger on the weekends. Parents’ activity levels influence girls’ levels more strongly than they influence boys’ levels. PMID:29503768

[Increase in cigarette smoking and decrease in the level of physical activity among Spanish adolescentes. AVENA study].

PubMed

Tercedor, P; Martín-Matillas, M; Chillón, P; Pérez López, I J; Ortega, F B; Wärnberg, J; Ruiz, J R; Delgado, M

2007-01-01

Cigarette smoking among adolescents as well as the level of physical activity constitutes a public health care issue. The aim is knowing the relationship between cigarette smoking and practice of physical activity. Schooled Spanish adolescents 2859 Spanish adolescents (1357 boys, 1502 girls; age range: 13-18.5 years). A questionnaire is applied to know the level of cigarette smoking and four other questionnaires to know the level of physical activity during different periods. 40.8% of the adolescents stated not doing any physical activity at all, boys being more active than girls (p < 0.001). 29.9% of the adolescents stated usually smoking cigarettes, without differences by gender. Both active boys and girls stated smoking less (P < or = 0.01). The greater the age, the higher cigarette smoking and the lower the level of physical activity, both in boys and girls (p < 0.001). The level of physical activity is low, being even lower for girls. Cigarette smoking shows a negative relationship with the level of physical activity, the individuals more physically active being those smoking the less.

Friendship networks and physical activity and sedentary behavior among youth: a systematized review

PubMed Central

2013-01-01

Background Low levels of physical activity and increased participation in sedentary leisure-time activities are two important obesity-risk behaviors that impact the health of today’s youth. Friend’s health behaviors have been shown to influence individual health behaviors; however, current evidence on the specific role of friendship networks in relation to levels of physical activity and sedentary behavior is limited. The purpose of this review was to summarize evidence on friendship networks and both physical activity and sedentary behavior among children and adolescents. Method After a search of seven scientific databases and reference scans, a total of thirteen articles were eligible for inclusion. All assessed the association between friendship networks and physical activity, while three also assessed sedentary behavior. Results Overall, higher levels of physical activity among friends are associated with higher levels of physical activity of the individual. Longitudinal studies reveal that an individual’s level of physical activity changes to reflect his/her friends’ higher level of physical activity. Boys tend to be influenced by their friendship network to a greater extent than girls. There is mixed evidence surrounding a friend’s sedentary behavior and individual sedentary behavior. Conclusion Friends’ physical activity level appears to have a significant influence on individual’s physical activity level. Evidence surrounding sedentary behavior is limited and mixed. Results from this review could inform effective public health interventions that harness the influence of friends to increase physical activity levels among children and adolescents. PMID:24289113

Redefining ADHD Using an Adult Population: Should Inattention be Viewed as a Separate Dimension From Cognitive and Physiological Activity Level?

PubMed

Miller, Nathan; Prevatt, Frances

2017-10-01

The purpose of this study was to reexamine the latent structure of ADHD and sluggish cognitive tempo (SCT) due to issues with construct validity. Two proposed changes to the construct include viewing hyperactivity and sluggishness (hypoactivity) as a single continuum of activity level, and viewing inattention as a separate dimension from activity level. Data were collected from 1,398 adults using Amazon's MTurk. A new scale measuring activity level was developed, and scores of Inattention were regressed onto scores of Activity Level using curvilinear regression. The Activity Level scale showed acceptable levels of internal consistency, normality, and unimodality. Curvilinear regression indicates that a quadratic (curvilinear) model accurately explains a small but significant portion of the variance in levels of inattention. Hyperactivity and hypoactivity may be viewed as a continuum, rather than separate disorders. Inattention may have a U-shaped relationship with activity level. Linear analyses may be insufficient and inaccurate for studying ADHD.

Relationships between perioperative physical activity and urinary incontinence after radical prostatectomy: an observational study

PubMed Central

2013-01-01

Background Higher physical activity levels are continence-protective in non-prostate cancer populations. Primary aims of this study were to investigate changes in physical activity levels over the perioperative period in patients having radical prostatectomy, and relationships between perioperative physical activity levels and post-prostatectomy urinary incontinence. Methods A prospective analysis of patients having radical prostatectomy and receiving perioperative physiotherapy including pelvic floor muscle training and physical activity prescription (n = 33). Physical activity levels were measured using the International Physical Activity Questionnaire and/or the SenseWear Pro3 Armband at four timepoints: before preoperative physiotherapy, the week before surgery, and 3 and 6 weeks postoperatively. Urinary incontinence was measured at 3 and 6 weeks postoperatively using a 24-hour pad test and the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ). Results Physical activity levels changed significantly over the perioperative period (p < 0.001). At 6 weeks postoperatively, physical activity levels did not differ significantly from baseline (p = 0.181), but remained significantly lower than the week before surgery (p = 0.002). There was no significant interaction effect between preoperative physical activity category and time on the 24-hour pad test (p = 0.726) or ICIQ (p = 0.608). Nor were there any significant correlations between physical activity levels and the 24-hour pad test and ICIQ at 3 or 6 weeks postoperatively. Conclusions This study provides novel data on perioperative physical activity levels for patients having radical prostatectomy. There was no relationship between perioperative physical activity levels and post-prostatectomy urinary incontinence, although participants had high overall preoperative physical activity levels and low overall urinary incontinence. PMID:24289104

Prenatal androgen exposure and children's aggressive behavior and activity level.

PubMed

Spencer, Debra; Pasterski, Vickie; Neufeld, Sharon; Glover, Vivette; O'Connor, Thomas G; Hindmarsh, Peter C; Hughes, Ieuan A; Acerini, Carlo L; Hines, Melissa

2017-11-01

Some human behaviors, including aggression and activity level, differ on average for males and females. Here we report findings from two studies investigating possible relations between prenatal androgen and children's aggression and activity level. For study 1, aggression and activity level scores for 43 girls and 38 boys, aged 4 to 11years, with congenital adrenal hyperplasia (CAH, a genetic condition causing increased adrenal androgen production beginning prenatally) were compared to those of similarly-aged, unaffected relatives (41 girls, 31 boys). Girls with CAH scored higher on aggression than unaffected girls, d=0.69, and unaffected boys scored higher on activity level than unaffected girls, d=0.50. No other group differences were significant. For study 2, the relationship of amniotic fluid testosterone to aggression and activity level was investigated in typically-developing children (48 girls, 44 boys), aged 3 to 5years. Boys scored higher than girls on aggression, d=0.41, and activity level, d=0.50. However, amniotic fluid testosterone was not a significant predictor of aggression or activity level for either sex. The results of the two studies provide some support for an influence of prenatal androgen exposure on children's aggressive behavior, but not activity level. The within-sex variation in amniotic fluid testosterone may not be sufficient to allow reliable assessment of relations to aggression or activity level. Copyright © 2017 Elsevier Inc. All rights reserved.

ActivityAware: An App for Real-Time Daily Activity Level Monitoring on the Amulet Wrist-Worn Device.

PubMed

Boateng, George; Batsis, John A; Halter, Ryan; Kotz, David

2017-03-01

Physical activity helps reduce the risk of cardiovascular disease, hypertension and obesity. The ability to monitor a person's daily activity level can inform self-management of physical activity and related interventions. For older adults with obesity, the importance of regular, physical activity is critical to reduce the risk of long-term disability. In this work, we present ActivityAware , an application on the Amulet wrist-worn device that measures daily activity levels (sedentary, moderate and vigorous) of individuals, continuously and in real-time. The app implements an activity-level detection model, continuously collects acceleration data on the Amulet, classifies the current activity level, updates the day's accumulated time spent at that activity level, logs the data for later analysis, and displays the results on the screen. We developed an activity-level detection model using a Support Vector Machine (SVM). We trained our classifiers using data from a user study, where subjects performed the following physical activities: sit, stand, lay down, walk and run. With 10-fold cross validation and leave-one-subject-out (LOSO) cross validation, we obtained preliminary results that suggest accuracies up to 98%, for n=14 subjects. Testing the ActivityAware app revealed a projected battery life of up to 4 weeks before needing to recharge. The results are promising, indicating that the app may be used for activity-level monitoring, and eventually for the development of interventions that could improve the health of individuals.

Leisure activity associated with cognitive ability level, but not cognitive change

PubMed Central

Gow, Alan J.; Avlund, Kirsten; Mortensen, Erik L.

2014-01-01

Although activity participation is promoted as cognitively protective, critical questions of causality remain. In a cohort followed every 5 years from age 75 to 85 years, potential reciprocal associations between level and change in leisure activity participation and level and change in cognitive abilities were examined. Participants in the Glostrup 1914 Cohort, a longitudinal study of aging, completed standardized cognitive ability tests and reported their leisure activity participation (11 activities defined a leisure activity score) at ages 75, 80, and 85. Higher leisure activity was associated with higher cognitive ability (significant correlations ranged from 0.15 to 0.31, p < 0.05). Between ages 75 and 85, participation in leisure activities and cognitive ability declined significantly. Growth curve models, which provided latent variables for level of and 10-year change in both leisure activity and cognitive ability, confirmed the positive association between levels of leisure activity and cognitive ability (path coefficient = 0.36, p < 0.001); however, neither leisure activity level nor change in leisure activity were associated with cognitive change. Although a positive association between leisure activity and cognitive ability was reported—the likely precedents of this are discussed—there was no evidence that a higher level or maintenance of leisure activity was protective against cognitive decline across a 10-year follow-up. PMID:25352824

Temperament and Physical Activity in Childhood.

PubMed

Song, MinKyoung; Corwyn, Robert F; Bradley, Robert H; Lumeng, Julie C

2017-11-01

Temperament activity level can serve as a proxy for nondeliberate activity and an important part of overall energy expenditure. However, little is known about any association between temperament activity level and children's levels of moderate- to vigorous-intensity physical activity. We examined whether temperament activity level in young children is associated with moderate- to vigorous-intensity physical activity later in childhood and midadolescence. We also assessed if parenting behaviors moderate any association. Data were obtained from 799 children and their mothers involved in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Growth curve analyses were used to examine the relationships over time, controlling for child and parent characteristics. High temperament activity level at age 4.5 was associated with higher moderate- to vigorous-intensity physical activity at age 9 (β = 5.15; SE =2.47; P < .001). The association became no longer significant after 10.2 years of age. The association was moderated by parental support for physical activity (β = -2.56; SE = 1.01; P = .01). Low temperament activity level in early childhood was a risk factor for low physical activity in later childhood and adolescence. Parental support for physical activity may be beneficial for children whose temperament activity level is low.

The effect of gender and level of vision on the physical activity level of children and adolescents with visual impairment.

PubMed

Aslan, Ummuhan Bas; Calik, Bilge Basakcı; Kitiş, Ali

2012-01-01

This study was planned in order to determine physical activity levels of visually impaired children and adolescents and to investigate the effect of gender and level of vision on physical activity level in visually impaired children and adolescents. A total of 30 visually impaired children and adolescents (16 low vision and 14 blind) aged between 8 and 16 years participated in the study. The physical activity level of cases was evaluated with a physical activity diary (PAD) and one-mile run/walk test (OMR-WT). No difference was found between the PAD and the OMR-WT results of low vision and blind children and adolescents. The visually impaired children and adolescents were detected not to participate in vigorous physical activity. A difference was found in favor of low vision boys in terms of mild, moderate activities and OMR-WT durations. However, no difference was found between physical activity levels of blind girls and boys. The results of our study suggested that the physical activity level of visually impaired children and adolescents was low, and gender affected physical activity in low vision children and adolescents. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Role of Exergaming in Improving Physical Activity: A Review

PubMed Central

Sween, Jennifer; Wallington, Sherrie Flynnt; Sheppard, Vanessa; Taylor, Teletia; Llanos, Adana A.; Adams-Campbell, Lucile Lauren

2013-01-01

Background The high prevalence of obesity in America can be attributed to inadequate energy expenditure as a result of high levels of physical inactivity. This review presents an overview of the current literature on physical activity, specifically through active videogame systems (exergaming) and how these systems can help to increase physical activity levels. Methods The search strategy for this review was to identify previous studies which investigated energy expenditure levels using a single active video game or a combination of active videogames. Results Based on data from 27 studies, a strong correlation exists between exergaming and increased energy expenditure (up to 300% above resting levels). The majority of active videogames tested were found to achieve physical activity levels of moderate intensity, which meet American College of Sports Medicine guidelines for health and fitness. Conclusions Exergaming is a new and exciting strategy to potentially improve physical activity levels and reduce obesity among Americans. PMID:25078529

Adolescents' physical activity is associated with previous and current physical activity practice by their parents.

PubMed

Christofaro, Diego Giulliano Destro; Andersen, Lars Bo; Andrade, Selma Maffei de; Barros, Mauro Virgílio Gomes de; Saraiva, Bruna Thamyres Ciccotti; Fernandes, Rômulo Araújo; Ritti-Dias, Raphael Mendes

The purpose of this study was to determine whether parents' current and previous physical activity practice is associated with adolescents' physical activity. The sample was composed of 1231 adolescents (14-17 years), and 1202 mothers and 871 fathers were interviewed. Weight and height of the adolescents were measured. Self-reported parents' weight and height were obtained. The current and previous physical activity levels (Baecke's questionnaire) of parents (during childhood and adolescence) and adolescents' physical activity levels were obtained using a questionnaire. The magnitude of the associations between parent and adolescent physical activity levels was determined by binary logistic regression (adjusted by sex, age, and socioeconomic level of adolescents and education level of parents). The current physical activity practice by parents was associated with adolescents' physical activity (p<0.001). The physical activities reported by parents in their childhood and adolescence were also associated with higher physical activity levels among adolescents. Adolescents whose parents were both physically active in the past and present were six times (OR=6.67 [CI=1.94-22.79]) more likely to be physically active compared to adolescents with no parents who were physically active in the past. The current and previous physical activities of parents were associated with higher levels of physical activity in adolescents, even after controlling for confounding factors. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Dimensions of Temperamental Activity Level and Adjustment

ERIC Educational Resources Information Center

Teglasi, Hedwig; French, Mila; Lohr, Lauren; Miller, Karen J.; Erwin, Holly Drewer; Rothman, Lee; Denny, Michelle

2008-01-01

The relationship between children's activity level and adjustment has been based on a one-dimensional conceptualization of activity level and warrants re-examination. Current questionnaires conflate amount of physical movement with its appropriateness to the context, making it impossible to tell which aspect of activity level accounts for its…

Parental Activity as a Determinant of Activity Level and Patterns of Activity in Obese Children.

ERIC Educational Resources Information Center

Kalakanis, Lisa E.; Goldfield, Gary S.; Paluch, Rocco A.; Epstein, Leonard H.

2001-01-01

Investigated the level and pattern of moderate-to-vigorous physical activity (MVPA) in obese children, examining predictors of their activity. Children and their parents wore accelerometers for several days and provided demographic data. Parental activity levels significantly and independently predicted and improved the prediction of children's…

Salivary Alpha-Amylase Activity Levels in Catatonic Schizophrenia Decrease after Electroconvulsive Therapy.

PubMed

Kanayama, Misako; Miyaoka, Tsuyoshi; Araki, Tomoko; Hayashida, Maiko; Hashioka, Sadayuki; Horiguchi, Jun

2018-01-01

Dysfunction of the autonomic nervous system (ANS) in schizophrenia has been detected by electrophysiological methods, but the underlying mechanisms remain unknown. Several studies have suggested that measuring salivary alpha-amylase activity levels is useful for evaluating the ANS activity and that sAA levels increase in schizophrenia and correlate with Brief Psychiatric Rating Scale (BPRS) scores. However, no study has examined the relationship between sAA activity levels and symptoms of schizophrenia with catatonic state. We present the case of a 59-year-old female with persistent catatonic schizophrenia treated by electroconvulsive therapy. We evaluated the ANS activity by measuring sAA activity levels before and after ECT, and we evaluated her symptoms using the BPRS and Bush-Francis Catatonia Rating Scale (BFCRS). ECT was highly effective and BPRS and BFCRS scores substantially decreased. sAA activity levels decreased from 125 kU/l to 33 kU/l. sAA activity levels could be a potential biomarker of schizophrenia with catatonic state.

Playground Designs to Increase Physical Activity Levels during School Recess: A Systematic Review

ERIC Educational Resources Information Center

Escalante, Yolanda; García-Hermoso, Antonio; Backx, Karianne; Saavedra, Jose M.

2014-01-01

School recess provides a major opportunity to increase children's physical activity levels. Various studies have described strategies to increase levels of physical activity. The purpose of this systematic review is therefore to examine the interventions proposed as forms of increasing children's physical activity levels during recess. A…

Investigation of the Relationship between Physical Activity Level and Healthy Life-Style Behaviors of Academic Staff

ERIC Educational Resources Information Center

Turkmen, Mutlu; Ozkan, Ali; Kul, Murat; Bozkus, Taner

2015-01-01

The purpose of the study was to determine the relationship of physical activity (PA) level and healthy life-style behaviors in academic staff in Bartin University, Turkey. The short form of International Physical Activity Questionnaire was administered for the determination of physical activity level of academic staff. Their PA levels were…

An examination of quality of care in Norwegian nursing homes - a change to more activities?

PubMed

Kjøs, Bente Ø; Havig, Anders K

2016-06-01

Studies on Norwegian nursing homes have shown that the general care is at a relatively high level, while the level of physical and social activities is relatively low. As a response to these findings, the Norwegian government has stressed the importance of activities in various white papers and circulars and, in recent years, has launched several campaigns specifically aimed at increasing the level of activities. The aim of the study was to examine the following: (i) how the government has succeeded in increasing the level of physical and social activities in Norwegian nursing homes; (ii) how the level of activities compares to the general care; and (iii) how the level of activities and the general care are influenced by the following facility characteristics: residents' mobility level, total staffing levels, ratio of RNs, ratio of unlicensed staff and ward size. A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. On a scale ranging from 1 to 7, the staff members assess the activity dimension to be 4.31 and the general care dimension to be 5.66. The activity dimension was significantly negatively correlated with the ratio of unlicensed staff, the ratio of Registered Nurses and the residents' mobility level, while the general care dimension was significantly negatively correlated with the ratio of unlicensed staff. The study shows that the level of physical and social activities offered to the residents is relatively low, while the general care level is significantly higher, in line with earlier studies. Consequently, the government has not succeeded with its current policy to increase the level of activities in nursing homes. The relationship between the two quality dimensions and the explanatory variables shows that nursing home quality is a complicated phenomenon. © 2015 Nordic College of Caring Science.

[Associations of obesity and physical activity with cognition in people aged 50 and above in Shanghai].

PubMed

Huang, Z Z; Zhang, Y C; Zheng, Y; Guo, Y F; Ruan, Y; Sun, S Y; Shi, Y; Gao, S N; Ye, J H; Yan, Y J; Wu, K; Xu, R F; Wu, F

2018-03-10

Objective: To investigate the associations of obesity and physical activity with cognition in the elderly. Methods: A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai. The subjects' body weight, body height, waist circumference and hip circumference were measured to calculate body mass index (BMI) and waist-hip ratio (WHR), and the data on self-reported physical activity level were collected through questionnaire survey. A comprehensive battery of cognitive tests was conducted to assess subjects' cognitive functions, including verbal recall, forward digit span (FDS), backward digit span (BDS), and verbal fluency (VF). General linear model was used to examine the associations of BMI, WHR and physical activity with cognition. Results: A total of 7 913 participants were included, with a median age of 60 years. Age, sex, education level, income level, BMI, WHR and physical activity level were significantly associated with cognitive scores in univariate analysis. After adjusted for age, sex, education level and income level, BMI was no longer significantly associated with cognitive scores in all cognitive functions (all P >0.01). WHR was significantly associated with VF score ( P <0.01). Abdominally obese participants had lower VF score than non-abdominally obese participants ( P <0.01). Physical activity level was significantly associated with all cognitive functions ( P <0.01). Compared with participants with moderate physical activity level, participants with low physical activity level had lower scores in all cognitive functions ( P <0.01). Conclusion: Abdominal obesity and low physical activity level were negatively associated with cognition level in the elderly, suggesting that waist circumference control and physical activity might help maintain cognition in the elderly.

An elevated level of physical activity is associated with normal lipoprotein(a) levels in individuals from Maracaibo, Venezuela.

PubMed

Bermúdez, Valmore; Aparicio, Daniel; Rojas, Edward; Peñaranda, Lianny; Finol, Freddy; Acosta, Luis; Mengual, Edgardo; Rojas, Joselyn; Arráiz, Nailet; Toledo, Alexandra; Colmenares, Carlos; Urribarí, Jesica; Sanchez, Wireynis; Pineda, Carlos; Rodriguez, Dalia; Faria, Judith; Añez, Roberto; Cano, Raquel; Cano, Clímaco; Sorell, Luis; Velasco, Manuel

2010-01-01

Coronary artery disease is the main cause of death worldwide. Lipoprotein(a) [Lp(a)], is an independent risk factor for coronary artery disease in which concentrations are genetically regulated. Contradictory results have been published about physical activity influence on Lp(a) concentration. This research aimed to determine associations between different physical activity levels and Lp(a) concentration. A descriptive and cross-sectional study was made in 1340 randomly selected subjects (males = 598; females = 712) to whom a complete clinical history, the International Physical Activity Questionnaire, and Lp(a) level determination were made. Statistical analysis was carried out to assess qualitative variables relationship by chi2 and differences between means by one-way analysis of variance considering a P value <0.05 as statistically significant. Results are shown as absolute frequencies, percentages, and mean +/- standard deviation according to case. Physical activity levels were ordinal classified as follows: low activity with 24.3% (n = 318), moderate activity with 35.0% (n = 458), and high physical activity with 40.8% (n = 534). Lp(a) concentration in the studied sample was 26.28 +/- 12.64 (IC: 25.59-26.96) mg/dL. Lp(a) concentration according to low, moderate, and high physical activity levels were 29.22 +/- 13.74, 26.27 +/- 12.91, and 24.53 +/- 11.35 mg/dL, respectively, observing statistically significant differences between low and moderate level (P = 0.004) and low and high level (P < 0.001). A strong association (chi2 = 9.771; P = 0.002) was observed among a high physical activity level and a normal concentration of Lp(a) (less than 30 mg/dL). A lifestyle characterized by high physical activity is associated with normal Lp(a) levels.

Where they live, how they play: Neighborhood greenness and outdoor physical activity among preschoolers

PubMed Central

2011-01-01

Background Emerging empirical evidence suggests exposure to "green" environments may encourage higher levels of physical activity among children. Few studies, however, have explored this association exclusively in pre-school aged children in the United States. We examined whether residing in neighborhoods with higher levels of greenness was associated with higher levels of outdoor physical activity among preschoolers. In addition, we also explored whether outdoor playing behaviors (e.g., active vs. quiet) were influenced by levels of neighborhood greenness independent of demographic and parental support factors. Results Higher levels of neighborhood greenness as measured by the Normalized Difference Vegetation Index (NDVI) was associated with higher levels of outdoor playing time among preschool-aged children in our sample. Specifically, a one unit increase in neighborhood greenness increased a child's outdoor playing time by approximately 3 minutes. A dose-response relationship was observed between increasing levels of parental support for physical activity (e.g., time spent playing with children) and child outdoor physical activity (p < 0.01). Conclusions Consistent with previous studies, neighborhood greenness influences physical activity behavior. However, for preschoolers, parental involvement may be more critical for improving physical activity levels. PMID:22165919

Physical activity, psychiatric distress, and interest in exercise group participation among individuals seeking methadone maintenance treatment with and without chronic pain.

PubMed

Beitel, Mark; Stults-Kolehmainen, Matthew; Cutter, Christopher J; Schottenfeld, Richard S; Eggert, Kathy; Madden, Lynn M; Kerns, Robert D; Liong, Christopher; Ginn, Joel; Barry, Declan T

2016-03-01

Physical activity may improve chronic pain, anxiety, and depression, which are prevalent among patients in methadone maintenance treatment (MMT), but relatively little is known about the physical activity levels or interest in exercise of patients in MMT. We used a brief self-report instrument to assess physical activity levels, chronic pain, psychiatric distress, and interest in exercise group participation among 303 adults seeking MMT. Most (73%) reported no moderate or vigorous intensity physical activity in the past week; 27% met recommended physical activity levels, and 24% reported interest in exercise group participation. Participants with (compared to those without) chronic pain had higher levels of psychiatric distress and were less likely to meet recommended levels of physical activity (p < .05), but did not differ significantly in their interest in participating in an exercise group. Participants who met recommended levels of physical activity in the past week were more likely to be men and had lower levels of depression than others (p < .05). Low levels of physical activity and low interest in exercise group participation among patients entering MMT point to the need for and likely challenges of implementing exercise interventions in MMT. © American Academy of Addiction Psychiatry.

Ghrelin and adipokines as circulating markers of disease activity in patients with Takayasu arteritis

PubMed Central

2012-01-01

Introduction The current markers of disease activity in Takayasu arteritis (TA) are insufficient for proper assessment. We investigated circulating levels of unacylated and acylated ghrelin, leptin and adiponectin and their relationships with disease activity in patients with TA. Methods This study included 31 patients with TA and 32 sex-, age- and body mass index-matched healthy controls. Disease activity was assessed in TA patients using various tools, including Kerr's criteria, disease extent index-Takayasu, physician's global assessment, radiological parameters, and laboratory markers. Plasma unacylated and acylated ghrelin, and serum leptin and adiponectin levels were measured using an enzyme-linked immunosorbent assay. Results Unacylated and acylated ghrelin levels were found to be significantly lower in TA patients than that in healthy controls. Patients with active disease had lower unacylated ghrelin levels than those with inactive disease and had lower acylated ghrelin levels than healthy controls. Ghrelin levels were negatively correlated with various parameters of disease activity. The leptin/ghrelin ratio was significantly higher in TA patients than controls. It was positively correlated with disease activity. There was a positive correlation between unacylated and acylated ghrelin and a negative correlation between leptin and ghrelin. There was no statistical difference in adiponectin levels between TA patients and controls. The radiological activity markers were positively correlated with other parameters of disease activity. Conclusions This study suggests that plasma unacylated and acylated ghrelin levels may be useful in monitoring disease activity and planning treatment strategies for patients with TA. The serum leptin level and leptin/ghrelin ratio may also be used to help assess the disease activity. PMID:23259466

Physical activity levels and patterns of 11-14 year-old Turkish adolescents.

PubMed

Kin-Isler, Ayse; Asci, F Hulya; Altintas, Atakan; Guven-Karahan, Bengu

2009-01-01

This study examined age and gender differences in physical activity levels and various physical activity patterns of 11-14-year-old Turkish adolescents and also determined if these differ between genders. Six hundred and fifty girls and 666 boys between the ages of 11 and 14 years constituted the sample of this study. Participants self-reported physical activity levels and patterns were determined by a Weekly Activity Checklist. A 2 x 4 (Gender x Age) MANOVA revealed overall significant main effect of gender and age on the physical activity level of adolescents; however, gender x age interaction effect was not significant. The findings indicated an interaction effect was not significant. The findings indicated an age-related decline in physical activity level, an increase in participation in low activities, and a decrease in participation in moderate and vigorous activities in 11-14-year-old Turkish adolescents. In addition it was found that boys were more active than girls and participated more in moderate and vigorous activities.

The reciprocal relationship between participation in leisure activities and cognitive functioning: the moderating effect of self-rated literacy level.

PubMed

Lifshitz-Vahav, Hefziba; Shrira, Amit; Bodner, Ehud

2017-05-01

Participation in leisure activities is beneficial for cognitive functioning of older adults, but it is less known whether it is also beneficial for those with low basic cognitive level. This study examined the reciprocal relationship between participating in leisure activities and cognitive functioning among low and higher literacy level older adults. Respondents aged 60 years and older who participated in both first waves (2005-2006 and 2009-2010) of the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) were divided into low (n = 139) and higher literacy level respondents (n = 714). They reported participation in leisure activities and completed measures of cognitive functioning at both waves. Cross-lagged models showed that participation in leisure activities predicted higher cognitive functioning four years later only among older adults with low literacy level. On the other hand, cognitive functioning predicted more participation in leisure activities four years later only among higher literacy level older adults. Participating in leisure activities may be especially beneficial to cognitive functioning among older adults with low literacy level, as their initial low cognitive level allows more room for cognitive improvement than among higher literacy level older adults. Public efforts aimed at increasing participation in leisure activities may therefore target particularly older adults with low basic cognitive level.

Intrapersonal, Behavioral, and Environmental Factors Associated With Meeting Recommended Physical Activity Among Rural Latino Youth

PubMed Central

Perry, Cynthia K.; Saelens, Brian E.; Thompson, Beti

2013-01-01

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 360 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level. PMID:22109778

Intrapersonal, behavioral, and environmental factors associated with meeting recommended physical activity among rural Latino youth.

PubMed

Perry, Cynthia K; Saelens, Brian E; Thompson, Beti

2011-11-01

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 3 60 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level.

Physical inactivity post-stroke: a 3-year longitudinal study.

PubMed

Kunkel, Dorit; Fitton, Carolyn; Burnett, Malcolm; Ashburn, Ann

2015-01-01

To explore change in activity levels post-stroke. We measured activity levels using the activPAL™ in hospital and at 1, 2 and 3 years' post-stroke onset. Of the 74 participants (mean age 76 (SD 11), 39 men), 61 were assessed in hospital: 94% of time was spent in sitting/lying, 4% standing and 2% walking. Activity levels improved over time (complete cases n = 15); time spent sitting/lying decreased (p = 0.001); time spent standing, walking and number of steps increased (p = 0.001, p = 0.028 and p = 0.03, respectively). At year 3, 18% of time was spent in standing and 9% walking. Time spent upright correlated significantly with Barthel (r = 0.69 on admission, r = 0.68 on discharge, both p < 0.01) and functional ambulation category scores (r = 0.55 on admission, 0.63 on discharge, both p < 0.05); correlations remained significant at all assessment points. Depression (in hospital), left hemisphere infarction (Years 1-2), visual neglect (Year 2), poor mobility and balance (Years 1-3) correlated with poorer activity levels. People with stroke were inactive for the majority of time. Time spent upright improved significantly by 1 year post-stroke; improvements slowed down thereafter. Poor activity levels correlated with physical and psychological measures. Larger studies are indicated to identify predictors of activity levels. Implications for Rehabilitation Activity levels (measured using activPAL™ activity monitor), increased significantly by 1 year post-stroke but improvements slowed down at 2 and 3 years. People with stroke were inactive for the majority of their day in hospital and in the community. Poor activity levels correlated with physical and psychological measures. Larger studies are indicated to identify the most important predictors of activity levels.

Soluble CD30 serum level in HCV-positive chronic active hepatitis: A surrogate marker of disease activity?

PubMed

Foschi, F G; Gramenzi, A; Castelli, E; Cursaro, C; Pagani, S; Margotti, M; D'Errico, A; Andreone, P; Stefanini, G F; Bernardi, M

2000-06-01

In the present study, high levels of CD30s, a glycoprotein preferentially expressed and released by T lymphocytes producing Th(2)-type cytokines, were seen in the sera of patients with chronic hepatitis C, and a correlation with histological activity of the disease was found. CD30s levels were assayed in the sera of 29 HCV RNA-positive patients with histologically proven chronic active hepatitis and in 30 healthy blood donors. Thirteen of 29 (45%) HCV patients had CD30s serum levels above the normal range (>20 U/ml). Mean CD30s serum levels were significantly higher in HCV patients than in controls (P<0.0005). A positive correlation was found between serum CD30s levels and both the histological activity index (r=0.59, P=0.001) and ALT serum levels (r=0.5; P=0.006). The raised CD30s level found in more severe HCV liver disease indirectly suggests activation and expansion of Th(2)cells. CD30s levels could represent a useful surrogate marker of activity in chronic HCV infections. Copyright 2000 Academic Press.

Physical activity level and associated factors among civil servants in Xi'an, China.

PubMed

Sun, Lijun; Jiang, Xun; Zhao, Xin; Zhang, Yuhai; Xu, Yongyong; Shang, Lei

2016-08-01

This study investigated physical activity levels and associated factors among civil servants in Xi'an, China, to provide reference data for the implementation of health improvement strategies among civil servants. A cross-section study. A random sample of 1000 civil servants aged 18-60 years and employed by the Xi'an civic government was assessed by using the Chinese version of the International Physical Activity Questionnaire. Associations between physical activity and sociodemographic characteristics, family history of chronic disease, and existing disease were evaluated by the Mann-Whitney U-test, Kruskal-Wallis H-test, and binary logistic regression. The response rate was 92.4%. The median physical activity score was 2227 metabolic equivalents of task (MET) minutes per week (interquartile range [IQR]: 1308-3802METmin/week). Among the 924 participants, 7.4% did not meet minimum recommendations for physical activity, 57.3% had moderate activity levels, and 35.4% had high activity levels. Participants spent most of their time on occupational activities (median: 869METmin/week, IQR: 228-1953METmin/week). Female sex (odds ratio [OR]:0.40, 95% confidence interval [CI]:0.29-0.55), age≥51 years (OR: 0.45, 95%CI: 0.27-0.75), and family history of chronic disease (OR: 0.67, 95%CI: 0.48-0.94) were associated with significantly lower odds of a high activity level. Most civil servants in Xi'an, China, have moderate activity levels. Some have high activity levels, but few engage in vigorous-intensity physical activity. Interventions to encourage a high level of physical activity are needed, especially for women, older civil servants, and those with family histories of chronic disease. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Physical activity affects plasma coenzyme Q10 levels differently in young and old humans.

PubMed

Del Pozo-Cruz, Jesús; Rodríguez-Bies, Elisabet; Ballesteros-Simarro, Manuel; Navas-Enamorado, Ignacio; Tung, Bui Thanh; Navas, Plácido; López-Lluch, Guillermo

2014-04-01

Coenzyme Q (Q) is a key lipidic compound for cell bioenergetics and membrane antioxidant activities. It has been shown that also has a central role in the prevention of oxidation of plasma lipoproteins. Q has been associated with the prevention of cholesterol oxidation and several aging-related diseases. However, to date no clear data on the levels of plasma Q during aging are available. We have measured the levels of plasmatic Q10 and cholesterol in young and old individuals showing different degrees of physical activity. Our results indicate that plasma Q10 levels in old people are higher that the levels found in young people. Our analysis also indicates that there is no a relationship between the degree of physical activity and Q10 levels when the general population is studied. However, very interestingly, we have found a different tendency between Q10 levels and physical activity depending on the age of individuals. In young people, higher activity correlates with lower Q10 levels in plasma whereas in older adults this ratio changes and higher activity is related to higher plasma Q10 levels and higher Q10/Chol ratios. Higher Q10 levels in plasma are related to lower lipoperoxidation and oxidized LDL levels in elderly people. Our results highlight the importance of life habits in the analysis of Q10 in plasma and indicate that the practice of physical activity at old age can improve antioxidant capacity in plasma and help to prevent cardiovascular diseases.

Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study.

PubMed

Tawashy, A E; Eng, J J; Lin, K H; Tang, P F; Hung, C

2009-04-01

This was a prospective cross-sectional study for people with chronic spinal cord injury (SCI). To (1) evaluate the intensity level and nature of physical activity in community-dwelling individuals living with SCI, and (2) explore the relation between descriptive individual variables (for example, lesion level), secondary complications and participation in physical activity. Urban community setting. A total of 49 subjects with SCI who used a manual wheelchair for primary mode of mobility (mean years since injury, 11.8; mean age, 43.7 years; 67% paraplegia) completed the physical activity recall assessment for people with SCI (PARA-SCI). Approximately 50% of reported physical activity among individuals with SCI is due to activities of daily living. The amount of physical activity was not related to lesion level, age, body mass index or waistline size. Greater heavy-intensity activity was related to lower levels of pain and fatigue and higher levels of self-efficacy, whereas higher amounts of mild-intensity activity and total activity were related to less depressive symptoms. Activities of daily living are a large component for physical activity among individuals with SCI. It appears that greater physical activity is associated with less secondary complications (pain, fatigue and depression) in individuals with SCI.

The relationship of self-concept and perceived athletic competence to physical activity level and gender among Turkish early adolescents.

PubMed

Aşçi, F H; Koşar, S N; Işler, A K

2001-01-01

The purpose of this study was to examine the self-concept and perceived athletic competence of Turkish early adolescents in relation to physical activity level and gender. Self-concept was assessed using the Piers-Harris Children's Self-Concept Scale, and perceived athletic competence was assessed by means of the Athletic Competence subscale of Harter's Self-Perception Profile for Children. In addition, the Weekly Activity Checklist was used for assessing physical activity level. Males and females were assigned to low and high physical activity level groups based on their mean scores. Multivariate analysis of variance revealed significant main effects for gender and physical activity level, but there was no significant gender by physical activity interaction. Univariate analysis demonstrated a significant main effect for physical activity level on perceived athletic competence but not global self-concept. In addition, univariate analysis did not reveal a significant difference in either global self-concept or perceived athletic competence with respect to gender.

Constructive alignment of a research-informed teaching activity within an undergraduate diagnostic radiography curriculum: A reflection.

PubMed

Higgins, R; Hogg, P; Robinson, L

2017-09-01

To evaluate the learning experience of a level 5 (year 2) student cohort within a research-informed teaching (RiT) activity and to map findings against learning outcomes and level descriptors using constructive alignment. An online questionnaire was used to explore the level 5 student experience of a Research-informed Teaching (RiT) activity. Responses were retrospectively mapped against Framework for Higher Education Qualifications (FHEQ) level descriptors for level 5 using constructive alignment. Thirty one out of 46 level 5 students completed the questionnaire (67% response rate). Analysis of the questionnaire supported the integration of this RiT activity within the curriculum in terms of learning and research skill development by students. However, it was identified that this activity could be revised further to better align with level 5 descriptors and incorporate additional higher level cognitive processes. Learning outcomes for this RiT activity were constructively aligned with FHEQ level 5 descriptors. Recommendations are provided on how these could be further refined to ensure students undertake a more critical approach to the application of theory into practice. Discussion also considers how this process could be used to develop a similar RiT activity at level 6 (year 3). Copyright © 2016 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

How Active Are Teens during Their Out-of-School Time? The View from Chicago. Chapin Hall Issue Brief

ERIC Educational Resources Information Center

Goerge, Robert M.; Cusick, Gretchen Ruth; Guiltinan, Shannon

2009-01-01

This issue brief explores levels of physical activity among high school students in Chicago Public Schools, including participation in sports, informal exercise, and other activities. Latent class analysis was used to classify students' levels of physical activity, revealing low levels of activity among most high school students. Multilevel…

A measurement error model for physical activity level as measured by a questionnaire with application to the 1999-2006 NHANES questionnaire.

PubMed

Tooze, Janet A; Troiano, Richard P; Carroll, Raymond J; Moshfegh, Alanna J; Freedman, Laurence S

2013-06-01

Systematic investigations into the structure of measurement error of physical activity questionnaires are lacking. We propose a measurement error model for a physical activity questionnaire that uses physical activity level (the ratio of total energy expenditure to basal energy expenditure) to relate questionnaire-based reports of physical activity level to true physical activity levels. The 1999-2006 National Health and Nutrition Examination Survey physical activity questionnaire was administered to 433 participants aged 40-69 years in the Observing Protein and Energy Nutrition (OPEN) Study (Maryland, 1999-2000). Valid estimates of participants' total energy expenditure were also available from doubly labeled water, and basal energy expenditure was estimated from an equation; the ratio of those measures estimated true physical activity level ("truth"). We present a measurement error model that accommodates the mixture of errors that arise from assuming a classical measurement error model for doubly labeled water and a Berkson error model for the equation used to estimate basal energy expenditure. The method was then applied to the OPEN Study. Correlations between the questionnaire-based physical activity level and truth were modest (r = 0.32-0.41); attenuation factors (0.43-0.73) indicate that the use of questionnaire-based physical activity level would lead to attenuated estimates of effect size. Results suggest that sample sizes for estimating relationships between physical activity level and disease should be inflated, and that regression calibration can be used to provide measurement error-adjusted estimates of relationships between physical activity and disease.

Physical activity in older, rural, Hispanic, and non-Hispanic white adults.

PubMed

Swenson, Carolyn J; Marshall, Julie A; Mikulich-Gilbertson, Susan K; Baxter, Judith; Morgenstern, Nora

2005-06-01

Understanding variations in physical activity patterns is important for planning health interventions. This study describes age-related change in physical activity in 903 rural Hispanic and non-Hispanic white (NHW) adults age 55-80. The Physical Activity History assessed 13 categories of productive and recreational activity during the past year with up to four assessments per participant from 1987 to 1998. The most common activities were walking and home maintenance/gardening. Productive and recreational physical activity levels were lower in women than men (P < 0.0001), and within each gender group Hispanics had lower levels of both activity types than NHW (P values less than 0.05). In men, productive activity steadily declined with age in NHW and Hispanics. Recreational activity increased slightly until age 63, then decreased after age 70. In women, productive activity initially stayed stable then decreased in NHW after age 63, and in Hispanics it decreased at younger ages before stabilizing after age 70. Recreational activity levels decreased steadily with age in all women, with a steeper rate of decline in NHW than Hispanics. In both ethnic groups, activity levels were lower in diabetics than nondiabetics, except for recreational activity in women where levels did not differ by diabetes status. The most common activities were similar to other studies of older adults, both recreational and productive activities contributed to total activity, and physical activity decreased in all gender-ethnic subgroups with age. Hispanic women reported the lowest activity levels. Interventions to maintain or increase recreational activity may need to target women at an earlier age than men.

[Active form of vitamin D in overweight and obese pediatric patients in northwest Mexico].

PubMed

Valle-Leal, Jaime; Limón-Armenta, Jasmin; Serrano-Osuna, Ricardo; López-Morales, Cruz Mónica; Alvárez-Bastidas, Lucia

Low levels of vitamin D have been associated with a range of clinical conditions such as obesity, insulin resistance, and diabetes mellitus, among others. There are few studies that measure the active form of vitamin D (1,25 (OH) 2 vitamin D) in obese children. However, published data are inconclusive. The aim of this study was to determine the active levels of vitamin D in obese and overweight children and to find an association between low levels of vitamin D, obesity and impaired glucose metabolism. A cross-sectional, analytical study was conducted in 6 to 12-year-old children with excess adiposity determined by waist-stature index and body mass index. Levels of glucose, insulin, complete lipid profile, homeostatic model assessment and the active form of vitamin D were measured in each patient. Levels < 30 pg/ml were considered as low levels of vitamin D. The prevalence of low levels of active vitamin D was 36%. A significant association between low levels of active vitamin D and high levels of insulin was found. No significant association was found between vitamin levels and adiposity measures. Low levels of active vitamin D were found in 36% of the population studied. A significant association with insulin resistance and hyperinsulinemia was demonstrated. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Physical activity levels in the treatment of juvenile fibromyalgia.

PubMed

Sherry, David D

2013-01-01

Physical activity is paramount in the treatment of juvenile fibromyalgia, although some interventions use indirect methods to increase activity levels rather than address physical dysfunction head-on. New research explores the effects of a psychotherapeutic approach on levels of physical activity in adolescents with fibromyalgia.

Burnout and its association with extracurricular activities among medical students in Saudi Arabia

PubMed Central

Almojali, Abdullah I.; Alothman, Ali S.; Masuadi, Emad M.; Alaqeel, Meshal K.

2017-01-01

Objectives To assess levels of burnout in medical students, and to explore the influence of extracurricular activities on burnout at a medical school in Saudi Arabia. Methods This cross-sectional study was conducted with first to fourth year medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia. Socio-demographic, burnout level (the Maslach Burnout Inventory-Student Survey, MBI-SS) and participation in extracurricular activities data were collected using a self-administered questionnaire. Statistical analyses were performed using the Pearson’s chi-square test and binary logistic regression. Results From the 306 medical students approached, 249 (81.4%) completed the questionnaire. The level of high burnout was 67.1% (n=167). The study revealed that the majority (62.3%, n=155) of students had high levels of cynicism, 58.6% (n=146) had high levels of emotional exhaustion, and 60.2% (n=150) had low levels of professional efficacy. Most of the students (73.5%, n=183) participated in extracurricular activities, and 112 (45%) students were organizers of extracurricular activities. No significant association was found between burnout levels and the frequency of involvement in extracurricular activities (χ2=2.2, df=2, p=0.333). However, students who were organizing extracurricular activities were less likely to have low professional efficacy (OR=0.51, 95% CI: 0.27- 0.96). Conclusions High levels of burnout were reported at this medical school. Although the burnout level is not significantly associated with the frequency of involvement in extracurricular activities, leading and organizing extracurricular activities might result in lower levels of burnout. Therefore, improving the students’ leadership skills should be considered in curriculum planning, and greater emphasis should be placed on the quality of involvement in extracurricular activities rather than the quantity. PMID:28454079

Burnout and its association with extracurricular activities among medical students in Saudi Arabia.

PubMed

Almalki, Sami A; Almojali, Abdullah I; Alothman, Ali S; Masuadi, Emad M; Alaqeel, Meshal K

2017-04-26

To assess levels of burnout in medical students, and to explore the influence of extracurricular activities on burnout at a medical school in Saudi Arabia. This cross-sectional study was conducted with first to fourth year medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia. Socio-demographic, burnout level (the Maslach Burnout Inventory-Student Survey, MBI-SS) and participation in extracurricular activities data were collected using a self-administered questionnaire. Statistical analyses were performed using the Pearson's chi-square test and binary logistic regression. From the 306 medical students approached, 249 (81.4%) completed the questionnaire. The level of high burnout was 67.1% (n=167). The study revealed that the majority (62.3%, n=155) of students had high levels of cynicism, 58.6% (n=146) had high levels of emotional exhaustion, and 60.2% (n=150) had low levels of professional efficacy. Most of the students (73.5%, n=183) participated in extracurricular activities, and 112 (45%) students were organizers of extracurricular activities. No significant association was found between burnout levels and the frequency of involvement in extracurricular activities (χ 2 =2.2, df=2, p=0.333). However, students who were organizing extracurricular activities were less likely to have low professional efficacy (OR=0.51, 95% CI: 0.27- 0.96). High levels of burnout were reported at this medical school. Although the burnout level is not significantly associated with the frequency of involvement in extracurricular activities, leading and organizing extracurricular activities might result in lower levels of burnout. Therefore, improving the students' leadership skills should be considered in curriculum planning, and greater emphasis should be placed on the quality of involvement in extracurricular activities rather than the quantity.

Relationship between diet and physical activity level in adolescents from post-grammar schools.

PubMed

Dmitruk, Agnieszka; Kunicka, Izabela; Popławska, Helena; Hołub, Wojciech

2016-01-01

Appropriate diet and physical activity are vital determinants of psychophysical development in children and adolescents. The aim of the study was to analyse an association between dietary habits and physical activity levels of adolescents from post-grammar schools. The study included 110 girls and 65 boys between 16 and 19 years of age from two post-grammar schools in Biała Podlaska in Poland. They were subjected to a diagnostic survey providing information on their diet (number of meals a day, their regularity, frequency of bread, dairy, meat, fish, sweet, fruit, vegetable and fast food consumption, preferred ways of food processing). Physical activity levels were determined with the International Physical Activity Questionnaire--Short Form (IPAQ-SF). Based on these data, the respondents were stratified to high, moderate and low physical activity groups. Due to small number of participants presenting with low physical activity levels, we did not include this group in further analyses. The significance of differences in the dietary habits of adolescents presenting with high and moderate physical activity levels was verified with the χ2 test. Most girls and boys presented with high levels of physical activity. However, we did not find an evident relationship between dietary habits and physical activity levels. Girls from high and moderate physical activity groups differed solely in terms of the number of daily meals, frequency of meat and sweet consumption, and significant intergroup differences observed among boys pertained to the frequencies of whole-wheat bread, meat and fast food consumption. The abovementioned food products were consumed more often by girls and boys presenting with high physical activity levels. The dietary mistakes observed in physically active adolescents from post-secondary schools justify intensification of their dietary education programs.

Effect of physical activity level on biomarkers of inflammation and insulin resistance over 5 years in outpatients with coronary heart disease (from the Heart and Soul Study).

PubMed

Jarvie, Jennifer L; Whooley, Mary A; Regan, Mathilda C; Sin, Nancy L; Cohen, Beth E

2014-10-15

Higher levels of physical activity are associated with lower rates of coronary heart disease (CHD). Previous studies have suggested that this is due partly to lower levels of inflammation and insulin resistance. The aim of this study was to determine whether physical activity level was associated with inflammation or insulin resistance during a 5-year period in outpatients with known CHD. A total of 656 participants from the Heart and Soul Study, a prospective cohort study of outpatients with documented CHD, were evaluated. Self-reported physical activity frequency was assessed at baseline and after 5 years of follow-up. Participants were classified as low versus high activity at each visit, yielding 4 physical activity groups: stable low activity, decreasing activity (high at baseline to low at year 5), increasing activity (low at baseline to high at year 5), and stable high activity. Year 5 markers of inflammation (C-reactive protein [CRP], interleukin-6, and fibrinogen) and insulin resistance (insulin, glucose, and glycated hemoglobin) were compared across the 4 activity groups. After 5 years of follow-up, higher activity was associated with lower mean levels of all biomarkers. In the fully adjusted regression models, CRP, interleukin-6, and glucose remained independently associated with physical activity frequency (log CRP, p for trend across activity groups = 0.03; log interleukin-6, p for trend = 0.01; log glucose, p for trend = 0.003). Subjects with stable high activity typically had the lowest levels of biomarkers. In conclusion, in this novel population of outpatients with known CHD followed for 5 years, higher physical activity frequency was independently associated with lower levels of CRP, interleukin-6, and glucose. Copyright © 2014 Elsevier Inc. All rights reserved.

How does the activity level of the parents influence their children's activity? The contemporary life in a world ruled by electronic devices.

PubMed

Brzęk, Anna; Strauss, Markus; Przybylek, Bianca; Dworrak, Tarja; Dworrak, Birgit; Leischik, Roman

2018-01-01

Apart from many positive changes associated with technical civilization, there are also - from the health point of view - some threats. The reduction in the level of physical activity is one of them. The aim of the study was to investigate whether there are any relationships between children's physical activity and behaviors, and to assess the impact of the adults' activity on their children's habits. The study involved a group of 340 children aged 7-12 years (mean age: 9.81 ±1.7) and their parents. In order to evaluate children's physical activity and the amount of time that they spend with electronic devices, an original questionnaire and the IPAQ questionnaire were used. Children usually use electronic devices between 2 and 7 days per week (mean: 4.74 ±0.86), regardless of sex ( p > 0.09) and spend between 5 and 1620 min per week (mean: 459.46 ±308.1) with their mobile phone, tablet, PCs and TVs. 67.92% of boys and 69.61% of girls lead an active lifestyle. The children's activity level depends on their parents' level of activity ( p < 0.000001). Parents of semi-active children lead a lifestyle with a moderate level of physical activity. The level of physical activity in younger children depends on the children's relationship with their parents and their level of activity. Children spend a lot of free time with their electronic devices. It is necessary to develop and implement activities intended to raise awareness of children and their families about the effects of hypokinesis.

Prevalence of physical activity levels by ethnicity among adults in Hawaii, BRFSS 2001.

PubMed

Mampilly, Carrie M; Yore, Michelle M; Maddock, Jay E; Nigg, Claudio R; Buchner, David; Heath, Gregory W

2005-10-01

Few studies have examined the differences in physical activity levels between subgroups of Asian or Pacific Islanders living in the United States. This study compared levels of physical activity for three subgroups of Asian or Pacific Islanders residing in Hawaii. Data on Native Hawaiian/Part Native Hawaiian (N=585), Filipino (N=548), Japanese (N=871), and White (N=1728) adults were obtained from the Hawaii 2001 Behavioral Risk Factor Surveillance System (BRFSS), which contained more detailed questions on ethnicity than are collected by most states. Six physical activity categories were compared: inactive, insufficient (some activity but less than recommended activity), moderate activity (> or = 30 minutes of moderate activity > or = 5 days a week), vigorous activity (> or = 20 minutes of vigorous activity > or = 3 days a week), recommended activity (meeting either moderate or vigorous activity requirements), and a recently suggested target of > or = 60 minutes of moderate activity 7 days a week or > or = 20 minutes of vigorous activity > or = 4 days a week. Among Asians or Pacific Islanders, Native Hawaiians/Part Native Hawaiians were most active (38.9% moderate and 23.9% vigorous), followed by Japanese (32.1%, 20.4%) and Filipinos (31.8%, 18.6%). Whites were more active than any of these three subgroups (47.2%, 35.4%). Differences in physical activity levels between subgroups of Asians or Pacific Islanders in Hawaii suggests that aggregated data for all subgroups obscures important information about disparities in activity levels. State efforts to reduce disparities in activity levels should take into account differences between Asian or Pacific Islander subgroups.

Global variations in the level of cancer-related research activity and correlation to cancer-specific mortality: Proposal for a global curriculum.

PubMed

Are, C; Caniglia, A; Malik, Mohammed; Smith, L; Cummings, Charmaine; Lecoq, Carine; Berman, R; Audisio, R; Wyld, L

2018-01-01

The aim of this study was to analyze global variations in the level of cancer-related research activity and correlate this with cancer-specific mortality. The SCOPUS database was explored to obtain data relating to the number of cancer-related publications per country. Cancer-specific mortality rates were obtained from the World Health Organization. Global variations in the level of scholarly activity were analyzed and correlated with variations in cancer-specific mortality. Data for 142 countries were obtained and significant variations in the level of research activity was noted. The level of research activity increased with rising socio-economic status. The United States was the most prolific country with 222,300 publications followed by Japan and Germany. Several countries in different regions of the world had a low level of research activity. An inverse relationship between the level of research activity and cancer-specific mortality was noted. This relationship persisted even in countries with a low level of research activity. The socioeconomic status of a nation and geographic location (continent) had a mixed influence with an overall apparent correlation with cancer-related research activity. This study demonstrates significant global variation in the level of cancer-related research activity and a correlation with cancer-specific mortality. The presence of a minimum set of standards for research literacy, as proposed by the European Society of Surgical Oncology and the Society of Surgical Oncology may contribute to enhanced research activity and improve outcomes for cancer patients worldwide. Copyright © 2017 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

34 CFR 300.814 - Other State-level activities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Other State-level activities. 300.814 Section 300.814...) For activities at the State and local levels to meet the performance goals established by the State... CHILDREN WITH DISABILITIES Preschool Grants for Children with Disabilities § 300.814 Other State-level...

The effects of physically active leisure on stress-health relationships.

PubMed

Iwasaki, Y; Zuzanek, J; Mannell, R C

2001-01-01

In this article, the effects of physically active leisure on the relationships between stress and health are examined using structural equation modeling (SEM). The analyses are based on data from Canada's 1994 National Population Health Survey (n = 17,626). Overall, physically active leisure was found to directly contribute to higher levels of physical health and wellbeing, and lower levels of mental ill-health among Canadians. When the respondents experienced higher levels of chronic stress, life event stress, and/or work stress, involvement in physically active leisure appeared to help them maintain good health and wellbeing. Also, higher levels of participation in physically active leisure helped paid workers suppress levels of work stress. Agencies involved in health promotion and lifestyle intervention should give greater consideration to physically active leisure. As a significant component of an active lifestyle, physically active leisure can contribute to better health, and provide a valuable resource for coping with stress.

Directly Observed Physical Activity Levels in Preschool Children

ERIC Educational Resources Information Center

Pate, Russell R.; McIver, Kerry; Dowda, Marsha; Brown, William H.; Addy, Cheryl

2008-01-01

Background: Millions of young children attend preschools and other structured child development programs, but little is known about their physical activity levels while in those settings. The purpose of this study was to describe the physical activity levels and demographic and school-related correlates of physical activity in children attending…

Birth Order and Activity Level in Children.

ERIC Educational Resources Information Center

Eaton, Warren O.; And Others

1989-01-01

Studied 7,018 children between birth and 7 years and 81 children of 5-8 years to test the hypothesis that birth order is negatively related to motor activity level. Activity level declined linearly across birth position, so that early-borns were rated as more active than later-borns. (RJC)

Physical activity, but not fitness level, is associated with depression in Australian adults.

PubMed

Forsyth, A; Williams, P; Deane, F P

2015-01-01

The objective of this study was to evaluate the fitness and physical activity levels of people referred to a nutrition and physical activity program for the management of mental health in general practice. General practitioners referred 109 patients being treated for depression and/or anxiety to a lifestyle intervention program. All participants completed anthropometric measurements and questionnaires including the Depression, Anxiety and Stress Scale (DASS) and the Active Australia Survey. Aerobic fitness was measured with the YMCA step test and muscular fitness was measured with repeated chair stands and arm curls. Fitness scores were compared to population norms, and physical activity levels were compared to population norms and national recommendations. Eighty percent of participants were overweight or obese. A greater proportion of study participants (51%) than the general Australian population (38%) met the recommended 150 minutes per week spent in moderate physical activity. However, participants demonstrated lower than average levels of fitness and participated in low levels of vigorous physical activity. Levels of physical activity, but not fitness, were inversely correlated with DASS scores. Patients presenting with depression and/or anxiety should be screened for physical activity behaviours and encouraged to meet the National Physical Activity Guidelines.

The potential role of advanced glycation end products (AGEs) and soluble receptors for AGEs (sRAGE) in the pathogenesis of adult-onset still's disease.

PubMed

Chen, Der-Yuan; Chen, Yi-Ming; Lin, Chi-Chen; Hsieh, Chia-Wei; Wu, Yen-Ching; Hung, Wei-Ting; Chen, Hsin-Hua; Lan, Joung-Liang

2015-05-09

Accumulating evidence has demonstrated a pathogenic role of advanced glycation end products (AGEs) and receptors for AGEs (RAGE) in inflammation. Soluble RAGE (sRAGE), with the same ligands-binding capacity as full-length RAGE, acts as a "decoy" receptor. However, there has been scanty data regarding AGEs and sRAGE in adult-onset Still's disease (AOSD). This study aimed to investigate AGEs and sRAGE levels in AOSD patients and examine their association with clinical characteristics. Using ELISA, plasma levels of AGEs and sRAGE were determined in 52 AOSD patients, 36 systemic lupus erythematosus(SLE) patients and 16 healthy controls(HC). Their associations with activity parameters and disease courses were evaluated. Significantly higher median levels of AGEs were observed in active AOSD patients (16.75 pg/ml) and active SLE patients (14.80 pg/ml) than those in HC (9.80 pg/ml, both p < 0.001). AGEs levels were positively correlated with activity scores (r = 0.836, p < 0.001), ferritin levels (r = 0.372, p < 0.05) and CRP levels (r = 0.396, p < 0.005) in AOSD patients. Conversely, significantly lower median levels of sRAGE were observed in active AOSD patients (632.2 pg/ml) and active SLE patients (771.6 pg/ml) compared with HC (1051.7 pg/ml, both p < 0.001). Plasma sRAGE levels were negatively correlated with AOSD activity scores (r = -0.320, p < 0.05). In comparison to AOSD patients with monocyclic pattern, significantly higher AGEs levels were observed in those with polycyclic or chronic articular pattern. With treatment, AGEs levels declined while sRAGE levels increased in parallel with the decrease in disease activity. The elevation of AGEs levels with concomitant decreased sRAGE levels in active AOSD patients, suggests their pathogenic role in AOSD.

How engaged are consumers in their health and health care, and why does it matter?

PubMed

Hibbard, Judith H; Cunningham, Peter J

2008-10-01

Patient activation refers to a person's ability to manage their health and health care. Engaging or activating consumers has become a priority for employers, health plans and policy makers. The level of patient activation varies considerably in the U.S. population, with less than half of the adult population at the highest level of activation, according to a new study by the Center for Studying Health System Change (HSC). Activation levels are especially low for people with low incomes, less education, Medicaid enrollees, and people with poor self-reported health. Higher activation levels are associated with much lower levels of unmet need for medical care and greater support from health care providers for self-management of chronic conditions.

Multi-sensor physical activity recognition in free-living.

PubMed

Ellis, Katherine; Godbole, Suneeta; Kerr, Jacqueline; Lanckriet, Gert

Physical activity monitoring in free-living populations has many applications for public health research, weight-loss interventions, context-aware recommendation systems and assistive technologies. We present a system for physical activity recognition that is learned from a free-living dataset of 40 women who wore multiple sensors for seven days. The multi-level classification system first learns low-level codebook representations for each sensor and uses a random forest classifier to produce minute-level probabilities for each activity class. Then a higher-level HMM layer learns patterns of transitions and durations of activities over time to smooth the minute-level predictions. [Formula: see text].

Serum Adipocytokine Levels as Surrogate Markers for Disease Activity of Crohn's Disease.

PubMed

Kim, Su Hwan; Jang, Seung Hyeon; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Kim, You Sun; Han, Dong Soo; Kim, Joo Sung

2017-05-01

Determining inflammatory activity is crucial for assessing disease activity and for tailoring therapy in patients with Crohn׳s disease (CD). This study aimed to evaluate adipocytokine levels in patients with CD and to determine whether they can serve as surrogate markers for disease activity. Serum samples and information regarding the clinical features of patients in the CD Network Project registry were collected from March 2009 to February 2012. Patients with CD and disease duration of at least 2 years were enrolled in this study. Fasting serum leptin, adiponectin, obestatin and ghrelin levels were measured, and their correlation with clinical features of the patients was analyzed. Serum adipocytokine levels were evaluated according to disease activity as determined by CD activity index score. A total of 153 patients with CD were included. Serum ghrelin levels negatively correlated with patient age (P = 0.041) and age at diagnosis (P = 0.017), and positively correlated with C-reactive protein (CRP) levels (P = 0.017). Multiple regression analysis showed that serum ghrelin levels were related only to CRP levels (P = 0.032). Like ghrelin, serum leptin levels were also related to CRP levels (P < 0.001). Obestatin and adiponectin levels were not related to CRP levels. Serum adipocytokine levels did not significantly differ across different disease locations or behaviors. Serum ghrelin levels were significantly lower in patients with CD with a history of surgery than in those without (P = 0.007). Serum ghrelin and leptin levels may be useful as surrogate markers for disease activity in patients with CD. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

[Levels of physical activity in an urban population from Temuco, Chile].

PubMed

Serón, Pamela; Muñoz, Sergio; Lanas, Fernando

2010-10-01

Physical activity plays a crucial role in the protection against cardiovascular diseases. To assess the level of physical activity in a group of subjects living in urban Temuco. Cross sectional study in a random sample of 1091 women aged 52 ± 10 years and 444 men aged 54 ± 10 years , living in Temuco, Chile. The level of physical activity was measured using the long form of the International Physical Activity Questionnaire (IPAQ). Age, gender, educational and socioeconomic level were also determined in study subjects. Median energy expenditure was 2150 and 1600 MET-minute/ week in men and women, respectively (p = 0,001). It decreased with age from a median of 1965 MET-minute/ week in those younger than 50 years old to 1647 MET-minute/ week among subjects aged between 51 and 60 years old and to 1485 MET-minute/ week among those older than 60 years. (p = 0,001). The frequency of high, moderate and low physical activity levels were 15.6, 66 and 18.4 % respectively. These levels were associated with gender, age, educational and socioeconomic level. There was a high frequency of low and moderate levels of physical activity in the urban population of Temuco, associated with female gender, advanced age and middle socioeconomic level.

Physical activity level in people with age related white matter changes correlates to better motor performance, lower comorbidity and higher cognitive level.

PubMed

Pettersson, Anna F; Wahlund, Lars-Olof; Bronge, Lena; Olsson, Elisabeth; Amberla, Kaarina; Baezner, Hansjoerg; Crisby, Milita

2017-07-12

Physical activity plays a pivotal role in the development of disability and may modify the negative effect of vascular risk factors on progression of both cardio and cerebrovascular disorders. The aim of this study was to evaluate the activity level in people with age-related white matter changes as identified on magnetic resonance imaging (MRI) in relation to motor performance, cognition and perceived health. Data came from the first year follow up of one participating centers of the LADIS study. Fifty one subjects were first enrolled in the study. Complete first year follow up data was available for 41 subjects. Information on comorbidity, physical activity level, physical function, cognition, level of white matter changes and perceived health was collected. Physical activity level was classified with a yes or no question and with the Frenchay Activities Index (FAI). Only 36% of the subjects in this study were physically active according to the yes/no question. 27.5% of the subjects were active according to the FAI score which evaluates the everyday activities. Being active discriminated subjects with better physical function. Subjects active according to the FAI score had a higher cognitive level (p ≤ 0.01), lower comorbidity (p = 0.02) and performed better on all motor function tasks as assessed by walking speed (p ≤ 0.01) and the Short Physical Performance battery (SPPB) (p ≤ 0.01). Being physically active seems to be a long term protective factor. In our study, the majority of subjects with Age Related White Mattter Changes (ARWMC) with no or mild Instrumental Activity of Daily Living (IADL) disability did not attain recommended level of activity at first year follow up. Whether or not increasing physical activity may slow down cognitive decline and lessen development of disability in physically inactive subjects with manifest ARWC remains to be studied. not applicable.

Induction of plasma acetylcholinesterase activity in mice challenged with organophosphorus poisons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Duysen, Ellen G.; Lockridge, Oksana, E-mail: olockrid@unmc.edu

2011-09-01

The restoration of plasma acetylcholinesterase activity in mice following inhibition by organophosphorus pesticides and nerve agents has been attributed to synthesis of new enzyme. It is generally assumed that activity levels return to normal, are stable and do not exceed the normal level. We have observed over the past 10 years that recovery of acetylcholinesterase activity levels in mice treated with organophosphorus agents (OP) exceeds pretreatment levels and remains elevated for up to 2 months. The most dramatic case was in mice treated with tri-cresyl phosphate and tri-ortho-cresyl phosphate, where plasma acetylcholinesterase activity rebounded to a level 250% higher thanmore » the pretreatment activity. The present report summarizes our observations on plasma acetylcholinesterase activity in mice treated with chlorpyrifos, chlorpyrifos oxon, diazinon, tri-ortho-cresyl phosphate, tri-cresyl phosphate, tabun thiocholine, parathion, dichlorvos, and diisopropylfluorophosphate. We have developed a hypothesis to explain the excess acetylcholinesterase activity, based on published observations. We hypothesize that acetylcholinesterase activity is induced when cells undergo apoptosis and that consequently there is a rise in the level of plasma acetylcholinesterase. - Highlights: > Acetylcholinesterase activity is induced by organophosphorus agents. > AChE induction is related to apoptosis. > Induction of AChE activity by OP is independent of BChE.« less

Physical activity level and fall risk among community-dwelling older adults.

PubMed

Low, Sok Teng; Balaraman, Thirumalaya

2017-07-01

[Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

The Effect of Gender and Level of Vision on the Physical Activity Level of Children and Adolescents with Visual Impairment

ERIC Educational Resources Information Center

Aslan, Ummuhan Bas; Calik, Bilge Basakci; Kitis, Ali

2012-01-01

This study was planned in order to determine physical activity levels of visually impaired children and adolescents and to investigate the effect of gender and level of vision on physical activity level in visually impaired children and adolescents. A total of 30 visually impaired children and adolescents (16 low vision and 14 blind) aged between…

Correlation of Level of Trauma Activation With Emergency Department Intervention.

PubMed

Cooper, Michael C; Srivastava, Geetanjali

2018-06-01

In-hospital trauma team activation criteria are formulated to identify severely injured patients requiring specialized multidisciplinary care. Efficacy of trauma activation (TA) criteria is commonly measured by emergency department (ED) disposition, injury severity score, and mortality. Necessity of critical ED interventions is another measure that has been proposed to evaluate the appropriateness of TA criteria. Two-year retrospective cohort study of 1715 patients from our trauma registry at a Level 1 pediatric trauma center. We abstracted data on acute interventions, level and criterion of TA, ED disposition, and mortality. We report odds ratio (OR) with 95% confidence intervals (CIs), positive predictive value, and frequency of acute interventions. Trauma activation was initiated for 947 (55%) of the 1715 patients. There were 426 ED interventions performed on 235 patients (14%); 67.8% were in level 1 activations; 17.6% in level 2, and 14.6% in level 3. Highest-level activations were highly associated with need for ED interventions (OR, 16.1; 95% CI, 11.5-22.4). The ORs for requiring an ED intervention were low for lower level activations (OR, 0.4; 95% CI, 0.3-0.5), trauma service consults (OR, 0.3; 95% CI, 0.2-0.4), and certain mechanism-based criteria. The ORs for ED intervention for isolated motor vehicle collision (0.2; 95% CI, 0.1-0.7), isolated all-terrain vehicle rollover (0.4; 95% CI, 0.1-1.7), and suspected spinal cord injury (0.5; 95% CI, 0.1-3.7) were significantly lower than 1. Highest-level activation criteria correlate with high utilization of ED resources and interventions. Lower level activation criteria and trauma service consult criteria are not highly correlated with need for ED interventions. Downgrading isolated motor vehicle collision and all-terrain vehicle rollovers and suspected spinal cord injury to lower level activations could decrease the overtriage rate, and adding age-specific bradycardia as a physiologic criterion could improve our undertriage rate.

Objectively-Measured Physical Activity Levels in Physical Education among Homeschool Children

ERIC Educational Resources Information Center

Swenson, Sarah; Pope, Zachary; Zeng, Nan

2016-01-01

Despite a growing population of homeschool children in the United States, little is known regarding their physical activity (PA) levels. Without access to physical education, homeschool children may engage in inadequate PA levels. The purpose of this study was to objectively examine the activity levels of homeschool students participating in a…

Effects of Curricular Activity on Students' Situational Motivation and Physical Activity Levels

ERIC Educational Resources Information Center

Gao, Zan; Hannon, James C.; Newton, Maria; Huang, Chaoqun

2011-01-01

The purpose of this study was to examine (a) the effects of three curricular activities on students' situational motivation (intrinsic motivation [IM], identified regulation [IR], external regulation, and amotivation [AM]) and physical activity (PA) levels, and (b) the predictive strength of situational motivation to PA levels. Four hundred twelve…

20 CFR 404.1573 - General information about work activity.

Code of Federal Regulations, 2011 CFR

2011-04-01

... business, this tends to show that you have the ability to work at the substantial gainful activity level... working at the substantial gainful activity level. If you are unable, because of your impairments, to do..., this does not show that you are working at the substantial gainful activity level. (c) If your work is...

20 CFR 416.973 - General information about work activity.

Code of Federal Regulations, 2011 CFR

2011-04-01

... activity level. (b) How well you perform. We consider how well you do your work when we determine whether... that you are working at the substantial gainful activity level. If you are unable, because of your... gainful activity level. If you are doing work that involves minimal duties that make little or no demands...

20 CFR 220.142 - General information about work activity.

Code of Federal Regulations, 2011 CFR

2011-04-01

... substantial gainful activity level. If the claimant is unable, because of his or her impairments, to do... activity level. If the claimant is doing work that involves minimal duties that make little or no demands... claimant is working at the substantial gainful activity level. (c) If the claimant's work is done under...

Physical activity levels and preferences of ethnically diverse visitors to Georgia State Parks

Treesearch

Lincoln Larson; Jason W. Whiting; Gary T. Green; Michael Bowker

2014-01-01

Parks provide many outdoor recreation opportunities that encourage physical activity and healthy lifestyles, and research has recently begun to explore the demographic, social, and environmental factors associated with park-based activity levels, particularly outside of urban areas. This study used a mixed methods approach to investigate physical activity levels and...

Non-Overweight and Overweight Children's Physical Activity during School Recess

ERIC Educational Resources Information Center

Ridgers, Nicola D.; Saint-Maurice, Pedro F.; Welk, Gregory J.; Siahpush, Mohammad; Huberty, Jennifer L.

2014-01-01

Objective: Little research has investigated children's physical activity levels during school recess and the contribution of recess to school day physical activity levels by weight status. The aims of this study were to examine non-overweight and overweight children's physical activity levels during school recess, and examine the contribution of…

The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program.

PubMed

Terry, Paul E; Fowles, Jinnet Briggs; Xi, Min; Harvey, Lisa

2011-01-01

PURPOSE. This study compares a traditional worksite-based health promotion program with an activated consumer program and a control program DESIGN. Group randomized controlled trial with 18-month intervention. SETTING. Two large Midwestern companies. SUBJECTS. Three hundred and twenty employees (51% response). INTERVENTION. The traditional health promotion intervention offered population-level campaigns on physical activity, nutrition, and stress management. The activated consumer intervention included population-level campaigns for evaluating health information, choosing a health benefits plan, and understanding the risks of not taking medications as prescribed. The personal development intervention (control group) offered information on hobbies. The interventions also offered individual-level coaching for high risk individuals in both active intervention groups. MEASURES. Health risk status, general health status, consumer activation, productivity, and the ability to evaluate health information. ANALYSIS. Multivariate analyses controlled for baseline differences among the study groups. RESULTS. At the population level, compared with baseline performance, the traditional health promotion intervention improved health risk status, consumer activation, and the ability to recognize reliable health websites. Compared with baseline performance, the activated consumer intervention improved consumer activation, productivity, and the ability to recognize reliable health websites. At the population level, however, only the activated consumer intervention improved any outcome more than the control group did; that outcome was consumer activation. At the individual level for high risk individuals, both traditional health coaching and activated consumer coaching positively affected health risk status and consumer activation. In addition, both coaching interventions improved participant ability to recognize a reliable health website. Consumer activation coaching also significantly improved self-reported productivity. CONCLUSION. An effective intervention can change employee health risk status and activation both at the population level and at the individual high risk level. However, program engagement at the population level was low, indicating that additional promotional strategies, such as greater use of incentives, need to be examined. Less intensive coaching can be as effective as more intensive, albeit both interventions produced modest behavior change and retention in the consumer activation arm was most difficult. Further research is needed concerning recruitment and retention methods that will enable populations to realize the full potential of activated consumerism.

Paraoxonase 1 activity and level of antibodies directed against oxidized low density lipoproteins in a group of an elderly population in Poland - PolSenior study.

PubMed

Bednarska-Makaruk, Małgorzata; Rodo, Maria; Szirkowiec, Walentyna; Mossakowska, Małgorzata; Puzianowska-Kuźnicka, Monika; Skalska, Anna; Zdrojewski, Tomasz; Ryglewicz, Danuta; Wehr, Hanna

2015-01-01

The aim of this study was to assess two factors influencing the amount of oxidized LDL-paraoxonase 1 (PON1) activity and the level of anti-oxidized LDL antibodies (anti-ox LDL) in a large group of elderly individuals in Poland. The effects of cognitive status, hypertension and metabolic syndrome and of selected serum lipids and inflammation indicators on PON1 activity and anti-ox LDL level were also examined. The investigated population consisted of 3154 individuals aged 65 and more - participants of the population-based PolSenior project. PON1 arylesterase activity was determined spectrophotometrically, anti-ox-LDL antibodies using ELISA method. PON1 activity significantly decreased with advancing age, was lower in males than in females and decreased in persons with impaired cognition. Individuals with hypertension and high lipid levels showed higher PON1 activity. Lower PON1 activity was related to higher level of inflammation indicators - hsCRP and IL-6. The significant association of PON1 activity with age, HDL-C, LDL-C, sex and IL-6 was confirmed in multivariate analysis. Anti-ox LDL antibodies level was significantly higher in the two oldest subgroups of males. It was significantly lower in males than in females. It was decreased in persons with higher serum triglycerides. No relationship of anti-ox LDL level with cognition, hypertension, metabolic syndrome, inflammation indicators and serum lipid levels was observed. In some persons very high levels of anti-ox LDL were stated, most frequently in the oldest persons, particularly in men. Both investigated antioxidant factors - PON1 activity and anti-ox LDL level, could play an important role in aging. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Interaction between leptin and leisure-time physical activity and development of hypertension.

PubMed

Asferg, Camilla; Møgelvang, Rasmus; Flyvbjerg, Allan; Frystyk, Jan; Jensen, Jan S; Marott, Jacob L; Appleyard, Merete; Schnohr, Peter; Jensen, Gorm B; Jeppesen, J Rgen

2011-12-01

OBJECTIVE. The mechanisms by which overweight and physical inactivity lead to hypertension are complex. Leptin, an adipocyte-derived hormone, has been linked with hypertension. We wanted to investigate the relationship between leptin, physical activity and new-onset hypertension. METHODS. The study was a prospective cohort study of 744 women and 367 men, who were normotensive in the third Copenhagen City Heart Study (CCHS) examination, performed 1991−94. Based on questionnaire items, the participants were divided into two groups with low (n = 674) and high (n = 437) levels of leisure-time physical activity, respectively. RESULTS. Between the third and the fourth CCHS examination, performed 2001?03, 304 had developed hypertension, defined as systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg or use of antihypertensive medication. In a logistic regression model, including age, sex, body mass index, SBP, DBP, level of physical activity and leptin, we found a significant interaction between leptin and level of physical activity with new-onset hypertension as outcome variable (p = 0.012). When we entered the interaction variables, effect of leptin with low level of physical activity and with high level of physical activity, respectively, in the original model, leptin predicted new-onset hypertension in participants with low level of physical activity [odds ratio (95% confidence interval): 1.16 (1.01−1.33) for one unit increase in log-transformed leptin levels, p = 0.038], but not in participants with high level of physical activity [0.88 (0.74−1.05), p = 0.15]. CONCLUSION. We found that leptin predicted new-onset hypertension but only in participants with low level of physical activity.

Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up.

PubMed

Krych, Aaron J; Reardon, Patrick J; Johnson, Nick R; Mohan, Rohith; Peter, Logan; Levy, Bruce A; Stuart, Michael J

2017-02-01

Medial meniscus posterior root tears (MMPRTs) are a significant source of pain and dysfunction, but little is known about the natural history and outcome and for non-operative management of these lesions. The purpose of this study was to evaluate (1) the mid-term clinical and radiographic outcomes of non-operative treatment of MMPRTs and (2) risk factors for worse outcomes. A retrospective review was performed for patients with symptomatic, unrepaired MMPRTs and a minimum 2-year follow-up for IKDC and Tegner outcome scores. Baseline and final radiographs were reviewed and graded according to Kellgren-Lawrence scores. Baseline MRIs were reviewed for the presence of meniscal extrusion, subchondral oedema, and insufficiency fractures. Failure was defined as conversion to arthroplasty or severely abnormal patient subjective IKDC score. Fifty-two patients (21M:31F) with a mean age of 58 ± 10 years were diagnosed with symptomatic MMPRTs clinically and confirmed by MRI and followed for a mean of 62 ± 30 months. Sixteen patients (31 %) underwent total knee arthroplasty at a mean of 30 ± 32 months after diagnosis with higher Kellgren-Lawrence grades associated with increased rates of arthroplasty (p = 0.01). Mean IKDC scores for the remaining patients were 61.2 ± 21 with significantly lower scores in females compared to males (75 ± 12 vs. 49 ± 20; p = 0.03). Mean Kellgren-Lawrence grades and rates of arthritis progressed over time on radiographs (1.5 ± 0.7 vs. 2.4 ± 1.0; p < 0.001 and 78 % vs. 51 %; p = 0.01). Overall, 87 % of patients failed non-operative treatment. Non-operative treatment of medial meniscus posterior horn root tears is associated with poor clinical outcome, worsening arthritis, and a relatively high rate of arthroplasty at 5-year follow-up. Female gender was associated with lower subjective scores and higher rate of arthroplasty. The current study provides a natural history benchmark for clinical outcomes that can be expected in patients with medial meniscus posterior horn root tears undergoing non-operative treatment and helps in counselling patients with these types of injuries. IV.

Relations of participation in organized activities to smoking and drinking among Japanese youth: contextual effects of structural social capital in high school.

PubMed

Takakura, Minoru

2015-09-01

This cross-sectional study examined the effect of school-level structural social capital on smoking and drinking among Japanese youth. Self-administered anonymous questionnaires were distributed to 3248 students at 29 high schools across Okinawa, Japan in 2008. Structural social capital was measured by students' participation in organized activities: student council, extracurricular activities, volunteer activities, community sports clubs, and youth associations. Contextual-level social capital was measured by aggregated school-level individual responses. At the individual level, extracurricular activity participation was negatively associated with smoking and drinking, whereas participation in youth associations was positively associated with smoking and drinking. School-level extracurricular activity participation was negatively associated with smoking among boys, whereas school-level participation in youth associations was positively associated with smoking among boys and girls and drinking among boys. This study suggests that structural social capital measured by participation in organized activities, especially extracurricular activities, might be an important way for youths to attain good health. This study also supports the idea that particular type of activities, such as youth associations, can lead to the so-called "dark side of social capital".

Matrix metalloproteinase 2 (MMP-2) levels are increased in active acromegaly patients.

PubMed

Karci, Alper Cagri; Canturk, Zeynep; Tarkun, Ilhan; Cetinarslan, Berrin

2017-07-01

During follow-up of acromegaly patients, there is a discordance rate of 30% between the measurements of growth hormone and insulin-like growth factor-1 levels. Further tests are required to determine disease activity in patients with discordant results. This study was planned to investigate an association of serum levels of matrix metalloproteinase-2, matrix metalloproteinase-9, and cathepsin B with disease activity in acromegaly patients. In this study, 64 acromegaly patients followed in our clinic were divided into two groups according to the 2010 consensus criteria for cure of acromegaly as patients with active disease (n = 24) and patients with controlled disease (n = 40). Serum matrix metalloproteinase-2, matrix metalloproteinase-9, and cathepsin B levels were measured by the enzyme-linked immunosorbent assay method. The mean serum matrix metalloproteinase-2 level was significantly higher in the active acromegaly patients than in the controlled acromegaly patients (150.1 ± 54.5 ng/mL vs. 100.2 ± 44.6 ng/mL; p < 0.0001). There was no significant difference between the active and controlled acromegaly patients regarding serum matrix metalloproteinase-9 and cathepsin B levels (p = 0.205 and p = 0.598, respectively). Serum matrix metalloproteinase-2 levels of 118.3 ng/mL and higher had a sensitivity of 75% and a specificity of 77.5% in determining active disease. The risk of active acromegaly was 3.3 fold higher in the patients with a matrix metalloproteinase-2 level of >118.3 ng/mL than in the patients with a matrix metalloproteinase-2 level of <118.3 ng/mL. In this study, serum matrix metalloproteinase-2 level is increased in the active acromegaly patients and a threshold value in determining active disease was defined for serum matrix metalloproteinase-2 level. This study is the first to compare acromegaly patients having active or controlled disease in terms of matrix metalloproteinase-2 and matrix metalloproteinase-9 levels. The results need to be confirmed by a study that will be conducted in a larger patient group also including a healthy control group to demonstrate the value of this novel marker in disease activity.

Impact of Activity Behaviors on Physical Activity Identity and Self-Efficacy.

ERIC Educational Resources Information Center

Miller, Kim H.; Ogletree, Robert J.; Welshimer, Kathleen

2002-01-01

Examined the relationship of physical activity level and length of time of adherence to physical activity with physical activity identity (PAI) and physical activity self-efficacy (PASE). Surveys of 409 adult university employees indicated that vigorous activity related to higher PAI and PASE scores, and activity level contributed significantly…

Assessment of Objectively Measured Physical Activity Levels in Individuals with Intellectual Disabilities with and without Down's Syndrome

PubMed Central

Phillips, Alexander C.; Holland, Anthony J.

2011-01-01

Objective To investigate, using accelerometers, the levels of physical activity being undertaken by individuals with intellectual disabilities with and without Down's syndrome. Methods One hundred and fifty two individuals with intellectual disabilities aged 12–70 years from East and South-East England. Physical activity levels in counts per minute (counts/min), steps per day (steps/day), and minutes of sedentary, light, moderate, vigorous, and moderate to vigorous physical activity (MVPA) measured with a uni-axial accelerometer (Actigraph GT1M) for seven days. Results No individuals with intellectual disabilities met current physical activity recommendations. Males were more active than females. There was a trend for physical activity to decline and sedentary behaviour to increase with age, and for those with more severe levels of intellectual disability to be more sedentary and less physically active, however any relationship was not significant when adjusted for confounding variables. Participants with Down's syndrome engaged in significantly less physical activity than those with intellectual disabilities without Down's syndrome and levels of activity declined significantly with age. Conclusions Individuals with intellectual disabilities, especially those with Down's syndrome may be at risk of developing diseases associated with physical inactivity. There is a need for well-designed, accessible, preventive health promotion strategies and interventions designed to raise the levels of physical activity for individuals with intellectual disabilities. We propose that there are physiological reasons why individuals with Down's syndrome have particularly low levels of physical activity that also decline markedly with age. PMID:22205957

Leisure time physical activity among pregnant women and its associations with maternal characteristics and pregnancy outcomes.

PubMed

Lindqvist, Maria; Lindkvist, Marie; Eurenius, Eva; Persson, Margareta; Ivarsson, Anneli; Mogren, Ingrid

2016-10-01

Physical activity during pregnancy is generally considered safe and beneficial for both the pregnant woman and her fetus. The overall aim was to investigate pregnant women's pre-pregnancy and early pregnancy physical activity and its associations with maternal characteristics and pregnancy outcomes. This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant women living in northern Sweden between 2011 and 2012. Almost half of the participants (47.1%) achieved the recommended level of physical activity. Compared to the women who did not achieve the recommended level of exercise, these women had lower BMI, very good or good self-rated health, and a higher educational level. No significant associations could be established between physical activity levels and GDM, birth weight, or mode of delivery. Positively, a considerably high proportion of Swedish pregnant women achieved the recommended level of physical activity. Factors associated with recommended physical activity level were BMI ≤30 kg/m(2), very good or good self-rated health, and higher educational level. Our findings emphasize the need for health care professionals to early detect and promote fertile and pregnant women towards health-enhancing physical activity, especially those with low levels of physical activity and overweight/obesity, to improve overall health in this population. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

Influence of Leisure Competence and Level of Leisure Activity on Life Satisfaction in Low-Income Older Adults in Rural South Korea.

PubMed

Choi, Jihea; Choi, Jung A

2017-03-01

The purpose of the current study was to investigate the relationships among leisure competence, level of leisure activity, and life satisfaction in low-income older adults in rural South Korea. A sample of 137 older adults answered the study questionnaire, and significant differences in leisure competence were noted depending on age, religion, and perceived health status as well as level of leisure activity based on perceived health status and type of leisure activities. There were also notable differences in life satisfaction regarding religion and perceived health status, and a correlation among leisure competence, level of leisure activity, and life satisfaction; the influencing power of leisure competence and level of leisure activity on life satisfaction was 47%. The findings suggest that enhancement of older adults' leisure competence may increase participation in leisure activities. [Res Gerontol Nurs. 2017; 10(2):67-75.]. Copyright 2017, SLACK Incorporated.

Activity Levels in Healthy Older Adults: Implications for Joint Arthroplasty

PubMed Central

Thorp, Laura E.; Orozco, Diego; Block, Joel A.; Sumner, Dale R.; Wimmer, Markus A.

2012-01-01

This work evaluated activity levels in a group of healthy older adults to establish a target activity level for adults of similar age after total joint arthroplasty (TJA). With the decreasing age of TJA patients, it is essential to have a reference for activity level in younger patients as activity level affects quality of life and implant design. 54 asymptomatic, healthy older adults with no clinical evidence of lower extremity OA participated. The main outcome measure, average daily step count, was measured using an accelerometer-based activity monitor. On average the group took 8813 ± 3611 steps per day, approximately 4000 more steps per day than has been previously reported in patients following total joint arthroplasty. The present work provides a reference for activity after joint arthroplasty which is relevant given the projected number of people under the age of 65 who will undergo joint arthroplasty in the coming years. PMID:23577274

The relationships of change in physical activity with change in depression, anxiety, and burnout: a longitudinal study of Swedish healthcare workers.

PubMed

Lindwall, Magnus; Gerber, Markus; Jonsdottir, Ingibjörg H; Börjesson, Mats; Ahlborg, Gunnar

2014-11-01

The purpose of the present study was to examine whether intraindividual changes in physical activity were correlated with intraindividual changes in mental health (depression, anxiety, and burnout) across four measurement time-points over 6 years, both from between-person and within-person perspectives. Health care workers (N = 3717; mean age = 46.9; SD = 10.0) were the target population in this study, which is part of a larger longitudinal survey that included questionnaires on physical activity levels and mental health (depression, anxiety, and burnout) at four time points across 6 years (2004-2010). Physical activity was assessed with an adapted version of the widely used 1-item, 4-level Saltin Grimby Physical Activity Level Scale (SGPALS). Depression, anxiety, and burnout were assessed using the Hospital Anxiety and Depression (HAD) scale and the Shirom-Melamed Burnout Questionnaire (SMBQ). Bivariate latent growth curve models were used to analyze the associations of change between physical activity and mental health. Baseline levels of physical activity were moderately associated with baseline levels of mental health (rs = -.27 to -.40, ps < .01). Changes in physical activity were moderately to strongly associated (rs = -.57 to -.79, ps <. 01) with change in mental health at the between-person (correlated change) level and significantly, but weakly (rs = -.08 to -.14, ps <.01), associated with change at the within-person (coupled change) level of analysis. Changes in physical activity were associated with, and traveled together with, changes in depression, anxiety, and burnout across time. Changes in physical activity, and not only current or previous levels of activity, may be important to consider in preventive work linked to mental health within this population. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Kinesiophobia in relation to physical activity in chronic neck pain.

PubMed

Demirbüken, İlkşan; Özgül, Bahar; Kuru Çolak, Tuğba; Aydoğdu, Onur; Sarı, Zübeyir; Yurdalan, Saadet Ufuk

2016-01-01

Little research is available concerning physical activity and its determinants in people with chronic neck pain. To explore the relation between kinesiophobia and physical activity and gender effect on these relations in people with chronic neck pain. Ninety-nine subjects (34 men and 65 women) with chronic neck pain were participated in the study. Pain intensity was assessed with Visual Analog Scale and kinesiophobia degree was determined by using Tampa Scale of Kinesiophobia. Level of physical activity was assessed with short form of the International Physical Activity Questionnaire. There was no statistically correlation between neck pain intensity and kinesiophobia degree (p= 0.246, r= 0.123) and physical activity level (p= 0.432, r= -0.083). It was also found that kinesiophobia degree was not correlated to physical activity level (p= 0.148, r= -0.153). There was a negative correlation between kinesiophobia degree and physical activity level only for women, not for men (p= 0.011, r= -0.318). Our results showed that although people with chronic neck pain reported higher pain intensity and fear of movement, pain intensity and kinesiophobia degree did not associate to their physical activity levels. It can be speculated that high kinesiophobia degrees cause low physical activity levels for women, but not for men.

Cancers in Australia in 2010 attributable to insufficient physical activity

PubMed Central

Olsen, Catherine M; Wilson, Louise F; Nagle, Christina M; Kendall, Bradley J; Bain, Christopher J; Pandeya, Nirmala; Webb, Penelope M; Whiteman, David C

2015-01-01

Objectives To estimate the proportion and numbers of cancers occurring in Australia in 2010 attributable to insufficient levels of physical activity. Methods We estimated the population attributable fraction (PAF) of cancers causally associated with insufficient physical activity (colon, post-menopausal breast and endometrium) using standard formulae incorporating prevalence of insufficient physical activity (<60 minutes at least 5 days/week), relative risks associated with physical activity and cancer incidence. We also estimated the proportion change in cancer incidence (potential impact fraction [PIF]) that may have occurred assuming that everyone with insufficient activity levels increased their exercise by 30 minutes/week. Results An estimated 1,814 cases of colon, post-menopausal breast and endometrial cancer were attributable to insufficient levels of physical activity: 707 (6.5%) colon; 971 (7.8%) post-menopausal breast; and 136 (6.0%) endometrial cancers. If those exercising below the recommended level had increased their activity level by 30 minutes/week, we estimate 314 fewer cancers (17% of those attributable to insufficient physical activity) would have occurred in 2010. Conclusions More than 1,500 cancers were attributable to insufficient levels of physical activity in the Australian population. Implications Increasing the proportion of Australians who exercise could reduce the incidence of several common cancers. PMID:26437732

Localization and quantification of carbonic anhydrase activity in the symbiotic Scyphozoan Cassiopea xamachana.

PubMed

Estes, Anne M; Kempf, Stephen C; Henry, Raymond P

2003-06-01

The relationship between density and location of zooxanthellae and levels of carbonic anhydrase (CA) activity was examined in Cassiopea xamachana. In freshly collected symbiotic animals, high densities of zooxanthellae corresponded with high levels of CA activity in host bell and oral arm tissues. Bleaching resulted in a significant loss of zooxanthellae and CA activity. Recolonization resulted in full restoration of zooxanthellar densities but only partial restoration of CA activity. High levels of CA activity were also seen in structures with inherently higher zooxanthellar densities, such as oral arm tissues. Similarly, the oral epidermal layer of bell tissue had significantly higher zooxanthellar densities and levels of CA activity than did aboral bell tissues. Fluorescent labeling, using 5-dimethylaminonapthalene-1-sulfonamide (DNSA) also reflected this tight-knit relationship between the presence and density of zooxanthellae, as DNSA-CA fluorescence intensity was greatest in host oral epithelial cells directly overlying zooxanthellae. However, the presence and density of zooxanthellae did not always correspond with enzyme activity levels. A transect of bell tissue from the margin to the manubrium revealed a gradient of CA activity, with the highest values at the bell margin and the lowest at the manubrium, despite an even distribution of zooxanthellae. Thus, abiotic factors may also influence the distribution of CA and the levels of CA activity.

The Relationship of Self-Concept and Perceived Athletic Competence to Physical Activity Level and Gender among Turkish Early Adolescents.

ERIC Educational Resources Information Center

Kosar, F. Hulya Asci S. Nazan; Isler, Ayse Kin

2001-01-01

Examined self-concept and perceived athletic competence of Turkish early adolescents in relation to physical activity level and gender. Multivariate analysis of variance revealed significant main effects for gender and physical activity level but no significant gender by physical activity interaction. Univariate analysis demonstrated significant…

Comparison of adult physical activity levels in three Swiss alpine communities with varying access to motorized transportation.

PubMed

Dombois, Oliver Thommen; Braun-Fahrländer, Charlotte; Martin-Diener, Eva

2007-09-01

To compare physical activity levels of residents of three Swiss alpine communities with varying access to motorized transport and to investigate whether socio-demographic factors, the settlement structure or means of transport affect these levels. Between January and February 2004 a computer assisted telephone interview was conducted with 901 randomly selected adults aged 18 years or older living in three Swiss alpine communities. In particular, information on moderate and vigorous intensity physical activities and on transport behaviour was collected. Respondents were categorized as 'sufficiently active' or 'insufficiently active' according to self-reported physical activity. People living in community 1 without access to motorized traffic were significantly more likely to be sufficiently active (Sex- and age-adjusted prevalences of sufficient total physical activity, 43.9% 95% CI: 38.3%-49.8%) compared to individuals living in the other two communities (community 2: 35.9%, 95% CI: 30.6%-41.6%, community 3: 32.7%, 95% CI: 27.5%-38.3%). The differences were due to higher levels of moderate physical activities. Vigorous physical activity levels did not differ between the communities. Community differences were explained by passive means of transport to work and for leisure time activities. Although the environment encountered in the three alpine communities is generally conducive to physical activity the majority of the participants did not achieve recommended activity levels. Passive mode of transport to work and during leisure time was strongly associated with insufficient total physical activity. Walking and cycling for transportation is thus a promising approach to promote health enhancing physical activity.

Levels of physical activity in patients with severe psoriasis: a cross-sectional questionnaire study.

PubMed

Torres, Tiago; Alexandre, José Manuel; Mendonça, Denisa; Vasconcelos, Carlos; Silva, Berta Martins; Selores, Manuela

2014-04-01

Psoriasis is a chronic inflammatory disease associated with increased cardiovascular mortality, secondary to the increased prevalence of cardiovascular risk factors and premature atherosclerosis. Physical activity is a vital component in prevention and management of cardiovascular disease. Few studies have examined the level of physical activity in psoriasis patients, using validated questionnaires or other objective assessment tools. The aim of this study was to analyze and compare physical activity undertaken by patients with severe psoriasis and healthy controls, using the International Physical Activity Questionnaire-Short Form (IPAQ-S), a validated instrument for assessing physical activity. Ninety patients with severe plaque-type psoriasis and 160 healthy subjects were enrolled in the present study. Physical activity was evaluated using IPAQ-S. Psoriasis patients had reduced levels of physical activity compared with non-psoriasis patients, regardless of sex or whether the variable was continuous or categorical. The odds ratio for low-level physical activity for psoriasis patients, compared with controls, was 3.42 (95% CI 1.47-7.91), indicating that this severe psoriasis population did not undertake recommended levels of physical activity. Psoriasis patients exhibit decreased levels of physical activity, possibly for both psychological and physiological reasons. The lack of physical activity may contribute to the increased risk of cardiovascular disease in psoriasis patients, in addition to the intrinsic risks related to systemic inflammation and psoriasis-linked comorbidities. Regular physical activity should be encouraged in all psoriasis patients because of its beneficial effects on systemic inflammation and cardiometabolic comorbidities associated with psoriasis.

Associations of objectively assessed physical activity and sedentary time with all-cause mortality in US adults: the NHANES study.

PubMed

Schmid, Daniela; Ricci, Cristian; Leitzmann, Michael F

2015-01-01

Sedentary behavior is related to increased mortality risk. Whether such elevated risk can be offset by enhanced physical activity has not been examined using accelerometry data. We examined the relations of sedentary time and physical activity to mortality from any cause using accelerometry data among 1,677 women and men aged 50 years or older from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 cycle with follow-up through December 31, 2006. During an average follow-up of 34.67 months and 4,845.42 person-years, 112 deaths occurred. In multivariate Cox proportional hazard models, greater sedentary time (≥ median of 8.60 hours/day) was associated with increased risk of mortality from any cause (relative risk (RR) = 2.03; 95% confidence interval (CI) = 1.09-3.81). Low level of moderate to vigorous physical activity (< median of 6.60 minutes/day) was also related to enhanced all-cause mortality risk (RR = 3.30; 95% CI = 1.33-8.17). In combined analyses, greater time spent sedentary and low levels of moderate to vigorous physical activity predicted a substantially elevated all-cause mortality risk. As compared with the combination of a low sedentary level and a high level of moderate to vigorous physical activity, the risks of mortality from all causes were 4.38 (95% CI = 1.26-15.16) for low levels of both sedentary time and physical activity, 2.79 (95% CI = 0.77-10.12) for greater time spent sedentary and high physical activity level, and 7.79 (95% CI = 2.26-26.82) for greater time spent sedentary and low physical activity level. The interaction term between sedentary time and moderate to vigorous physical activity was not statistically significant (p = 0.508). Both high levels of sedentary time and low levels of moderate to vigorous physical activity are strong and independent predictors of early death from any cause. Whether a high physical activity level removes the increased risk of all-cause mortality related to sedentariness requires further investigation.

Associations of Objectively Assessed Physical Activity and Sedentary Time with All-Cause Mortality in US Adults: The NHANES Study

PubMed Central

Schmid, Daniela; Ricci, Cristian; Leitzmann, Michael F.

2015-01-01

Background Sedentary behavior is related to increased mortality risk. Whether such elevated risk can be offset by enhanced physical activity has not been examined using accelerometry data. Materials and Methods We examined the relations of sedentary time and physical activity to mortality from any cause using accelerometry data among 1,677 women and men aged 50 years or older from the National Health and Nutrition Examination Survey (NHANES) 2003–2004 cycle with follow-up through December 31, 2006. Results During an average follow-up of 34.67 months and 4,845.42 person-years, 112 deaths occurred. In multivariate Cox proportional hazard models, greater sedentary time (≥ median of 8.60 hours/day) was associated with increased risk of mortality from any cause (relative risk (RR) = 2.03; 95% confidence interval (CI) = 1.09-3.81). Low level of moderate to vigorous physical activity (< median of 6.60 minutes/day) was also related to enhanced all-cause mortality risk (RR = 3.30; 95% CI = 1.33-8.17). In combined analyses, greater time spent sedentary and low levels of moderate to vigorous physical activity predicted a substantially elevated all-cause mortality risk. As compared with the combination of a low sedentary level and a high level of moderate to vigorous physical activity, the risks of mortality from all causes were 4.38 (95% CI = 1.26-15.16) for low levels of both sedentary time and physical activity, 2.79 (95% CI = 0.77-10.12) for greater time spent sedentary and high physical activity level, and 7.79 (95% CI = 2.26-26.82) for greater time spent sedentary and low physical activity level. The interaction term between sedentary time and moderate to vigorous physical activity was not statistically significant (p = 0.508). Conclusions Both high levels of sedentary time and low levels of moderate to vigorous physical activity are strong and independent predictors of early death from any cause. Whether a high physical activity level removes the increased risk of all-cause mortality related to sedentariness requires further investigation. PMID:25768112

Everyday physical activity and adiposity in Prader-Willi syndrome.

PubMed

van den Berg-Emons, Rita; Festen, Dederieke; Hokken-Koelega, Anita; Bussmann, Johannes; Stam, Henk

2008-11-01

The aim of this study was to assess the impact of Prader-Willi syndrome (PWS) on the level of everyday physical activity and to explore whether the activity level is related to adiposity. Measurements were performed with an accelerometry-based Activity Monitor during two consecutive schooldays in 12 children with PWS (7-16 years of age) and in 12 age- and gender-matched, healthy children. Adiposity was assessed by body mass index standard deviation scores and by percentage body fat (dual energy X-ray absorptiometry). Mean duration of dynamic activities (expressed as percentage of 24 h) was lower in children with PWS than in the comparison group (8.7 [2.5]% and 12.0 [3.1]%, respectively; p = 0.01). Six children with PWS had normal activity levels. Physical activity level was not related to adiposity. The results indicate that, as a group, children with PWS have an inactive lifestyle. However, children with PWS cannot be stereotyped as inactive since half of them had normal activity levels.

Goal adjustment, physical and sedentary activity, and well-being and health among breast cancer survivors.

PubMed

Wrosch, Carsten; Sabiston, Catherine M

2013-03-01

This longitudinal study examined whether goal adjustment capacities (i.e., goal disengagement and goal reengagement) would predict breast cancer survivors' emotional well-being and physical health by facilitating high levels of physical activity and low levels of sedentary activity. Self-reports of goal adjustment capacities were measured among 176 female breast cancer survivors at baseline. Self-reports of physical activity, sedentary activity, daily affect, and daily physical health symptoms (e.g., nausea or pain) were measured at baseline and 3-month follow-up. Goal reengagement predicted high levels of positive affect and low levels of physical symptoms at baseline and increases in positive affect over 3 months. The combination of high goal disengagement and high goal reengagement was associated with particularly large 3-month increases in positive affect. The effects of goal reengagement on baseline affect and physical health were mediated by high baseline levels of physical activity, and the interaction effect on 3-month changes in positive affect was mediated by low baseline levels of sedentary activity. Goal adjustment capacities can exert beneficial effects on breast cancer survivors' well-being and physical health by facilitating adaptive levels of physical and sedentary activity. Integrating goal adjustment processes into clinical practice may be warranted. Copyright © 2012 John Wiley & Sons, Ltd.

Net superoxide levels: steeper increase with activity in cooler female and hotter male lizards.

PubMed

Ballen, Cissy; Healey, Mo; Wilson, Mark; Tobler, Michael; Wapstra, Erik; Olsson, Mats

2012-03-01

Ectotherms increase their body temperature in response to ambient heat, thereby elevating their metabolic rate. An often inferred consequence of this is an overall upregulation of gene expression and energetic expenditure, and a concomitant increased production of reactive oxygen species (e.g. superoxide) and, perhaps, a shortened lifespan. However, recent work shows that this may be a superficial interpretation. For example, sometimes a reduced temperature may in fact trigger up-regulation of gene expression. We studied temperature and associated activity effects in male and female Australian painted dragon lizards (Ctenophorus pictus) by allowing the lizards to bask for 4 h versus 12 h, and scoring their associated activity (inactive versus active basking and foraging). As predicted, long-basking lizards (hereafter 'hot') showed heightened activity in both sexes, with a more pronounced effect in females. We then tested for sex-specific effects of basking treatment and activity levels on the increase in net levels of superoxide. In males, short-baskers (hereafter 'cold') had significantly more rapidly decreasing levels of superoxide per unit increasing activity than hot males. In females, however, superoxide levels increased faster with increasing activity in the cold than in the hot basking treatment, and females earlier in the ovarian cycle had lower superoxide levels than females closer to ovulation. In short, males and females differ in how their levels of reactive oxygen species change with temperature-triggered activity.

Increased visfatin levels are associated with higher disease activity in anti-Jo-1-positive myositis patients.

PubMed

Hulejová, Hana; Kryštůfková, Olga; Mann, Heřman; Klein, Martin; Pavlíčková, Klára; Zámečník, Josef; Vencovský, Jiří; Šenolt, Ladislav

2016-01-01

The aim of this study was to evaluate serum levels of visfatin in anti-Jo-1-positive myositis patients, its expression in muscle tissue and to investigate potential relationships between visfatin, B-cell activating factor of the TNF family (BAFF), disease activity and anti-Jo-1 autoantibody levels. Serum levels of visfatin and BAFF were measured in 38 anti-Jo-1 positive myositis patients and 35 healthy subjects. Disease activity was evaluated by myositis disease activity assessment tool (MYOACT) using visual analogue scales (VAS) and by serum muscle enzymes. Visfatin expression was evaluated by immunohistochemistry in muscle tissue of myositis patients (n=10) and compared with non-inflammatory control muscle tissue samples from patients with myasthenia gravis (n=5). Serum visfatin and BAFF levels were significantly higher in myositis patients compared to healthy subjects and were associated with clinical muscle activity assessed by VAS. Only serum BAFF levels, but not visfatin levels, positively correlated with muscle enzyme concentrations and anti-Jo1 antibody levels. There was a positive correlation between visfatin and BAFF serum levels in myositis patients but a negative correlation was observed in healthy subjects. Visfatin expression was up-regulated in endomysial and perimysial inflammatory infiltrates of muscle tissue from myositis patients. Up-regulation of visfatin in myositis muscle tissue and an association between increased visfatin levels and muscle disease activity evaluated by MYOACT in anti-Jo-1 positive myositis patients could support possible role of visfatin in the pathogenesis of myositis.

Physical, Psychological and Emotional Benefits of Green Physical Activity: An Ecological Dynamics Perspective.

PubMed

Yeh, Hsiao-Pu; Stone, Joseph Antony; Churchill, Sarah May; Wheat, Jonathan Stephen; Brymer, Eric; Davids, Keith

2016-07-01

Increasing evidence supports the multiple benefits to physical, psychological and emotional wellbeing of green physical activity, a topic of increasing interest in the past decade. Research has revealed a synergistic benefit of green physical activity, which includes all aspects of exercise and physical activity in the presence of nature. Our theoretical analysis suggests there are three distinct levels of engagement in green physical activity, with each level reported to have a positive effect on human behaviours. However, the extent to which each level of green physical activity benefits health and wellbeing is assumed to differ, requiring confirmation in future research. This elucidation of understanding is needed because previous literature has tended to focus on recording empirical evidence rather than developing a sound theoretical framework to understand green physical activity effects. Here we propose an ecological dynamics rationale to explain how and why green physical activity might influence health and wellbeing of different population groups. This framework suggests a number of unexplored, interacting constraints related to types of environment and population groups, which shape reported levels of benefit of green physical activity. Further analysis is needed to clarify the explicit relationship between green physical activity and health and wellbeing, including levels of engagement, types of environmental constraints, levels of physical activity, adventure effects, skill effects and sampling of different populations.

The interplay between physical activity and anxiety sensitivity in fearful responding to carbon dioxide challenge.

PubMed

Smits, Jasper A J; Tart, Candyce D; Rosenfield, David; Zvolensky, Michael J

2011-01-01

Physical activity may confer protective effects in the development of anxiety and its disorders. These effects may be particularly strong among individuals who have elevated levels of anxiety sensitivity (AS; i.e., the fear of somatic arousal), an established cognitive-based risk factor for anxiety and its disorders. The present study performed a laboratory test of the interplay between physical activity and AS. The participants were adults free of Axis I psychopathology (n = 145) who completed measures of physical activity and AS before undergoing a recurrent 20% carbon dioxide-enriched air (CO(2)) challenge. Consistent with the hypothesis, physical activity was significantly related to CO(2) challenge reactivity among persons with elevated levels of AS, at high levels of physical activity (p < .001) but not at low levels of physical activity (p = .90). Also consistent with hypothesis, irrespective of the level of physical activity, physical activity did not relate significantly to CO(2) challenge reactivity among persons with normative levels of AS (p = .28). These findings provide novel empirical insight into the role that physical activity may play in terms of resiliency for the development of anxiety disorders. Specifically, the protective effects of physical activity may only be evident at higher doses and among persons who are at increased risk of developing anxiety disorders because they have elevated AS.

Recreational physical activity levels in healthy older women: the importance of fear of falling.

PubMed

Bruce, David G; Devine, Amanda; Prince, Richard L

2002-01-01

To examine whether fear of falling is a probable cause of reduced recreational physical activity levels in healthy older women. Cross-sectional analysis of baseline data from a longitudinal study. One thousand five hundred older, ambulatory women (aged 70-85), selected at random from the electoral roll. Self-reported recreational physical activity levels and fear of falling, demographic variables, anthropometric variables and measures of disability, and physical and cognitive function. The study subjects had low levels of physical and cognitive impairments; 24.1% of the group was obese (body mass index> 30). Twenty-six percent of the women did not participate in recreational physical activity; 39% participated in sufficient activity to gain probable health benefits. Although the women who did not participate in recreational activities were most likely to report fear of falling (45.2%), it was common in the group as a whole (33.9%), including the most active women (27.0%). Independent risk factors for nonparticipation in physical activity were fear of falling (odds ratio (OR)=0.70, 95% confidence interval (CI)=0.54-0.90, P=.006), obesity (OR=0.50, 95% CI=0.38-0.66, P=.001), and slower times on the timed up-and-go test (OR=0.88, 95% CI=0.84-0.92, P=.001). Fear of falling was also independently associated with lower recreational physical activity levels in women who were active (beta=-0.09, P=.003). Subgroup analysis suggested that fear of falls affected activity levels at a predisability stage in women with mildly impaired mobility. Fear of falling is common in healthy, high-functioning older women and is independently associated with reduced levels of participation in recreational physical activity. Fear of falling is an important psychological barrier that may need to be overcome in programs attempting to improve activity levels in older women.

Abdominal obesity and physical inactivity are associated with erectile dysfunction independent of body mass index.

PubMed

Janiszewski, Peter M; Janssen, Ian; Ross, Robert

2009-07-01

Erectile dysfunction (ED) is common among men with an elevated body mass index (BMI). However, a high waist circumference (WC) and low levels of physical activity may predict ED independently of BMI. We investigated the independent relationships between BMI, WC, and physical activity with ED. Subjects consisted of 3,941 adult men (age > or = 20 years) with no history of prostate cancer from the 2001-2004 National Health and Nutrition Examination Survey. Logistic regression analyses were used to examine the relative odds of ED association with categories of BMI, WC, and physical activity. Established thresholds were used to divide subjects into three WC and BMI categories. Physical activity level was divided into active (> or =150 min/week), moderately active (30-149 min/week), and inactive (<30 min/week) categories. A single survey question was used to assess the presence of ED. After control for potential confounders, men with either a high WC or an obese BMI had an approximately 50% higher odds of having ED compared with men with a low WC or a normal BMI, respectively. Further, moderately active or inactive men had an approximately 40-60% greater odds of ED compared with active men. When all three predictors (WC, BMI, and physical activity level) were entered into the same logistic regression model, both a high WC and low physical activity level (moderately active and inactive) were independently associated with a greater odds of ED, whereas BMI level was not. Maintaining a WC level below 102 cm and achieving the recommended amount of moderate-intensity physical activity (>or =150 min/week) is associated with the maintenance of proper erectile function, regardless of BMI level. These findings suggest that the clinical screening for ED risk should include the assessment of WC and physical activity level in addition to BMI.

Early androgens, activity levels and toy choices of children in the second year of life.

PubMed

Alexander, Gerianne M; Saenz, Janet

2012-09-01

The hypothesis that stronger preferences for active play styles contribute to stronger preferences for male-typical toys was examined in 47 boys and 37 girls at 19-months of age using ambulatory monitoring technology (i.e., actigraphy) to measure activity levels during contact with male-typical, female-typical, and gender-neutral toys. Digit ratios and salivary testosterone levels were measured earlier in children at 3-4 months of age. There were no significant sex differences in digit ratios, salivary testosterone levels, or overall activity levels during toy play. In contrast, contact times showed large sex differences in infants' toy preferences. The within-sex comparisons showed that infant girls had significant preferences for female-typical toys over male-typical toys, whereas infant boys showed only a small preference for male-typical toys over female-typical toys. More male-typical digit ratios in early infancy predicted higher activity counts during toy play and less female-typical toy preferences in girls. However, in both sexes, activity levels were unrelated to toy preferences suggesting that factors other than activity level preferences contribute to the early emergence of gender-linked toy preferences. Copyright © 2012 Elsevier Inc. All rights reserved.

Ferromagnetic interaction model of activity level in workplace communication

NASA Astrophysics Data System (ADS)

Akitomi, Tomoaki; Ara, Koji; Watanabe, Jun-ichiro; Yano, Kazuo

2013-03-01

The nature of human-human interaction, specifically, how people synchronize with each other in multiple-participant conversations, is described by a ferromagnetic interaction model of people’s activity levels. We found two microscopic human interaction characteristics from a real-environment face-to-face conversation. The first characteristic is that people quite regularly synchronize their activity level with that of the other participants in a conversation. The second characteristic is that the degree of synchronization increases as the number of participants increases. Based on these microscopic ferromagnetic characteristics, a “conversation activity level” was modeled according to the Ising model. The results of a simulation of activity level based on this model well reproduce macroscopic experimental measurements of activity level. This model will give a new insight into how people interact with each other in a conversation.

Predictors of physical activity and sedentary behaviours among 11-16 year olds: Multilevel analysis of the 2013 Health Behaviour in School-aged Children (HBSC) study in Wales.

PubMed

Morgan, Kelly; Hallingberg, Britt; Littlecott, Hannah; Murphy, Simon; Fletcher, Adam; Roberts, Chris; Moore, Graham

2016-07-15

The present study investigated associations between individual- and school-level predictors and young people's self-reported physical activity (total activity and moderate-to-vigorous activity) and sedentary behaviours. Individual-level data provided by the 2013/14 cross-sectional survey 'Health Behaviour in School-aged Children (HBSC) study in Wales' were linked to school-level data within the 'HBSC School Environment Questionnaire'. The final sample comprised 7,376 young people aged 11-16 years across 67 schools. Multilevel modelling was used to examine predictors of total physical activity, moderate-to-vigorous physical activity (MVPA) and sedentary behaviours (screen-based behaviours). Taking more physical activity (less than 5 days vs. 5 or more days per week), engaging in higher levels of MVPA (less than 4 hours vs. 4 or more hours per week) and reporting 2 or less hours of sedentary time were predicted by several individual level variables. Active travel to school positively predicted high levels of physical activity, however, gender stratified models revealed active travel as a predictor amongst girls only (OR:1.25 (95 % CI:1.05 - 1.49)). No school-level factors were shown to predict physical activity levels, however, a lower school socio-economic status was associated with a higher level of MVPA (OR:1.02 (95 % CI:1.01 - 1.03)) and a lower risk of sedentary behaviour (OR:0.97 (95 % CI:0.96 - 0.99)). A shorter lunch break (OR:1.33 (95 % CI:1.11 - 1.49)) and greater provision of facilities (OR:1.02 (95 % CI:1.00 - 1.05)) were associated with increased sedentary activity. Gender stratified models revealed that PE lesson duration (OR:1.18 (95 % CI:1.01 - 1.37)) and the provision of sports facilities (OR:1.03 (95 % CI:1.00 - 1.06)) were predictors of boy's sedentary behaviours only. Shorter lunch breaks were associated with increased sedentary time. Therefore, while further research is needed to better understand the causal nature of this association, extending lunch breaks could have a positive impact on sedentary behaviour through the provision of more time for physical activity. The findings also suggest that active travel could offer a mechanism for increasing physical activity levels particularly amongst girls. Particularly, the design and evaluation of interventions to promote physical activity during school hours should employ a comprehensive approach, including a focus on school policies and behaviours both in and out of school hours.

Does arthroscopic rotator cuff repair improve patients' activity levels?

PubMed

Baumgarten, Keith M; Chang, Peter S; Dannenbring, Tasha M; Foley, Elaine K

2018-06-04

Rotator cuff repair decreases pain, improves range of motion, and increases strength. Whether these improvements translate to an improvement in a patient's activity level postoperatively remains unknown. The Shoulder Activity Level is a valid and reliable outcomes survey that can be used to measure a patient's shoulder-specific activity level. Currently, there are no studies that examine the effect of rotator cuff repair on shoulder activity level. Preoperative patient-determined outcomes scores collected prospectively on patients undergoing rotator cuff repair were compared with postoperative scores at a minimum of 2 years. These scores included the Shoulder Activity Level, Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, Single Assessment Numeric Evaluation, and simple shoulder test. Inclusion criteria were patients undergoing arthroscopic rotator cuff repair. Included were 281 shoulders from 273 patients with a mean follow-up of 3.7 years. The postoperative median Western Ontario Rotator Cuff Index (42 vs. 94), American Shoulder and Elbow Surgeons (41 vs. 95), Single Assessment Numeric Evaluation (30 vs. 95), and simple shoulder test (4 vs. 11) scores were statistically significantly improved compared with preoperative scores (P < .0001). The postoperative median Shoulder Activity Level score decreased compared with the preoperative score (12 vs. 11; P < .0001). Patients reported a statistically significant deterioration of their Shoulder Activity Level score after rotator cuff repair compared with their preoperative scores, although disease-specific and joint-specific quality of life scores all had statistically significantly improvement. This study suggests that patients generally have (1) significant improvements in their quality of life and (2) small deteriorations in activity level after arthroscopic rotator cuff repair. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Factors influencing subjective perceptions of everyday occupations: comparing day centre attendees with non-attendees.

PubMed

Argentzell, Elisabeth; Leufstadius, Christel; Eklund, Mona

2012-01-01

Subjective perceptions of everyday occupations are important for the well-being of people with psychiatric disabilities (PD) and are likely to vary with factors such as attending a day centre or not, activity level, self-mastery, sociodemographic and clinical factors. To explore differences in subjective perceptions of occupation and activity level between day centre attendees and non-attendees, and to investigate factors of importance for the subjective perceptions of occupations. The study groups comprised 175 participants: 93 day centre attendees and 82 non-attendees. Data were collected with instruments concerning; subjective perceptions of everyday occupations, activity level, self-mastery, and sociodemographic and clinical factors. Day centre attendees perceived higher levels of occupational value and activity level, while the groups perceived a similar level of satisfaction with daily occupations. For the total sample, self-mastery influenced both valued and satisfying everyday occupations while only value was affected by activity level. Satisfaction with daily occupation increased with age and both value and satisfaction increased with lower levels of psychiatric symptoms. Day centres provide perceptions of occupational value and stimulate activity. Non-differences between the groups regarding satisfaction with everyday occupations implied, however, that day centres might not cover all relevant occupational needs.

An examination of eating attitudes and physical activity levels of Turkish university students with regard to self-presentational concern.

PubMed

Aşçi, F Hülya; Tüzün, Macide; Koca, Canan

2006-11-01

This study aimed to examine eating attitudes and physical activity level of young women and men university students with regard to social physique anxiety level. 482 university students participated in this study voluntarily. "Eating Attitude Test (EAT-40)", "Social Physique Anxiety Scale" and "Physical Activity Assessment Questionnaire" were used to assess the eating attitude, social physique anxiety and physical activity level of participants, respectively. Women and men participants in this study were assigned to high (HSPA) and low (LSPA) social physique anxiety groups with respect to their median scores. Men had favorable eating attitudes and higher physical activity level than women. In addition, participants in the HSPA group had unfavorable eating attitudes and higher physical activity MET values than participants in the LSPA group. On the other hand, groupxgender interaction was only significant for the eating attitudes scores but, not for physical activity level. Women in the HSPA group scored higher on the EAT-40 than men in HSPA and women and men in the LSPA groups.

Hepatic CYP1A levels and EROD activity in English sole: biomonitoring of marine contaminants in Vancouver Harbour.

PubMed

Miller, K A; Addison, R F; Bandiera, S M

2004-01-01

To assess chemical contaminant stress in the marine environment, ethoxyresorufin-O-deethylase (EROD) activity and cytochrome P450 1A (CYP1A) expression were measured in 88 English Sole (Pleuronectes vetulus) collected during May and June 1999 from four sites in Vancouver Harbour and at an expected reference site outside the harbour. Hepatic microsomes were prepared from the fish and analyzed for total CYP content, EROD activity, and CYP1A protein levels. Hepatic EROD activity and CYP1A protein levels were elevated in fish from two sites in the inner harbour. A comparison with sediment chemistry data showed that fish with increased EROD activity and CYP1A levels came from sites containing relatively high levels of polycyclic aromatic hydrocarbons and polychlorinated biphenyls. Unexpectedly high levels of EROD activity and CYP1A protein were also found in fish from a reference site near Gibsons, in Howe Sound. The elevated EROD activity and CYP1A expression in fish from this site cannot be explained by the chemical analysis data collected.

Ambulatory Physical Activity Performance in Youth With Cerebral Palsy and Youth Who Are Developing Typically

PubMed Central

Bjornson, Kristie F; Belza, Basia; Kartin, Deborah; Logsdon, Rebecca; McLaughlin, John F

2007-01-01

Background and Purpose Assessment of walking activity in youth with cerebral palsy (CP) has traditionally been “capacity-based.” The purpose of this study was to describe the day-to-day ambulatory activity “performance” of youth with CP compared with youth who were developing typically. Subjects Eighty-one youth with CP, aged 10 to 13 years, who were categorized as being in Gross Motor Function Classification System (GMFCS) levels I to III and 30 age-matched youth who were developing typically were recruited. Methods Using a cross-sectional design, participants wore the StepWatch monitor for 7 days while documenting average daily total step counts, percentage of all time active, ratio of medium to low activity levels, and percentage of time at high activity levels. Results The youth with CP demonstrated significantly lower levels of all outcomes than the comparison group. Discussion and Conclusion Daily walking activity and variability decreased as functional walking level (GMFCS level) decreased. Ambulatory activity performance within the context of the daily life for youth with CP appears valid and feasible as an outcome for mobility interventions in CP. PMID:17244693

Passion for leisure activity contributes to pain experiences during rehabilitation.

PubMed

Courbalay, Anne; Deroche, Thomas; Brewer, Britton

2017-03-01

The primary aim of this study was to determine whether the levels of obsessive passion (OP) and harmonious passion for a suspended leisure activity contribute to pain catastrophizing and pain intensity in patients undergoing the rehabilitation process. The secondary aim was to examine whether the levels of passion associated with a maintained leisure activity offset the contribution of having a leisure activity suspended to pain intensity and catastrophizing. Ninety-one outpatients from functional rehabilitation units (Mage=37, SD=13.44 years) completed measures of pain catastrophizing, pain intensity, and passion about valued leisure activities (one they were prevented from practicing and one they remained able to practice). Correlation analysis showed that the level of OP for a suspended valued leisure activity was positively associated with pain catastrophizing and pain intensity. Results showed that pain catastrophizing mediated the relationship between this level of passion and pain intensity. The levels of harmonious passion and OP for a maintained valued leisure activity did not offset the contribution of OP for a suspended leisure activity to pain-related outcomes. When prevented from practicing a valued leisure activity, only OP contributes to the prediction of pain catastrophizing and pain intensity. The contribution of pain catastrophizing provides a potential explanation for why the level of OP for a suspended leisure activity is related to pain intensity ratings. The benefits of maintaining a valued leisure activity during rehabilitation do not seem sufficient to counterbalance the maladaptive effects of being prevented from the practice of a previous/another valued leisure activity.

Physical activity, self-efficacy, and health-related quality of life in persons with multiple sclerosis: analysis of associations between individual-level changes over one year.

PubMed

Motl, Robert W; McAuley, Edward; Wynn, Daniel; Sandroff, Brian; Suh, Yoojin

2013-03-01

Physical activity and self-efficacy represent behavioral and psychological factors, respectively, that are compromised in persons with multiple sclerosis (MS), but might be modifiable through intervention and result in better health-related quality of life (HRQOL). The present study adopted a panel research design and examined the associations between individual-level changes in physical activity, self-efficacy, and HRQOL over a one-year period in persons with MS. The sample consisted of 269 persons with relapsing-remitting MS who completed the Godin Leisure-Time Questionnaire (GLTEQ), Multiple Sclerosis Self-Efficacy (MSSE) Scale, and Multiple Sclerosis Quality of Life-29 (MSIS-29) Scale on two occasions that were separated by 1 year. The data were analyzed using panel analysis in Mplus 3.0. The initial panel analysis indicated that individual-level change in physical activity was associated with individual-level change in both physical and psychological HRQOL. The subsequent panel analysis indicated that (a) individual-level change in self-efficacy for functioning with MS was associated with individual-level change in physical HRQOL, whereas individual-level change in self-efficacy for control was associated with individual-level change in psychological HRQOL; (b) individual-level change in self-efficacy for functioning with MS, but not self-efficacy for control, mediated the association between individual-level change in physical activity and physical HRQOL; and (c) individual-level change in self-efficacy for controlling MS was the strongest predictor of individual-level change in HRQOL. Physical activity and self-efficacy both might be important targets of subsequent behavioral and self-management interventions for improving the HRQOL of persons with MS, although self-efficacy is seemingly more important than physical activity.

Physical activity increases survival after heart valve surgery.

PubMed

Lund, K; Sibilitz, K L; Berg, S K; Thygesen, L C; Taylor, R S; Zwisler, A D

2016-09-01

Increased physical activity predicts survival and reduces risk of readmission in patients with coronary heart disease. However, few data show how physical activity is associated with survival and readmission after heart valve surgery. Objective were to assess the association between physical activity levels 6-12 months after heart valve surgery and (1) survival, (2) hospital readmission 18-24 months after surgery and (3) participation in exercise-based cardiac rehabilitation. Prospective cohort study with registry data from The CopenHeart survey, The Danish National Patient Register and The Danish Civil Registration System of 742 eligible patients. Physical activity was quantified with the International Physical Activity Questionnaire and analysed using Kaplan-Meier analysis and Cox regression and logistic regression methods. Patients with a moderate to high physical activity level had a reduced risk of mortality (3 deaths in 289 patients, 1%) compared with those with a low physical activity level (13 deaths in 235 patients, 5.5%) with a fully adjusted HR of 0.19 (95% CI 0.05 to 0.70). In contrast, physical activity level was not associated with the risk of hospital readmission. Patients who participated in exercise-based cardiac rehabilitation (n=297) were more likely than the non-participants (n=200) to have a moderate or high physical activity level than a low physical activity level (fully adjusted OR: 1.52, 95% CI 1.03 to 2.24). Moderate to high levels of physical activity after heart valve surgery are positively associated with higher survival rates and participation in cardiac rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Serum vaspin levels are associated with physical activity or physical fitness in Japanese: a pilot study.

PubMed

Miyatake, Nobuyuki; Wada, Jun; Nakatsuka, Atsuko; Sakano, Noriko; Teshigawara, Sanae; Miyachi, Motohiko; Tabata, Izumi; Numata, Takeyuki

2014-05-01

To investigate the link between serum vaspin levels and physical activity and/or physical fitness in Japanese. A total of 156 subjects (81 men and 75 women) was enrolled in this cross-sectional study. Serum vaspin levels, physical activity by uniaxial accelerometers, peak oxygen uptake, and metabolic risk parameters were evaluated. We also assessed anthropometric and body composition parameters. Serum vaspin levels were over the level of 10 ng/mL in 15 subjects (9.6 %: Vaspin High group). In Vaspin Low group (<5 ng/mL: 74 men and 67 women), serum vaspin levels were 0.12 ± 0.18 ng/mL in men and 0.39 ± 0.70 ng/mL in women. Peak oxygen uptake was significantly and positively correlated with serum vaspin levels even after adjusting for age, physical activity evaluated by Σ[metabolic equivalents × h per week (METs[Symbol: see text]h/w)], BMI, and other confounding factors in men. In turn, physical activity was significantly and positively correlated with serum vaspin levels even after adjusting for confounding factors in women. Serum vaspin levels were closely associated with physical fitness in men and physical activity in women independent of body composition in this Japanese cohort.

[Serum levels of vitamin D in systemic lupus erythematosus patients (SLE) and their relationship with disease activity: longitudinal study].

PubMed

García-Carrasco, Mario; Mendoza-Pinto, Claudia; Ayón-Aguilar, Jorge; Soto-Santillán, Pamela; Rodríguez-Gallegos, Alma; Escamilla-Márquez, Marco Antonio; Méndez-Martínez, Socorro

2016-10-01

To determine changes over time of serum levels of 25-hydroxy vitamin D (25(OH)D) in Mexican patients with SLE and their relationship with disease activity. Longitudinal and observational study. Women with SLE were included. Serum levels of 25(OH)D were measured at baseline and after two years; the disease activity was measured with MEX-SLEDAI. Patients with initial suboptimal levels of 25(OH)D received supplements or increased doses of calcitriol. 105 women with SLE were included, mean age 49.4 ± 11 years. Serum levels of 25(OH)D were higher at two years (baseline 20 ± 6.8 vs. follow-up 22.7 ± 7.7; p = < 0.001). There were no differences between disease activity scores at baseline and two years (baseline 1.7 ± 1.9 vs. follow-up 1.1 ± 1.7; p = 0.7). Serum levels of 25(OH)D did not correlate with disease activity during the follow up, p = 0.7. No correlation was found between changes in MEX-SLEDAI scores and serum levels of 25(OH)D, p = 0.87. Mexican women with SLE had increased serum levels of 25(OH)D. No correlation between serum levels of 25(OH)D and disease activity was found.

A Systematic Review of Montessori-Based Activities for Persons With Dementia.

PubMed

Sheppard, Christine L; McArthur, Caitlin; Hitzig, Sander L

2016-02-01

Montessori-based activities are becoming a popular approach for the care of older adults living with dementia. The aim of this study was to systematically assess the quality of the research examining the benefits of Montessori-based activities for persons with dementia. Six peer-reviewed databases were systematically searched for all relevant articles published until April 2015. Included articles were peer-reviewed studies published in English that employed Montessori-based activities with persons with dementia. Methodological quality was assessed by 2 independent raters using the Physiotherapy Evidence Database Scale or the Downs and Black evaluation tool. Levels of evidence were assigned to the study design using a modified Sackett scale. One hundred fifty articles were identified, and 14 were selected for inclusion. Level-2 evidence examining the impact of Montessori-based activities on eating behaviors suggested that difficulties with eating could be reduced with Montessori training. There was limited level-4 evidence for the benefits of Montessori-based activities on cognition, wherein benefits appeared to be specific to lower-level cognitive abilities including memory and attention. Finally, there is level-1 (n = 1), level-2 (n = 3), and level-4 (n = 6) evidence for the benefits of Montessori-based activities on engagement and affect, whereby constructive engagement and positive affect were heightened. Overall, there is a strong level of evidence for the benefits of Montessori-based activities on eating behaviors and weak evidence for the benefits on cognition. Evidence for the benefits of Montessori-based activities on engagement and affect are mixed. Future research is needed to examine the long-term benefits of Montessori-based activities. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Influence of physical inactivity in psychophysiological state of breast cancer survivors.

PubMed

Ariza-García, A; Galiano-Castillo, N; Cantarero-Villanueva, I; Fernández-Lao, C; Díaz-Rodríguez, L; Arroyo-Morales, M

2013-11-01

Physical inactivity has been postulated as mediator of the relationship between cancer-related symptoms and psychoneurobiological alterations. The aim of the study was to evaluate the influence of physical inactivity level on mood state, fitness level as well as on salivary markers of the hypothalamic-pituitary-adrenal axis (cortisol) and the SNS (α-amylase) in breast cancer survivors. One hundred and eight breast cancer survivors (stages I-IIIa) participated in this cross-sectional study. Data were gathered on the following: Minnesota Leisure Time Physical Activity Questionnaire, profile of mood state, 6-min walk test, force handgrip, blood pressure, salivary cortisol concentration and salivary α-amylase activity. For our analysis, two groups were formed based on physical activity level measured as energy expenditure during diary leisure activities of the participants at the moment of the study, a physical inactivity level group (<3 METs × h/week) and an adequate physical activity level group (>3 METs × h/week). Fitness level was significantly higher in the active than the inactive group, while anger, fatigue, depression, confusion, mood disturbance, diastolic blood pressure and salivary α-amylase activity were significantly greater in the inactive than the active group. These results suggest that physical inactivity induces a worse psychoneurobiological state in inactive than in active breast cancer survivors. © 2013 John Wiley & Sons Ltd.

Differential Expression of NADPH Oxidases Depends on Skeletal Muscle Fiber Type in Rats.

PubMed

Loureiro, Adriano César Carneiro; do Rêgo-Monteiro, Igor Coutinho; Louzada, Ruy A; Ortenzi, Victor Hugo; de Aguiar, Angélica Ponte; de Abreu, Ewerton Sousa; Cavalcanti-de-Albuquerque, João Paulo Albuquerque; Hecht, Fabio; de Oliveira, Ariclécio Cunha; Ceccatto, Vânia Marilande; Fortunato, Rodrigo S; Carvalho, Denise P

2016-01-01

NADPH oxidases (NOX) are important sources of reactive oxygen species (ROS) in skeletal muscle, being involved in excitation-contraction coupling. Thus, we aimed to investigate if NOX activity and expression in skeletal muscle are fiber type specific and the possible contribution of this difference to cellular oxidative stress. Oxygen consumption rate, NOX activity and mRNA levels, and the activity of catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD), as well as the reactive protein thiol levels, were measured in the soleus (SOL), red gastrocnemius (RG), and white gastrocnemius (WG) muscles of rats. RG showed higher oxygen consumption flow than SOL and WG, while SOL had higher oxygen consumption than WG. SOL showed higher NOX activity, as well as NOX2 and NOX4 mRNA levels, antioxidant enzymatic activities, and reactive protein thiol contents when compared to WG and RG. NOX activity and NOX4 mRNA levels as well as antioxidant enzymatic activities were higher in RG than in WG. Physical exercise increased NOX activity in SOL and RG, specifically NOX2 mRNA levels in RG and NOX4 mRNA levels in SOL. In conclusion, we demonstrated that NOX activity and expression differ according to the skeletal muscle fiber type, as well as antioxidant defense.

Attachment, childhood abuse, and IBD-related quality of life and disease activity outcomes.

PubMed

Caplan, Rachel A; Maunder, Robert G; Stempak, Joanne M; Silverberg, Mark S; Hart, Tae L

2014-05-01

This study examined attachment style as a moderator of the relationship between childhood abuse and inflammatory bowel disease (IBD)-related outcomes. Study participants were 205 patients with IBD from Mount Sinai Hospital in Toronto. Participants completed self-report questionnaires regarding personal relationships, abuse history, and IBD-related information. Multiple regression models were fit using 3 outcome variables: disease-related quality of life (QOL), disease activity for ulcerative colitis, and disease activity for Crohn's disease. Patients reporting less severe abuse and low levels of avoidant attachment had the highest levels of QOL, whereas patients reporting high levels of avoidant attachment had the lowest levels of QOL, regardless of abuse severity. Patients reporting greater anxious attachment had lower QOL scores. Patients reporting less severe abuse and low levels of avoidant attachment had the lowest levels of disease activity, whereas patients reporting high levels of avoidant attachment had the highest levels of ulcerative colitis-related disease activity, regardless of abuse severity. However, for anxious attachment, there was no significant main effect or significant interaction of abuse by anxious attachment on ulcerative colitis-related disease activity. Childhood abuse and attachment style were not found to be associated with Crohn's disease-related disease activity. Adult attachment style may moderate the relationship between childhood abuse and IBD-related outcomes, by impacting one's QOL and disease activity. Distinct types of insecure attachment styles may impact these relationships differently. Psychological interventions focusing on attachment styles of patients with IBD have the potential to improve IBD-related QOL and disease activity.

Physical activity in adolescents: analysis of the social influence of parents and friends.

PubMed

Cheng, Luanna Alexandra; Mendonça, Gerfeson; Farias Júnior, José Cazuza de

2014-01-01

To analyze the association between physical activity and social support from parents and friends on the physical activity level among adolescents. Data from 2,361 adolescents (56.6% females; mean age 16.4; SD = 1.2), from public and private high schools were analyzed. The physical activity level of the adolescents, parents, and friends were measured through a questionnaire. Parents' and friends' support and self-efficacy were measured using two previously tested scales. Data analysis was performed using the structural equation modeling in IBM® SPSS® Amos™ 20.0. Physical activity of friends was directly associated with physical activity level of adolescents. Physical activity of the father was associated with that of their sons, and the physical activity of mother was associated with that of their daughters. An indirect association was identified between the physical activity of parents and friends with physical activity level of the adolescents, mediated by social support. Social support was directly associated with physical activity in adolescents of both genders and indirectly mediated by self-efficacy. Parents and friends have a social influence on adolescents' level of physical activity through the mechanism of behavior modeling or through social support, mediated by self-efficacy. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Sound-level-dependent representation of frequency modulations in human auditory cortex: a low-noise fMRI study.

PubMed

Brechmann, André; Baumgart, Frank; Scheich, Henning

2002-01-01

Recognition of sound patterns must be largely independent of level and of masking or jamming background sounds. Auditory patterns of relevance in numerous environmental sounds, species-specific vocalizations and speech are frequency modulations (FM). Level-dependent activation of the human auditory cortex (AC) in response to a large set of upward and downward FM tones was studied with low-noise (48 dB) functional magnetic resonance imaging at 3 Tesla. Separate analysis in four territories of AC was performed in each individual brain using a combination of anatomical landmarks and spatial activation criteria for their distinction. Activation of territory T1b (including primary AC) showed the most robust level dependence over the large range of 48-102 dB in terms of activated volume and blood oxygen level dependent contrast (BOLD) signal intensity. The left nonprimary territory T2 also showed a good correlation of level with activated volume but, in contrast to T1b, not with BOLD signal intensity. These findings are compatible with level coding mechanisms observed in animal AC. A systematic increase of activation with level was not observed for T1a (anterior of Heschl's gyrus) and T3 (on the planum temporale). Thus these areas might not be specifically involved in processing of the overall intensity of FM. The rostral territory T1a of the left hemisphere exhibited highest activation when the FM sound level fell 12 dB below scanner noise. This supports the previously suggested special involvement of this territory in foreground-background decomposition tasks. Overall, AC of the left hemisphere showed a stronger level-dependence of signal intensity and activated volume than the right hemisphere. But any side differences of signal intensity at given levels were lateralized to right AC. This might point to an involvement of the right hemisphere in more specific aspects of FM processing than level coding.

Barriers to Physical Activity on University Student

NASA Astrophysics Data System (ADS)

Jajat; Sultoni, K.; Suherman, A.

2017-03-01

The purpose of the research is to analyze the factors that become barriers to physical activity in university students based on physical activity level. An internet-based survey was conducted. The participants were 158 University students from Universitas Pendidikan Indonesia. Barriers to Physical Activity Quiz (BPAQ) were used to assessed the factors that become barriers to physical activity in university students. IPAQ (short form) were used to assessed physical activity level. The results show there was no differences BPAQ based on IPAQ level. But when analyzed further based on seven factors barriers there are differences in factors “social influence and lack of willpower” based IPAQ level. Based on this it was concluded that the “influence from other and lack of willpower” an inhibiting factor on students to perform physical activity.

Purposeful exercise and lifestyle physical activity in the lives of young adult women: findings from a diary study.

PubMed

O'Dougherty, Maureen; Arikawa, Andrea; Kaufman, Beth C; Kurzer, Mindy S; Schmitz, Kathryn H

2009-12-01

It is important to know how physical activity is incorporated in women's lives to assess ways they can feasibly attain and maintain lifelong healthy practices. This study aimed to determine whether patterns of activity differed among young women whose physical activity met nationally recommended levels from those who did not. The sample was 42 women (aged 18-30 years) who had completed an exercise intervention (22 from the exercise group, 20 from the control group). Participants recorded pedometer steps and physical activities in diaries including form, duration and perceived exertion during 12 randomly assigned weeks over 26 weeks. We divided the sample into quartiles of moderate to vigorous physical activity to examine the composition of physical activities per quartile. Walking and shopping comprised the majority of physical activity in the lowest quartile of moderate to vigorous physical activity. In the second and third quartiles, walking and household/childcare together comprised more than two-thirds of all activities. Only in the highest quartile was cardio activity (not including walking, shopping and household/childcare) the largest proportion of activity; this category stood alone as varying significantly across quartiles of moderate to vigorous physical activity (p < 0.005). Among these young adult women, self-reported "lifestyle" physical activity was not sufficient to meet recommended levels of moderate to vigorous physical activity. The one-quarter who met recommended levels of moderate to vigorous physical activity did so largely through purposeful physical activities directly associated with exercise. Further research is needed to refine means of more fully measuring physical activities that women frequently perform, with particular attention to household work, childcare and shopping and to differing combinations of activities and levels of exertion by which diverse women can meet the recommended levels. The findings of this small scale study reinforce the ongoing benefit of recommending structured, planned physical activity at moderate and vigorous levels of intensity to young, healthy women to ensure they obtain the health benefits.

Impact of urban sprawl on overweight, obesity, and physical activity in Sydney, Australia.

PubMed

Garden, Frances L; Jalaludin, Bin B

2009-01-01

Obesity and inadequate physical activity are major risk factors for many diseases. The built environment plays an important role in influencing participation in physical activity. We aimed to determine whether urban sprawl in Sydney, Australia is associated with overweight/obesity and levels of physical activity. We used a cross-sectional multilevel study design to relate urban sprawl (based on population density) measured at an area level to overweight/obesity and levels of physical activity measured at an individual level whilst controlling for individual and area level covariates in metropolitan Sydney. Individual level data were obtained from the 2002 and 2003 New South Wales Population Health Survey. We had information on 7,290 respondents. The mean population density was 2,168 persons per square kilometer (standard deviation=1,741, range=218-7,045). After controlling for individual and area level covariates, for an inter-quartile increase in sprawl, the odds of being overweight was 1.26 (95% CI=1.10-1.44), the odds of being obese was 1.47 (95% CI=1.24-1.75), the odds of inadequate physical activity was 1.38 (95% CI=1.21-1.57), and the odds of not spending any time walking during the past week was 1.58 (95% CI=1.28-1.93). Living in more sprawling suburbs increases the risk of overweight/obesity and inadequate physical activity despite the relatively low levels of urban sprawl in metropolitan Sydney. Modifications to the urban environment to increase physical activity may be worthwhile.

Physical activity and sex hormone levels in estradiol- and placebo-treated postmenopausal women.

PubMed

Choudhury, Farzana; Bernstein, Leslie; Hodis, Howard N; Stanczyk, Frank Z; Mack, Wendy J

2011-10-01

Postmenopausal changes in the hormonal milieu in women with or without hormone therapy are hypothesized to be the pathway for a number of menopause-associated modifications in physiology and disease risk. Physical activity may modify these changes in women's hormone profiles. The crucial yet complex relationship between physical activity and physiologic and pharmacologic sex hormone levels in postmenopausal women has not been investigated sufficiently. Using structured recall, physical activity was assessed longitudinally during a period of 2 years in 194 postmenopausal women (90 randomized to 1 mg 17β-estradiol treatment daily and 104 randomized to placebo) in the Estrogen in the Prevention of Atherosclerosis Trial. The levels of physical activity were correlated with the serum sex hormone and the serum hormone-binding globulin levels in each treatment group. Among the placebo-treated women, total energy expenditure was positively associated with sex hormone-binding globulin (SHBG; P < 0.001) and inversely associated with testosterones (total, bioavailable, or free) and androstenedione (P < 0.001 for all), as well as with estradiol (P = 0.02). In estradiol-treated women, estradiol levels were inversely associated with total energy expenditure (P = 0.002) and weekly hours spent in moderate or more vigorous physical activity (P = 0.001). Physical activity is associated with lower serum levels of estradiol in both hormone therapy-treated and untreated women. In placebo-treated women only, physical activity is associated with reduced androgen levels and elevated SHBG levels.

Effects of aging and calorie restriction on rat skeletal muscle glycogen synthase and glycogen phosphorylase

PubMed Central

Montori-Grau, Marta; Minor, Robin; Lerin, Carles; Allard, Joanne; Garcia-Martinez, Celia; de Cabo, Rafael; Gómez-Foix, Anna M.

2016-01-01

Calorie restriction’s (CR) effects on age-associated changes in glycogen-metabolizing enzymes were studied in rat soleus (SOL) and tibialis anterior (TA) muscles. Old (24 months) compared to young (6 months) rats maintained ad libitum on a standard diet had reduced glycogen synthase (GS) activity, lower muscle GS protein levels, increased phosphorylation of GS at site 3a with less activation in SOL. Age-associated impairments in GS protein and activation-phosphorylation were also shown in TA. There was an age-associated reduction in glycogen phosphorylase (GP) activity level in SOL, while brain/muscle isoforms (B/M) of GP protein levels were higher. GP activity and protein levels were preserved, but GP was inactivated in TA with age. Glycogen content was unchanged in both muscles. CR did not alter GS or GP activity/protein levels in young rats. CR hindered age-related decreases in GS activity/protein, unrelated to GS mRNA levels, and GS inactivation-phosphorylation; not on GP. In older rats, CR enhanced glycogen accumulation in SOL. Short-term fasting did not recapitulate CR effects in old rats. Thus, the predominant age-associated impairments on skeletal muscle GS and GP activities occur in the oxidative SOL muscle of rats, and CR can attenuate the loss of GS activity/activation and stimulate glycogen accumulation. PMID:19341787

Activity Level Assessment Using a Smart Cushion for People with a Sedentary Lifestyle.

PubMed

Ma, Congcong; Li, Wenfeng; Gravina, Raffaele; Cao, Jingjing; Li, Qimeng; Fortino, Giancarlo

2017-10-03

As a sedentary lifestyle leads to numerous health problems, it is important to keep constant motivation for a more active lifestyle. A large majority of the worldwide population, such as office workers, long journey vehicle drivers and wheelchair users, spends several hours every day in sedentary activities. The postures that sedentary lifestyle users assume during daily activities hide valuable information that can reveal their wellness and general health condition. Aiming at mining such underlying information, we developed a cushion-based system to assess their activity levels and recognize the activity from the information hidden in sitting postures. By placing the smart cushion on the chair, we can monitor users' postures and body swings, using the sensors deployed in the cushion. Specifically, we construct a body posture analysis model to recognize sitting behaviors. In addition, we provided a smart cushion that effectively combine pressure and inertial sensors. Finally, we propose a method to assess the activity levels based on the evaluation of the activity assessment index (AAI) in time sliding windows. Activity level assessment can be used to provide statistical results in a defined period and deliver recommendation exercise to the users. For practical implications and actual significance of results, we selected wheelchair users among the participants to our experiments. Features in terms of standard deviation and approximate entropy were compared to recognize the activities and activity levels. The results showed that, using the novel designed smart cushion and the standard deviation features, we are able to achieve an accuracy of (>89%) for activity recognition and (>98%) for activity level recognition.

Activity Level Assessment Using a Smart Cushion for People with a Sedentary Lifestyle

PubMed Central

Li, Wenfeng; Gravina, Raffaele; Cao, Jingjing; Li, Qimeng

2017-01-01

As a sedentary lifestyle leads to numerous health problems, it is important to keep constant motivation for a more active lifestyle. A large majority of the worldwide population, such as office workers, long journey vehicle drivers and wheelchair users, spends several hours every day in sedentary activities. The postures that sedentary lifestyle users assume during daily activities hide valuable information that can reveal their wellness and general health condition. Aiming at mining such underlying information, we developed a cushion-based system to assess their activity levels and recognize the activity from the information hidden in sitting postures. By placing the smart cushion on the chair, we can monitor users’ postures and body swings, using the sensors deployed in the cushion. Specifically, we construct a body posture analysis model to recognize sitting behaviors. In addition, we provided a smart cushion that effectively combine pressure and inertial sensors. Finally, we propose a method to assess the activity levels based on the evaluation of the activity assessment index (AAI) in time sliding windows. Activity level assessment can be used to provide statistical results in a defined period and deliver recommendation exercise to the users. For practical implications and actual significance of results, we selected wheelchair users among the participants to our experiments. Features in terms of standard deviation and approximate entropy were compared to recognize the activities and activity levels. The results showed that, using the novel designed smart cushion and the standard deviation features, we are able to achieve an accuracy of (>89%) for activity recognition and (>98%) for activity level recognition. PMID:28972556

Homeostatic and non-homeostatic appetite control along the spectrum of physical activity levels: An updated perspective.

PubMed

Beaulieu, Kristine; Hopkins, Mark; Blundell, John; Finlayson, Graham

2017-12-28

The current obesogenic environment promotes physical inactivity and food consumption in excess of energy requirements, two important modifiable risk factors influencing energy balance. Habitual physical activity has been shown to impact not only energy expenditure, but also energy intake through mechanisms of appetite control. This review summarizes recent theory and evidence underpinning the role of physical activity in the homeostatic and non-homeostatic mechanisms controlling appetite. Energy intake along the spectrum of physical activity levels (inactive to highly active) appears to be J-shaped, with low levels of physical activity leading to dysregulated appetite and a mismatch between energy intake and expenditure. At higher levels, habitual physical activity influences homeostatic appetite control in a dual-process action by increasing the drive to eat through greater energy expenditure, but also by enhancing post-meal satiety, allowing energy intake to better match energy expenditure in response to hunger and satiety signals. There is clear presumptive evidence that physical activity energy expenditure can act as a drive (determinant) of energy intake. The influence of physical activity level on non-homeostatic appetite control is less clear, but low levels of physical activity may amplify hedonic states and behavioural traits favouring overconsumption indirectly through increased body fat. More evidence is required to understand the interaction between physical activity, appetite control and diet composition on passive overconsumption and energy balance. Furthermore, potential moderators of appetite control along the spectrum of physical activity, such as body composition, sex, and type, intensity and timing of physical activity, remain to be fully understood. Copyright © 2018 Elsevier Inc. All rights reserved.

Gender differences in objectively assessed physical activity in asthmatic and non-asthmatic children.

PubMed

Yiallouros, Panayiotis K; Economou, Mary; Kolokotroni, Ourania; Savva, Savvas C; Gavatha, Marina; Ioannou, Phivos; Karpathios, Themistoclis; Middleton, Nicos

2015-04-01

To compare objectively assessed physical activity levels, between asthmatic children and non-asthmatic controls. From a random community sample of 794 children aged 8-9 years, in a case-control design, 104 children with ever doctor's diagnosis of asthma and 99 non-asthmatic controls were recruited and had assessment of physical activity with biaxial accelerometers for 7 days. Children with active (also reporting at least one episode of wheezing in the last 12 months) and inactive (no wheezing in past 12 months) asthma appeared to have similar physical activity and sedentary activity levels compared to non-asthmatic children. However, girls with active asthma had significantly lower moderate-to-vigorous physical activity (MVPA) levels than their peers with adjusted geometric mean ratio of 0.59 (95% CI: 0.369, 0.929, P-value = 0.024). No difference in physical and sedentary activity levels was observed between asthmatic and non-asthmatic boys. The difference between genders in the comparison of MVPA levels in asthmatics and controls was statistically significant (P-value of likelihood ratio test [LRT] for effect modification by gender = 0.034). Unlike boys, girls with active asthma appear to be less active than their healthy peers, and this gender difference might explain the inconsistent evidence from previous reports on physical activity levels in asthmatic children. Further studies are needed to confirm the gender interaction in the childhood asthma-physical activity relation and the implications on current guidelines for physical exercise prescriptions in asthmatic children. © 2014 Wiley Periodicals, Inc.

Relationship between child care centers' compliance with physical activity regulations and children's physical activity, New York City, 2010.

PubMed

Stephens, Robert L; Xu, Ye; Lesesne, Catherine A; Dunn, Lillian; Kakietek, Jakub; Jernigan, Jan; Khan, Laura Kettel

2014-10-16

Physical activity may protect against overweight and obesity among preschoolers, and the policies and characteristics of group child care centers influence the physical activity levels of children who attend them. We examined whether children in New York City group child care centers that are compliant with the city's regulations on child physical activity engage in more activity than children in centers who do not comply. A sample of 1,352 children (mean age, 3.39 years) served by 110 group child care centers in low-income neighborhoods participated. Children's anthropometric data were collected and accelerometers were used to measure duration and intensity of physical activity. Multilevel generalized linear regression modeling techniques were used to assess the effect of center- and child-level factors on child-level physical activity. Centers' compliance with the regulation of obtaining at least 60 minutes of total physical activity per day was positively associated with children's levels of moderate to vigorous physical activity (MVPA); compliance with the regulation of obtaining at least 30 minutes of structured activity was not associated with increased levels of MVPA. Children in centers with a dedicated outdoor play space available also spent more time in MVPA. Boys spent more time in MVPA than girls, and non-Hispanic black children spent more time in MVPA than Hispanic children. To increase children's level of MVPA in child care, both time and type of activity should be considered. Further examination of the role of play space availability and its effect on opportunities for engaging in physical activity is needed.

Changes in physical activity, self-efficacy and depressive symptoms in adolescent girls.

PubMed

Neissaar, Inga; Raudsepp, Lennart

2011-08-01

The purpose of this study was to examine the longitudinal relationships between naturally occurring changes in leisure-time physical activity, depressive symptoms and self-efficacy in adolescent girls. We also aimed to test whether depressive symptoms would moderate the self-efficacy-physical activity relationship. Participants were 181 urban adolescent girls. Physical activity was measured using the 3-Day Physical Activity Recall. Self-efficacy and depressive symptoms were assessed using questionnaires. Body height and body mass were measured and body mass index (BMI) was calculated. Data were collected on three occasions over a 2-year period. There was a decrease in physical activity and self-efficacy and increase in depressive symptoms across three measurement occasions. There were statistically significant and negative relationships between initial level and change for physical activity and depressive symptoms. Initially higher levels of physical activity were related with initially lower levels of depressive symptoms, and change in physical activity across time was inversely associated with change in levels of depressive symptoms across measurements. There were statistically significant and positive relationships between initial level and change for physical activity and self-efficacy after controlling effect of BMI. Latent growth modeling (LGM) also indicated a moderating effect of depressive symptoms on the self-efficacy-physical activity relationship. Girls who had high initial levels of self-efficacy and smaller increases in depressive symptoms had the lowest decline in physical activity participation. Our results encourage the design of interventions that reduce depressive symptoms and increase self-efficacy as a possible of means of increasing adolescent girls' physical activity.

[Prevalence of physical activity in primary health care workers of Catalonia].

PubMed

Molina Aragonés, J M; Sánchez San Cirilo, S; Herreros López, M; Vizcarro Sanagustín, D; López Pérez, C

Physical inactivity is the fourth leading risk factor for global mortality, and a significant percentage of the world population does not perform the necessary physical activity for health benefits. Certain professional groups are seen as an example for the general population with whom they interact. Prevalence of physical activity in health workers, one of these reference groups, is mainly unknown. The aim of this study has been to assess the prevalence of physical activity levels in Primary Health Care professionals. A study was conducted on the physical activity levels in Primary Health Care workers who came voluntarily for a medical examination in 2014, and completed the short version of the International Physical Activity Questionnaire activity. A low level of physical activity was reported by 26.5% of those taking part, with 31.5% of the medical group indicating a low level of activity, followed by support staff (28.1%), nurses (24.7%), and finally the administrative staff (19.0%). The physical activity levels of Primary Health Care staff are significantly different from those of the general reference population. The latter has a higher percentage of physical activity of mild to moderate intensity, and below the level of physical activity of high intensity. Although there seems to be a tendency to significantly lower physical activity in other health groups, we do not have sufficiently reliable data to compare them. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

10 CFR 110.50 - Terms.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and activity level in TBq, both for single and aggregate shipments; (E) Make, model and serial number... exporting facility; (D) Radionuclides and activity level in TBq, both for single and aggregate shipments; (E) Make, model and serial number, radionuclide, and activity level for any Category 1 and 2 sealed sources...

Incorporating Duration Information in Activity Recognition

NASA Astrophysics Data System (ADS)

Chaurasia, Priyanka; Scotney, Bryan; McClean, Sally; Zhang, Shuai; Nugent, Chris

Activity recognition has become a key issue in smart home environments. The problem involves learning high level activities from low level sensor data. Activity recognition can depend on several variables; one such variable is duration of engagement with sensorised items or duration of intervals between sensor activations that can provide useful information about personal behaviour. In this paper a probabilistic learning algorithm is proposed that incorporates episode, time and duration information to determine inhabitant identity and the activity being undertaken from low level sensor data. Our results verify that incorporating duration information consistently improves the accuracy.

Distribution and activity levels of matrix metalloproteinase 2 and 9 in canine and feline osteosarcoma

PubMed Central

Gebhard, Christiane; Fuchs-Baumgartinger, Andrea; Razzazi-Fazeli, Ebrahim; Miller, Ingrid; Walter, Ingrid

2016-01-01

Overexpression of matrix metalloproteinases (MMPs) has been associated with increased tumor aggressiveness and metastasis dissemination. We investigated whether the contrasting metastatic behavior of feline and canine osteosarcoma is related to levels and activities of MMP2 and MMP9. Zymography and immunohistochemistry were used to determine expression levels of MMP2 and MMP9 in canine and feline osteosarcoma. Using immunohistochemistry, increased MMP9 levels were identified in most canine osteosarcomas, whereas cat samples more often displayed moderate levels. High levels of pro-MMP9, pro-MMP2, and active MMP2 were detected by gelatin zymography in both species, with significantly higher values for active MMP2 in canine osteosarcoma. These findings indicate that MMP2 is probably involved in canine and feline osteosarcoma and their expression and activity could be associated with the different metastatic behavior of canine and feline osteosarcoma. PMID:26733734

Increased choline kinase activity in 1,2-dimethylhydrazine-induced rat colon cancer.

PubMed

Nakagami, K; Uchida, T; Ohwada, S; Koibuchi, Y; Morishita, Y

1999-11-01

Cancer cells acquire particular characteristics that benefit their proliferation. We previously reported that human colon cancers examined had increased choline kinase activity and phosphocholine levels. The elevated phosphocholine levels were in part due to both activation of choline kinase and increased choline kinase alpha protein levels. In this report, we analyzed choline kinase, which catalyzes the phosphorylation of choline to produce phosphocholine, in rat 1,2-dimethylhydrazine (DMH)-induced colon cancer. This study is the first to demonstrate increased choline kinase alpha enzymatic activity, protein levels, and mRNA levels in DMH-induced colon cancer as well as human colon cancer, although phosphocholine was not increased in DMH-induced rat cancer. The increase in the mRNA level was partly due to an increase in the transcription of the choline kinase alpha gene. The increased choline kinase activity may be a specific characteristic acquired by cancer cells that benefits their proliferation.

Distribution and activity levels of matrix metalloproteinase 2 and 9 in canine and feline osteosarcoma.

PubMed

Gebhard, Christiane; Fuchs-Baumgartinger, Andrea; Razzazi-Fazeli, Ebrahim; Miller, Ingrid; Walter, Ingrid

2016-01-01

Overexpression of matrix metalloproteinases (MMPs) has been associated with increased tumor aggressiveness and metastasis dissemination. We investigated whether the contrasting metastatic behavior of feline and canine osteosarcoma is related to levels and activities of MMP2 and MMP9. Zymography and immunohistochemistry were used to determine expression levels of MMP2 and MMP9 in canine and feline osteosarcoma. Using immunohistochemistry, increased MMP9 levels were identified in most canine osteosarcomas, whereas cat samples more often displayed moderate levels. High levels of pro-MMP9, pro-MMP2, and active MMP2 were detected by gelatin zymography in both species, with significantly higher values for active MMP2 in canine osteosarcoma. These findings indicate that MMP2 is probably involved in canine and feline osteosarcoma and their expression and activity could be associated with the different metastatic behavior of canine and feline osteosarcoma.

Preliminary evidence that self-efficacy predicts physical activity in multiple sclerosis.

PubMed

Motl, Robert W; McAuley, Edward; Doerksen, Shawna; Hu, Liang; Morris, Katherine S

2009-09-01

Individuals with multiple sclerosis (MS) are less physically active than non diseased people. One method for increasing physical activity levels involves the identification of factors that correlate with physical activity and that are modifiable by a well designed intervention. This study examined two types of self-efficacy as cross-sectional and prospective correlates of objectively measured physical activity in 16 individuals with a diagnosis of MS. The participants completed two measures of self-efficacy and then wore an accelerometer for a 5-day period at baseline and then at 3 months follow-up. Self-efficacy for continued physical activity was associated with baseline and follow-up levels of physical activity. Self-efficacy for overcoming barriers was associated with follow-up levels of physical activity and change in physical activity across a 3-month period. Researchers should consider self-efficacy as a possible component of an intervention that is designed to increase physical activity levels in those with MS. International Journal of Rehabilitation Research

Physical education resources, class management, and student physical activity levels: a structure-process-outcome approach to evaluating physical education effectiveness.

PubMed

Bevans, Katherine B; Fitzpatrick, Leslie-Anne; Sanchez, Betty M; Riley, Anne W; Forrest, Christopher

2010-12-01

This study was conducted to empirically evaluate specific human, curricular, and material resources that maximize student opportunities for physical activity during physical education (PE) class time. A structure-process-outcome model was proposed to identify the resources that influence the frequency of PE and intensity of physical activity during PE. The proportion of class time devoted to management was evaluated as a potential mediator of the relations between resource availability and student activity levels. Data for this cross-sectional study were collected from interviews conducted with 46 physical educators and the systematic observation of 184 PE sessions in 34 schools. Regression analyses were conducted to test for the main effects of resource availability and the mediating role of class management. Students who attended schools with a low student-to-physical educator ratio had more PE time and engaged in higher levels of physical activity during class time. Access to adequate PE equipment and facilities was positively associated with student activity levels. The availability of a greater number of physical educators per student was found to impact student activity levels by reducing the amount of session time devoted to class management. The identification of structure and process predictors of student activity levels in PE will support the allocation of resources and encourage instructional practices that best support increased student activity levels in the most cost-effective way possible. Implications for PE policies and programs are discussed. © 2010, American School Health Association.

Measures of Patient Activation and Social Support in a Peer-Led Support Network for Women With Cardiovascular Disease.

PubMed

Witt, Dawn; Benson, Gretchen; Campbell, Susan; Sillah, Arthur; Berra, Kathy

Social support has been associated with beneficial effects on many disease states and overall health and well-being. However, there is limited research exploring the impact of peer-led support models among women living with coronary heart disease. This study describes the structure of peer-led support groups offered by WomenHeart (WH): The National Coalition for Women Living with Heart Disease, and assesses WH participants' quality of life and social, emotional, and physical health. Participants were recruited from 50 WH groups. A 70-item online survey was administered, and the main analytic sample included 157 women. Multivariate logistic regression was used to examine the association between patient activation levels (lower activation levels: 1, 2 vs higher activation levels: 3, 4) and social support scores (range: lowest 8 to highest 34), adjusting for age. High levels of social support, patient activation, physical activity, and low levels of stress, anxiety, and depression were reported. Those who were at or above the median for the social support measures (indicating high levels of social support) had greater odds of high levels of patient activation (level 3 or 4) than individuals reporting low levels of social support (OR = 2.23; 95% CI, 1.04-4.76; P = .012). Women who regularly attended a support group by a trained peer leader were highly engaged in their health care and had low levels of stress, anxiety, and depression. These findings lend credibility to the value of the peer support model and could potentially be replicated in other disease states to enhance patient care.

Physical activity level and physical functionality in nonagenarians compared to individuals aged 60-74 years.

PubMed

Frisard, Madlyn I; Fabre, Jennifer M; Russell, Ryan D; King, Christina M; DeLany, James P; Wood, Robert H; Ravussin, Eric

2007-07-01

Functional dependence and the risks of disability increase with age. The loss of independence is thought to be partially due to a decrease in physical activity. However, in populations, accurate measurement of physical activity is challenging and may not provide information on functional impairment. This study therefore assessed physical functionality and physical activity level in a group of nonagenarians (11 men/11 women; 93+/-1 years, 66.6+/-2.4 kg, body mass index [BMI]=24+/-1 kg/m2) and a group of participants aged 60-74 years (17 men/15 women; 70+/-1 years, 83.3+/-3.0 kg, BMI=29+/-1 kg/m2) from the Louisiana Healthy Aging Study. Physical activity level was calculated from total energy expenditure (TEE) and resting metabolic rate (RMR). Physical functionality was assessed using the Reduced Continuous Scale Physical Functional Performance Test (CS-PFP10). Nonagenarians had lower absolute (p<.001) and adjusted (p<.007) TEE compared to participants aged 60-74 years which was attributed to a reduction in both RMR and physical activity level. Nonagenarians also had reduced functional performance (p<.001) which was correlated with activity level (r=0.68, p<.001). When compared to individuals aged 60-74 years, 73% of the reduction in TEE in nonagenarians can be attributed to a reduction in physical activity level, the remaining being accounted for by a reduction in RMR. The reduced physical activity in nonagenarians is associated with less physical functionality. This study provides the first objective comparison of physical functionality and actual levels of physical activity in older individuals.

Towards a new paradigm: Activity level balanced sustainability reporting.

PubMed

Samudhram, Ananda; Siew, Eu-Gene; Sinnakkannu, Jothee; Yeow, Paul H P

2016-11-01

Technoeconomic paradigms based economic growth theories suggest that waves of technological innovations drove the economic growth of advanced economies. Widespread economic degradation and pollution is an unintended consequence of such growth. Tackling environmental and social issues at firm levels would help us to overcome such issues at macro-levels. Consequently, the Triple Bottom Line (TBL) reporting approach promotes firm level economic, environmental and social performances. Incorporating Zink's (2014) 3-pillar presentation model, this paper indicates that economic, social and environmental performances tend to be reported at firm level. All three pillars are not covered evenly at the activity levels. Thus, a loophole is identified whereby excellent environmental performance at activity levels could potentially leave poor social performance undisclosed. A refinement of the TBL paradigm, whereby all three pillars are covered at the activity level, is suggested, to enhance sustainability reporting. Copyright © 2016 Elsevier Ltd. All rights reserved.

The intensity of physical activity influences bone mineral accrual in childhood: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark.

PubMed

Heidemann, Malene; Mølgaard, Christian; Husby, Steffen; Schou, Anders J; Klakk, Heidi; Møller, Niels Chr; Holst, René; Wedderkopp, Niels

2013-03-02

Studies indicate genetic and lifestyle factors can contribute to optimal bone development. In particular, the intensity level of physical activity may have an impact on bone health. This study aims to assess the relationship between physical activity at different intensities and Bone Mineral Content (BMC), Bone Mineral Density (BMD) and Bone Area (BA) accretion. This longitudinal study is a part of The CHAMPS study-DK. Whole-body DXA scans were performed at baseline and after two years follows up. BMC, BMD, and BA were measured. The total body less head (TBLH) values were used. Physical activity (PA) was recorded by accelerometers (ActiGraph, model GT3X). Percentages of different PA intensity levels were calculated and log odds of two intensity levels of activity relative to the third level were calculated. Multilevel regression analyses were used to assess the relationship between the categories of physical activity and bone traits. Of 800 invited children, 742 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow up. Complete datasets were obtained in 602/742 (81%) children. Mean (range) of age was 11.5 years (9.7-13.9). PA at different intensity levels was for boys and girls respectively, sedentary 62% and 64%, low 29% for both genders and moderate to high 9% and 7% of the total time. Mean (range) BMC, BMD, and BA was 1179 g (563-2326), 0.84 g/cm2 (0.64-1.15) and 1393 cm2 (851-2164), respectively. Valid accelerometer data were obtained for a mean of 6.1 days, 13 hours per day. There 7was a positive relationship between the log odds of moderate to high-level PA versus low level activity and BMC, BMD and BA. Children with an increased proportion of time in moderate to high-level activity as opposed to sedentary and low-level activity achieved positive effects on BMC, BMD and BA.

A systematic review of physical activity levels in Native American populations in Canada and the United States in the last 50 years.

PubMed

Foulds, H J A; Warburton, D E R; Bredin, S S D

2013-07-01

Physical activity is beneficial for many chronic conditions. However, activity levels of Native Americans are not well known. This systematic review investigated if Native American populations achieve the recommended physical activity levels, compared current and past activity levels, and assessed the ability of exercise training programmes to improve health outcomes among this population. Electronic databases (e.g. MEDLINE, EMBASE) were searched and citations were cross-referenced. Included articles reported physical activity levels or investigations among Native Americans. This search identified 89 articles: self-report (n = 61), accelerometry and pedometry (n = 10), metabolic monitoring (n = 10) and physical activity interventions (n = 17). Few adults were found to meet the physical activity recommendations (27.2% [95% confidence interval = 26.9-27.5%] self-report, 9% [4-14%] accelerometry). Among children/youth, 26.5% (24.6-28.4%) (self-report) to 45.7% (42.3-49.1%) (pedometry/accelerometry) met the recommendations. Adults and children/youth were generally identified as physically inactive (via doubly labelled water). Overall, Native American adults reported lower activity levels since 2000, compared to 1990s, although similar to 1980s. Few physical activity interventions employed strong methodologies, large sample sizes and objective outcome measures. There is a clear need to increase Native American populations' physical activity. Additional research is required to evaluate exercise training programmes among this population. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

Parental Perceptions of Physical Activity Benefits for Youth With Developmental Disabilities.

PubMed

Pitchford, E Andrew; Siebert, Erin; Hamm, Jessica; Yun, Joonkoo

2016-01-01

Physical activity promotion is of need for youth with developmental disabilities. Parental perceptions of physical activity benefits may influence youth behaviors. This study investigated the relationship between parental beliefs on the importance of physical activity and physical activity levels among youth with disabilities. Parents and caregivers of 113 youth with disabilities reported on the perceived benefits of physical activity, the child's physical activity level, and demographic information. Linear regression analyses to examine the relative association between parental perceived benefits and child physical activity (R² = 0.19) indicated that physical activity level was predicted by parental beliefs and child gender. Health promotion for youth with disabilities should consider educating parents and caregivers of physical activity benefits, in addition to creating more opportunities.

Is change in environmental supportiveness between primary and secondary school associated with a decline in children׳s physical activity levels?

PubMed

Coombes, Emma; Jones, Andy; Page, Angie; Cooper, Ashley R

2014-09-01

Using a sample of English schoolchildren, we evaluate whether a change in school local area environmental supportiveness between primary and secondary school is associated with changes in active travel behaviours and physical activity levels. Participant׳s activity levels and travel behaviours were recorded for a week during their primary school final year and secondary school first year. Environmental supportiveness was evaluated using a Geographical Information System. Children attending both a primary and secondary school with a more supportive local environment were more likely to maintain active travel behaviours than those with less supportive environments. However, no trends were apparent with change in school supportiveness and change in physical activity. Policies that focus on the maintenance and uptake of active travel behaviours may help maintain children׳s physical activity levels into adolescence. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Biological/Genetic Regulation of Physical Activity Level: Consensus from GenBioPAC.

PubMed

Lightfoot, J Timothy; DE Geus, Eco J C; Booth, Frank W; Bray, Molly S; DEN Hoed, Marcel; Kaprio, Jaakko; Kelly, Scott A; Pomp, Daniel; Saul, Michael C; Thomis, Martine A; Garland, Theodore; Bouchard, Claude

2018-04-01

Physical activity unquestionably maintains and improves health; however, physical activity levels globally are low and not rising despite all the resources devoted to this goal. Attention in both the research literature and the public policy domain has focused on social-behavioral factors; however, a growing body of literature suggests that biological determinants play a significant role in regulating physical activity levels. For instance, physical activity level, measured in various manners, has a genetic component in both humans and nonhuman animal models. This consensus article, developed as a result of an American College of Sports Medicine-sponsored round table, provides a brief review of the theoretical concepts and existing literature that supports a significant role of genetic and other biological factors in the regulation of physical activity. Future research on physical activity regulation should incorporate genetics and other biological determinants of physical activity instead of a sole reliance on social and other environmental determinants.

Promoting physical activity and improving dietary quality of Singaporean adolescents: effectiveness of a school-based fitness and wellness program.

PubMed

Loong, Claudine; Leo, Latasha; Goh, Danielle; Lim, Pei Sin; Loke, Wai Mun

2018-01-13

Limited data are available on the effectiveness of the school-based structured fitness and wellness program to influence dietary quality and physical activity levels in Singaporean adolescents. The study examined if a 20-h (over 10 weeks) school-based structured fitness and wellness module affects the diet quality indices, energy intakes, physical activity levels and the associated energy expenditures in a group of healthy, male adolescents with low diet quality and physical activity levels. Participant demography, anthropometry, dietary intake and daily physical activity were obtained at the beginning, mid-point and end of the 10-week program. Physical activity levels were assessed accelerometrically over a 1-weekday period. Dietary intake were taken using a structured 7-day food diary, and diet quality assessed using the Diet Quality Index-International (DQI-I). The 31 enrolled participants (age 19.8 ± 0.6 years) with body mass index (BMI) (19.8 ± 0.6 kg/m2) followed diets of low diet quality scores (48.3 ± 9.6 out of 100) and engaged in 3.87 ± 2.00 h of physical activity daily before the start of the intervention. Their dietary quality and physical activity levels did not change significantly throughout the intervention period. They scored poorly in the moderation and overall balance components of the diet quality assessment. The physical activity duration correlated inversely to the diet quality scores. Our results suggest that the prescribed school-based fitness and wellness module was ineffective in influencing the diet quality and physical activity levels of Singaporean male adolescents with low diet quality and physical activity levels.

Physical Activity Levels during Adventure-Physical Education Lessons

ERIC Educational Resources Information Center

Gehris, Jeffrey; Myers, Elizabeth; Whitaker, Robert

2012-01-01

Adventure-physical education has been proposed to promote adolescents' physical development, but little is known about physical activity levels during such lessons. Using the System for Observing Fitness Instruction Time, we observed students' (ages 11-14 years) physical activity levels in co-educational classes during 43 adventure-physical…

20 CFR 404.1574a - When and how we will average your earnings.

Code of Federal Regulations, 2011 CFR

2011-04-01

... has been no change in the substantial gainful activity earnings levels, we will average your earnings... time during which the substantial gainful activity earnings levels change, we will average your earnings separately for each period in which a different substantial gainful activity earnings level...

20 CFR 404.1574a - When and how we will average your earnings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... has been no change in the substantial gainful activity earnings levels, we will average your earnings... time during which the substantial gainful activity earnings levels change, we will average your earnings separately for each period in which a different substantial gainful activity earnings level...

Math in Action. Number-Sense Fun: Solving Riddles, Making Change.

ERIC Educational Resources Information Center

Bresser, Rusty; Sheffield, Stephanie; Burns, Marilyn, Ed.

1997-01-01

Presents two activities for teaching elementary level mathematics by immersing students in worthwhile literature (the Hello Math Reader series) while introducing them to real-life mathematics. The primary level activity teaches students to use number relationships to solve math riddles. The intermediate level activity has students explore…

Relationships among Physical Activity Levels, Psychomotor, Psychosocial, and Cognitive Development of Primary Education Students.

ERIC Educational Resources Information Center

Isler, Ayse Kin; Asci, F. Hulya; Kosar, S. Nazan

2002-01-01

Investigated the relationships of physical activity levels and psychomotor, psychosocial, and cognitive development among Turkish elementary school students. Student evaluations indicated that physical activity level was an important factor in determining student psychomotor development, but it was not important in determining psychosocial and…

Macroenvironmental factors including GDP per capita and physical activity in Europe.

PubMed

Cameron, Adrian J; Van Stralen, Maartje M; Kunst, Anton E; Te Velde, Saskia J; Van Lenthe, Frank J; Salmon, Jo; Brug, Johannes

2013-02-01

Socioeconomic inequalities in physical activity at the individual level are well reported. Whether inequalities in economic development and other macroenvironmental variables between countries are also related to physical activity at the country level is comparatively unstudied. We examined the relationship between country-level data on macroenvironmental factors (gross domestic product (GDP) per capita, public sector expenditure on health, percentage living in urban areas, and cars per 1000 population) with country-level physical activity prevalence obtained from previous pan-European studies. Studies that assessed leisuretime physical activity (n = 3 studies including 27 countries in adults, n = 2 studies including 28 countries in children) and total physical activity (n = 3 studies in adults including 16 countries) were analyzed separately as were studies among adults and children. Strong and consistent positive correlations were observed between country prevalence of leisure-time physical activity and country GDP per capita in adults (average r = 0.70; all studies, P G 0.05). In multivariate analysis, country prevalence of leisure-time physical activity among adults remained associated with country GDP per capita (two of three studies) but not urbanization or educational attainment. Among school-age populations, no association was found between country GDP per capita and country prevalence of leisure-time physical activity. In those studies that assessed total physical activity (which also includes occupational and transport physical activity), no association with country GDP per capita was observed. Clear differences in national leisure-time physical activity levels throughout Europe may be a consequence of economic development. Lack of economic development of some countries in Europe may make increasing leisure-time physical activity more difficult. Further examination of the link between country GDP per capita and national physical activity levels (across leisure-time, occupational, and transport-related domains) is warranted.

Motor Skills and Free-Living Physical Activity Showed No Association Among Preschoolers in 2012 U.S. National Youth Fitness Survey.

PubMed

Loprinzi, Paul D; Frith, Emily

2017-04-01

Albeit limited, some emerging work, using convenience-based samples, has demonstrated that greater motor skill development is associated with higher physical activity among preschool-aged children. The purpose of this study was to evaluate this topic using data from the 2012 National Youth Fitness Survey that included 329 preschool-aged children (3-5 years). Parents proxy-reported their child's physical activity, with motor skill level assessed from the Test of Gross Motor Development-Second Edition (TGMD2). Motor skill levels (Gross Motor Quotient, locomotor or object control) were not associated with preschool free-living physical activity in any analytic model. Thus, in this large sample of preschoolers, contrary to research with older children, motor skill level was not associated with physical activity. Findings are discussed in terms of study limitations of (a) a reliance on parent report of children's physical activity levels and (b) the possibility that physical activity data within the national survey were too limited in range to show possible associations to motor skill development with higher levels of free-living physical activity in preschoolers.

Validation of the Physical Activity Scale for individuals with physical disabilities.

PubMed

van den Berg-Emons, Rita J; L'Ortye, Annemiek A; Buffart, Laurien M; Nieuwenhuijsen, Channah; Nooijen, Carla F; Bergen, Michael P; Stam, Henk J; Bussmann, Johannes B

2011-06-01

To determine the criterion validity of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) by means of daily physical activity levels measured by using a validated accelerometry-based activity monitor in a large group of persons with a physical disability. Cross-sectional. Participants' home environment. Ambulatory and nonambulatory persons with cerebral palsy, meningomyelocele, or spinal cord injury (N=124). Not applicable. Self-reported physical activity level measured by using the PASIPD, a 2-day recall questionnaire, was correlated to objectively measured physical activity level measured by using a validated accelerometry-based activity monitor. Significant Spearman correlation coefficients between the PASIPD and activity monitor outcome measures ranged from .22 to .37. The PASIPD overestimated the duration of physical activity measured by using the activity monitor (mean ± SD, 3.9±2.9 vs 1.5±0.9h/d; P<.01). Significant correlation (ρ=-.74; P<.01) was found between average number of hours of physical activity per day measured by using the 2 methods and difference in hours between methods. This indicates larger overestimation for persons with higher activity levels. The PASIPD correlated poorly with objective measurements using an accelerometry-based activity monitor in people with a physical disability. However, similar low correlations between objective and subjective activity measurements have been found in the general population. Users of the PASIPD should be cautious about overestimating physical activity levels. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Predictors of activity level and retention among African American lay health advisors (LHAs) from The National Witness Project: Implications for the implementation and sustainability of community-based LHA programs from a longitudinal study.

PubMed

Shelton, Rachel C; Dunston, Sheba King; Leoce, Nicole; Jandorf, Lina; Thompson, Hayley S; Crookes, Danielle M; Erwin, Deborah O

2016-03-22

Lay health advisor (LHA) programs are increasingly being implemented in the USA and globally in the context of health promotion and disease prevention. LHAs are effective in addressing health disparities when used to reach medically underserved populations, with strong evidence among African American and Hispanic women. Despite their success and the evidence supporting implementation of LHA programs in community settings, there are tremendous barriers to sustaining LHA programs and little is understood about their implementation and sustainability in "real-world" settings. The purpose of this study was to (1) propose a conceptual framework to investigate factors at individual, social, and organizational levels that impact LHA activity and retention; and (2) use prospective data to investigate the individual, social, and organizational factors that predict activity level and retention among a community-based sample of African American LHAs participating in an effective, evidence-based LHA program (National Witness Project; NWP). Seventy-six LHAs were recruited from eight NWP sites across the USA. Baseline predictor data was collected from LHAs during a telephone questionnaire administered between 2010 and 2011. Outcome data on LHA participation and program activity levels were collected in the fall of 2012 from NWP program directors. Chi-square and ANOVA tests were used to identify differences between retained and completely inactive LHAs, and LHAs with high/moderate vs. low/no activity levels. Multivariable logistic regression models were conducted to identify variables that predicted LHA retention and activity levels. In multivariable models, LHAs based at sites with academic partnerships had increased odds of retention and high/moderate activity levels, even after adjusting for baseline LHA activity level. Higher religiosity among LHAs was associated with decreased odds of being highly/moderately active. LHA role clarity and self-efficacy were associated with retention and high/moderate activity in multivariable models unadjusted for baseline LHA activity level. Organizational and role-related factors are critical in influencing the retention and activity levels of LHAs. Developing and fostering partnerships with academic institutions will be important strategies to promote successful implementation and sustainability of LHA programs. Clarifying role expectations and building self-efficacy during LHA recruitment and training should be further explored to promote LHA retention and participation.

Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98)

PubMed Central

2012-01-01

Background We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. Methods The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. Results After adjusting for age and region, a higher education level was associated with more leisure-time activity – with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively. Conclusions In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time. PMID:23241280

Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98).

PubMed

Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M

2012-12-15

We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively. In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.

Impact of pain characteristics and fear-avoidance beliefs on physical activity levels among older adults with chronic pain: a population-based, longitudinal study.

PubMed

Larsson, Caroline; Ekvall Hansson, Eva; Sundquist, Kristina; Jakobsson, Ulf

2016-02-24

To explore the level of physical activity in a population based sample of older adults; to analyze the influence of pain characteristics and fear-avoidance beliefs as predictors of physical activity among older adults reporting chronic pain. Demographics, pain characteristics (duration, intensity), physical activity, kinesiophobia (excessive fear of movement/(re) injury), self-efficacy and self-rated health were measured with questionnaires at baseline and 12-months later. Logistic regression analyses were done to identify associations at baseline and predictors of physical activity 12-months later during follow-up. Of the 1141 older adults (mean age 74.4 range 65-103 years, 53.5% women) included in the study, 31.1% of those with chronic pain were sufficiently active (scoring ≥ 4 on Grimby's physical activity scale) compared to 56.9% of those without chronic pain. Lower age (OR = 0.93, 95% CI = 0.88-0.99), low kinesiophobia OR = 0.95, 95% CI = 0.91-0.99), and higher activity level at baseline (OR = 10.0, 95% CI = 4.98-20.67) significantly predicted higher levels of physical activity in individuals with chronic pain. The level of physical activity was significantly lower among those with chronic pain and was significantly associated with kinesiophobia. Our findings suggest that fear- avoidance believes plays a more important role in predicting future physical activity levels than pain characteristics. Thus our findings are important to consider when aiming to increase physical activity in older adults that have chronic pain.

Self-reported leisure time physical activity: a useful assessment tool in everyday health care.

PubMed

Rödjer, Lars; Jonsdottir, Ingibjörg H; Rosengren, Annika; Björck, Lena; Grimby, Gunnar; Thelle, Dag S; Lappas, Georgios; Börjesson, Mats

2012-08-24

The individual physical activity level is an independent risk factor for cardiovascular disease and death, as well as a possible target for improving health outcome. However, today's widely adopted risk score charts, typically do not include the level of physical activity. There is a need for a simple risk assessment tool, which includes a reliable assessment of the level of physical activity. The aim of this study was therefore, to analyse the association between the self-reported levels of physical activity, according to the Saltin-Grimby Physical Activity Level Scale (SGPALS) question, and cardiovascular risk factors, specifically focusing on the group of individuals with the lowest level of self-reported PA. We used cross sectional data from the Intergene study, a random sample of inhabitants from the western part of Sweden, totalling 3588 (1685 men and 1903 women, mean age 52 and 51). Metabolic measurements, including serum-cholesterol, serum-triglycerides, fasting plasma-glucose, waist circumference, blood pressure and resting heart rate, as well as smoking and self-reported stress were related to the self-reported physical activity level, according to the modernized version of the SGPALS 4-level scale. There was a strong negative association between the self-reported physical activity level, and smoking, weight, waist circumference, resting heart rate, as well as to the levels of fasting plasma-glucose, serum-triglycerides, low-density lipoproteins (LDL), and self-reported stress and a positive association with the levels of high-density lipoproteins (HDL). The individuals reporting the lowest level of PA (SGPALS, level 1) had the highest odds-ratios (OR) for having pre-defined levels of abnormal risk factors, such as being overweight (men OR 2.19, 95% CI: 1.51-3.19; women OR 2.57, 95 % CI: 1.78-3.73), having an increased waist circumference (men OR 3.76, 95 % CI: 2.61-5.43; women OR 2.91, 95% CI: 1.94-4.35) and for reporting stress (men OR 3.59, 95 % CI: 2.34-5.49; women OR 1.25, 95% CI: 0.79-1.98), compared to the most active individuals, but also showed increased OR for most other risk factors analyzed above. The self-reported PA-level according to the modernized Saltin-Grimby Physical Activity Level Scale, SGPALS, is associated with the presence of many cardiovascular risk factors, with the most inactive individuals having the highest risk factor profile, including self-reported stress. We propose that the present SGPALS may be used as an additional, simple tool in a routine risk assessment in e.g. primary care, to identify inactive individuals, with a higher risk profile.

Self-reported leisure time physical activity: a useful assessment tool in everyday health care

PubMed Central

2012-01-01

Background The individual physical activity level is an independent risk factor for cardiovascular disease and death, as well as a possible target for improving health outcome. However, today´s widely adopted risk score charts, typically do not include the level of physical activity. There is a need for a simple risk assessment tool, which includes a reliable assessment of the level of physical activity. The aim of this study was therefore, to analyse the association between the self-reported levels of physical activity, according to the Saltin-Grimby Physical Activity Level Scale (SGPALS) question, and cardiovascular risk factors, specifically focusing on the group of individuals with the lowest level of self-reported PA. Methods We used cross sectional data from the Intergene study, a random sample of inhabitants from the western part of Sweden, totalling 3588 (1685 men and 1903 women, mean age 52 and 51). Metabolic measurements, including serum-cholesterol, serum-triglycerides, fasting plasma-glucose, waist circumference, blood pressure and resting heart rate, as well as smoking and self-reported stress were related to the self-reported physical activity level, according to the modernized version of the SGPALS 4-level scale. Results There was a strong negative association between the self-reported physical activity level, and smoking, weight, waist circumference, resting heart rate, as well as to the levels of fasting plasma-glucose, serum-triglycerides, low-density lipoproteins (LDL), and self-reported stress and a positive association with the levels of high-density lipoproteins (HDL). The individuals reporting the lowest level of PA (SGPALS, level 1) had the highest odds-ratios (OR) for having pre-defined levels of abnormal risk factors, such as being overweight (men OR 2.19, 95% CI: 1.51-3.19; women OR 2.57, 95 % CI: 1.78-3.73), having an increased waist circumference (men OR 3.76, 95 % CI: 2.61-5.43; women OR 2.91, 95% CI: 1.94-4.35) and for reporting stress (men OR 3.59, 95 % CI: 2.34-5.49; women OR 1.25, 95% CI: 0.79-1.98), compared to the most active individuals, but also showed increased OR for most other risk factors analyzed above. Conclusion The self-reported PA-level according to the modernized Saltin-Grimby Physical Activity Level Scale, SGPALS, is associated with the presence of many cardiovascular risk factors, with the most inactive individuals having the highest risk factor profile, including self-reported stress. We propose that the present SGPALS may be used as an additional, simple tool in a routine risk assessment in e.g. primary care, to identify inactive individuals, with a higher risk profile. PMID:22920914

Pythagoras Meets Van Hiele.

ERIC Educational Resources Information Center

Flores, Alfinio

1993-01-01

Develops the Pythagorean Theorem in the context of the Van Hiele levels by presenting activities appropriate for each level. Activities point to preparatory development (level 0), give 3 different versions of Euclid's proof (levels 1, 2, and 3), give some generalizations of the theorem (level 3), and explore the Pythagorean relationship in other…

76 FR 52672 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, Level 1...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

...-2011-0012] Agency Information Collection Activities: Submission for OMB Review; Comment Request, Level 1 Assessment and Level 3 Evaluations for the Center for Domestic Preparedness (CDP) AGENCY: Federal... . SUPPLEMENTARY INFORMATION: Collection of Information Title: Level 1 Assessment and Level 3 Evaluations for the...

Are Korean Adults Meeting the Recommendation for Physical Activity during Leisure Time?

PubMed Central

Cho, Min-Haeng

2014-01-01

[Purpose] The purpose of this study was to determine if Korean adults meet their physical activity recommendations during their leisure time to promote a healthy living. [Subjects and Methods] The sample included South Korean adults, aged over 20, who were currently residing in K City, South Korea. The author used a quota sampling technique to select 1,000 samples. Of the 1,000 questionnaires distributed, 845 questionnaires were used to conduct a χ2 test. [Results] It was revealed by the questionnaire that there was a clear distinction in the categories of very high level activity (11.0%), high level activity (29.1%), acceptable level activity (12.9%), low level activity (9.7%), and inactive level of physical activity (38.3%) in Korean adults’ leisure time. [Conclusions] The most interesting finding was that more than half of Korean adults do reach the recommendation of at least 30 minutes of moderate activity, on three or more days a week for at least three months. The other interesting finding was that the questionnaire is a useful instrument suitable for analyzing the recommendations of physical activity, comprising frequency, intensity, time, and overall duration. PMID:25013279

Does regional disadvantage affect health-related sport and physical activity level? A multi-level analysis of individual behaviour.

PubMed

Wicker, Pamela; Downward, Paul; Lera-López, Fernando

2017-11-01

This study examines the role of regional government quality in health-related participation in sport and physical activity among adults (18-64 years) in 28 European countries. The importance of the analysis rests in the relative autonomy that regional and local governments have over policy decisions connected with sport and physical activity. While existing studies have focussed on economic and infrastructural investment and expenditure, this research investigates the quality of regional governments across 208 regions within 28 European countries. The individual-level data stem from the 2013 Eurobarometer 80.2 (n = 18,675) and were combined with regional-level data from Eurostat. An individual's level of participation in sport and physical activity was measured by three variables reflecting whether an individual's activity level is below, meets, or exceeds the recommendations of the World Health Organization. The results of multi-level analyses reveal that regional government quality has a significant and positive association with individual participation in sport and physical activity at a level meeting or exceeding the guidelines. The impact is much larger than that of regional gross domestic product per capita, indicating that regional disadvantage in terms of political quality is more relevant than being disadvantaged in terms of economic wealth.

Sex Hormone Effects on Physical Activity Levels: Why Doesn’t Jane Run as Much as Dick?

PubMed Central

Bowen, Robert S.; Turner, Michael J.; Lightfoot, J. Timothy

2010-01-01

The relationship between physical activity levels and disease rates have become an important health related concern in the developed world. Heart disease, certain cancers, and obesity persist at epidemic rates in the United States and Western Europe. Increased physical activity levels have been shown to reduce the occurrence of many chronic diseases leading to reductions in the burden on the health care system. Activity levels in humans are affected by many cultural and environmental factors, nevertheless current research points to a strong biological input with potential genetic, neurological, and endocrinological origins. Of unique interest, the sex hormones appear to have a very strong influence on activity levels. The current animal literature suggests that females tend to be more active than males due to biological pathways of estrogenic origin. The majority of human epidemiological and anthropological data, on the contrary, suggest women are less active than men in spite of this inherent activity-increasing mechanism. The purpose of this manuscript was to review the current literature regarding the control of physical activity levels by the sex hormones in humans. Using the natural transitional phases of the aging endocrine system, natural periodicity of the menstrual cycle, and pharmacological/hormone replacement therapy as variable experimental stages, some authors have been able to provide some information regarding the existence of an inherent activity-increasing mechanism in humans. In brief, activity levels during life stages prior to and after menopause do not significantly differ, despite the vast changes in sex hormone levels and function. Activity difference throughout a regular menstrual cycle do not appear to influence activity levels in humans either—an effect that is pronounced in the female rodent. The use of hormone replacement therapies provide researchers with more systematic controls over hormone modulation in human subjects; however, this benefit comes with additional confounding variables, mostly due to disease or other states of malfunction. Despite the addition of these confounding factors, minor changes to the activity pattern have been observed in women, especially during the initial administration for the therapy. Observations are yet to be made in male subjects during replacement therapy. In general, some evidence exists suggesting that a biological mechanism—extending from the sex hormones—influences activity in humans. Unfortunately, despite a small number of investigative reports, the paucity of human research investigating how the sex hormones affect activity levels in humans prevents conclusive delineation of the mechanisms involved. Future research in this unique sub-field of endocrinology and exercise science utilizing more appropriate research protocols and effective techniques will provide definitive evidence of such mechanisms. PMID:21142285

Association between physical activity level and consumption of fruit and vegetables among adolescents in northeast Brazil

PubMed Central

Silva, Diego Augusto Santos; Silva, Roberto Jerônimo dos Santos

2015-01-01

OBJECTIVE: To determine the association between low levels of physical activity and consumption of fruits and vegetables among adolescents. METHODS: This cross-sectional study included 2,057 adolescents aged 13 to 18 years from the city of Aracaju, Northeastern Brazil. We analyzed the level of physical activity, consumption of fruits and vegetables by standardized and validated questionnaires. The control variables were sex, age, socioeconomic status, maternal education, alcohol consumption and smoking. For data analysis, univariate and multivariate logistic regression were used, with a significance level of 5%. RESULTS: The prevalence of low levels of physical activity was 81.9%; the inadequate consumption of fruits ocurred in 79.1% and the inadequate consumption of vegetables in 90.6%. Adolescents who consumed few fruits daily had an increase in 40% of chance of being insufficiently active and, for those who consumed few vegetable's the likelihood of being insufficiently active was 50% higher, compared to those who had adequate intake of these foods. CONCLUSIONS: Low levels of physical activity were associated with inadequate fruit and vegetable intake among adolescents in a city in northeastern Brazil. These findings suggest that insufficiently active adolescents have other unhealthy behaviors that may increase the risk of chronic diseases in adulthood. PMID:25887930

Corticosterone level and central dopaminergic activity involved in agile and exploratory behaviours in formosan wood mice (Apodemus semotus).

PubMed

Shieh, Kun-Ruey; Yang, Shu-Chuan

2018-03-27

The native Formosan wood mouse (Apodemus semotus) is the dominant rodent in Taiwan. In their natural environment, Formosan wood mice exhibit high locomotor activity, including searching and exploratory behaviours, which is observed similarly in the laboratory environment. How the behavioural responses of Formosan wood mice exhibit in elevated plus maze and marble burying tests remains unclear. How corticosterone levels and central dopaminergic activities are related to the behaviours in these tests is also unclear. This study compared the behaviours of Formosan wood mice with that of C57BL/6J mice using the elevated plus maze and marble burying tests, and measured the corticosterone levels and central dopaminergic activities. Formosan wood mice showed greater locomotor and exploratory activity than the C57BL/6J mice. Similarly, the marble burying and rearing numbers were higher for Formosan wood mice. High locomotor and exploratory behaviours were strongly correlated with corticosterone levels after acute mild restraint stress in Formosan wood mice. The anxiolytic, diazepam, reduced the high exploratory activity, corticosterone levels and central dopaminergic activities. The high locomotor and exploratory behaviours of Formosan wood mice are related to the corticosterone levels and central dopaminergic activities. These data may explain Formosan wood mice dominance in the intermediate altitude of Taiwan.

Increased serum APRIL differentially correlates with distinct cytokine profiles and disease activity in systemic lupus erythematosus patients.

PubMed

Boghdadi, Ghada; Elewa, Enass A

2014-09-01

Cytokines play an important role in the pathogenesis of systemic lupus erythematosus (SLE). Among the cytokines that regulate B cell homeostasis is a proliferation-inducing ligand (APRIL). This study aimed to determine whether serum levels of APRIL are raised in patients with SLE and correlate with disease activity or proinflammatory cytokines production, or both. Serum APRIL, interleukin-17 (IL-17), IL-4 and interferon gamma (IFN-γ) levels were measured in forty patients with SLE and 30 healthy controls. Disease activity was assessed by SLE disease activity index (SLEDAI), and results were correlated with serum APRIL levels. Serum APRIL levels were significantly higher in patients with SLE than in healthy controls. Positive correlation was found between serum APRIL levels and total SLEDAI score and anti-dsDNA antibody titers. Moreover, serum APRIL levels was significantly higher in patients with arthritis, mucocutaneous manifestations and proteinuria. APRIL is increased in patients with active SLE accompanying the increase of IL-17 and IFN-γ. Significant positive correlations between serum levels of APRIL and IL-17 and IFN-γ and a negative correlation between serum levels of APRIL and IL-4 were found. The results suggest that APRIL may be an important marker of disease activity in patients with SLE. We provide the analyses of APRIL levels in patients with SLE, suggesting new tools for the diagnosis, prognosis and possible therapeutic management of SLE.

Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK).

PubMed

Hebert, Jeffrey J; Møller, Niels C; Andersen, Lars B; Wedderkopp, Niels

2015-01-01

Many children fail to meet international guideline recommendations for health-related activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), and intervention studies to date have reported negligible effects. Explore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance. This prospective cohort study was nested in the Childhood Health, Activity, and Motor Performance School Study Denmark. Study participants were a representative sample of 1124 primary school students. Organized leisure-time sport participation was reported via text messaging and physical activity was objectively measured over seven days with accelerometry. Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients (b) and adjusted odds ratios (aOR). Participants were 53% female, with mean(SD) age = 8.4(1.4) years. Boys were more active than girls (p<0.001), and physical activity levels and guideline concordance decreased with age (p<0.001). Soccer participation at any frequency was associated with greater overall MVPA (b[95% CI] = 0.66[0.20,1.13] to 2.44[1.44,3.44]). Depending on participation frequency, this equates to 5-20 minutes more MVPA on the average day and 3 to 15 fold increased odds of achieving recommended levels of health-related physical activity (aOR[95%CI] = 3.04[1.49,6.19] to 14.49[1.97,106.56]). Similar associations were identified among children playing handball at least twice per week. Relationships with other sports (gymnastics, basketball, volleyball) were inconsistent. Many children, particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations. Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international guideline concordance in children.

Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK)

PubMed Central

Hebert, Jeffrey J.; Møller, Niels C.; Andersen, Lars B.; Wedderkopp, Niels

2015-01-01

Introduction Many children fail to meet international guideline recommendations for health-related activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), and intervention studies to date have reported negligible effects. Objective Explore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance. Methods This prospective cohort study was nested in the Childhood Health, Activity, and Motor Performance School Study Denmark. Study participants were a representative sample of 1124 primary school students. Organized leisure-time sport participation was reported via text messaging and physical activity was objectively measured over seven days with accelerometry. Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients (b) and adjusted odds ratios (aOR). Results Participants were 53% female, with mean(SD) age = 8.4(1.4) years. Boys were more active than girls (p<0.001), and physical activity levels and guideline concordance decreased with age (p<0.001). Soccer participation at any frequency was associated with greater overall MVPA (b[95% CI] = 0.66[0.20,1.13] to 2.44[1.44,3.44]). Depending on participation frequency, this equates to 5–20 minutes more MVPA on the average day and 3 to 15 fold increased odds of achieving recommended levels of health-related physical activity (aOR[95%CI] = 3.04[1.49,6.19] to 14.49[1.97,106.56]). Similar associations were identified among children playing handball at least twice per week. Relationships with other sports (gymnastics, basketball, volleyball) were inconsistent. Conclusions Many children, particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations. Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international guideline concordance in children. PMID:26262678

State-dependent, bidirectional modulation of neural network activity by endocannabinoids.

PubMed

Piet, Richard; Garenne, André; Farrugia, Fanny; Le Masson, Gwendal; Marsicano, Giovanni; Chavis, Pascale; Manzoni, Olivier J

2011-11-16

The endocannabinoid (eCB) system and the cannabinoid CB1 receptor (CB1R) play key roles in the modulation of brain functions. Although actions of eCBs and CB1Rs are well described at the synaptic level, little is known of their modulation of neural activity at the network level. Using microelectrode arrays, we have examined the role of CB1R activation in the modulation of the electrical activity of rat and mice cortical neural networks in vitro. We find that exogenous activation of CB1Rs expressed on glutamatergic neurons decreases the spontaneous activity of cortical neural networks. Moreover, we observe that the net effect of the CB1R antagonist AM251 inversely correlates with the initial level of activity in the network: blocking CB1Rs increases network activity when basal network activity is low, whereas it depresses spontaneous activity when its initial level is high. Our results reveal a complex role of CB1Rs in shaping spontaneous network activity, and suggest that the outcome of endogenous neuromodulation on network function might be state dependent.

[Physical activity and cardiovascular risk factors among Chilean young men and women].

PubMed

Arteaga, Antonio; Bustos, Patricia; Soto, Rodrigo; Velasco, Nicolás; Amigo, Hugo

2010-10-01

Physical activity (PA) has a protective role in cardiovascular diseases. To quantify PA in young adults and to correlate it with cardiovascular risk factors. A cross-sectional study was performed employing the international physical activity questionnaire (IPAQ), to measure the PA of 983 randomly selected young adults from Valparaiso region born between 1974 and 1978. Its results were associated with levels of obesity, insulin resistance and cardiovascular risk factors defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP- ATP III) RESULTS: Mean physical activity among men and women was 3731 ± 3923 and 1360 ± 2303 METs-minutes/week, respectively (p < 0.001). Fifty percent of women and 21.5% of men had an insufficient level of physical activity (p < 0.001). Sixty percent of men and 23.4% of women had an intense level of physical activity (p < 0.001). There was an inverse association of physical activity and insulin resistance. A high physical activity was protective, specially among men, against a low HDL cholesterol level and high triglyceride levels with Odds Ratios of 0.59 (confidence interval (CI): 0,35-0.98) and 0.49 (CI: 0,27-0,87) respectively, after adjusting for body mass index and age. In this sample, men had higher levels of physical activity, that was protective against insulin resistance and the presence of cardiovascular risk factors.

Association between levels of physical activity and poor self-rated health in Korean adults: The Third Korea National Health and Nutrition Examination Survey (KNHANES), 2005.

PubMed

Han, M A; Kim, K S; Park, J; Kang, M G; Ryu, S Y

2009-10-01

To investigate the association between level of physical activity and poor self-rated health in Korean adults. A cross-sectional study was conducted on 7,800 adults aged > or =19 years who completed the Health Interview and the Health Behavior Surveys, issued during the Third National Health and Nutrition Examination Survey (2005). The association between self-rated health and physical activity was tested using Chi-squared test. Multiple logistic regression analysis was used to calculate the odds ratios of poor self-rated health for different levels of physical activity after adjusting for physical and chronic medical conditions. The prevalence of poor self-rated health was significantly lower as the level of physical activity increased, and odds ratios for poor self-rated health were significantly lower for higher levels of physical activity after adjusting for age, marital status, educational status, smoking, alcohol consumption, and the number of physical impairments and chronic medical conditions. The association was similar in different age groups and among healthy respondents and respondents with physical impairments or chronic medical conditions. Physical activity was positively associated with self-rated health in Koreans. The independent association between a lower level of physical activity and poor self-rated health supports public health programmes that encourage regular physical activity.

Psychosocial and demographic predictors of postpartum physical activity.

PubMed

Guardino, Christine M; Hobel, Calvin J; Shalowitz, Madeleine U; Ramey, Sharon L; Dunkel Schetter, Christine

2018-05-08

Physical activity promotes better health outcomes across the lifespan, and provides physical and mental health benefits for women who have recently given birth. However, research has not adequately characterized physical activity levels or risk factors for inadequate physical activity during the postpartum period. The objective of the present study was to describe levels and correlates of physical activity at 6 months postpartum in mothers of diverse race/ethnicity (55% African American, 23% White, 22% Hispanic/Latina), with the majority living in or near poverty. We analyzed data collected by the five-site Community Child Health Network study. Women (n = 1581) were recruited shortly after the birth of a child. Multinomial logistic regression models tested associations of demographic factors and self-reported stress in several life domains with total physical activity levels at 6-9 months postpartum, including activities done at work, at home, for transportation, and leisure. Thirty-five percent of participants in this sample reported low levels of physical activity. African American race, Latina ethnicity, and living in a rural area were associated with low levels of physical activity, whereas working outside the home was associated with high physical activity. Contrary to hypotheses, chronic stress was not associated with physical activity with the exception of financial stress, which predicted greater likelihood of being highly physically active. These findings suggest that optimal postpartum care should integrate physical activity promotion, and that African American, Latina, and rural-dwelling women may benefit most from efforts to promote activity following birth.

Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder.

PubMed

Jha, Manish K; Teer, Raymond B; Minhajuddin, Abu; Greer, Tracy L; Rush, A John; Trivedi, Madhukar H

2017-01-01

Major depressive disorder (MDD) significantly impacts performance of both work- and nonwork-related routine daily activities. We have shown that work productivity is significantly impaired in employed MDD patients, but the extent of impairments in nonwork-related routine activities and its association with antidepressant treatment outcomes has not been established. Activity impairment was measured using the sixth item of Work Productivity and Activity Impairment Scale in the Combining Medications to Enhance Depression Outcomes (CO-MED) trial (n=665). Published norms were used to define activity impairment levels. The relationship between activity impairment and baseline sociodemographic and clinical characteristics was evaluated along with changes in activity impairment and its relationship with other clinical outcomes such as symptom severity, function, and side effect burden. Remission status at 3 and 7 months was predicted based on week 6 activity impairment level. Higher psychosocial and cognitive impairments and greater number of comorbid medical conditions were associated with greater activity impairment at baseline. Proportion of participants with severe activity impairment declined from 47.6% at baseline to 18.7% at 3 months, while mean activity impairment decreased from 57.1 at baseline to 32.8 at 3 months. During course of treatment, levels of activity impairment correlated most strongly with psychosocial function among measures of symptom severity, function, quality of life, and side effect burden. No or minimal activity impairment at week 6 was associated with two to three times higher rates of remission at 3 and 7 months as compared to moderate or severe activity impairment levels even after controlling for remission status at week 6 and select baseline variables. Depressed patients have high levels of nonwork-related activity impairment at baseline that improves significantly with treatment and independently predicts long-term clinical outcomes. Brief systematic assessment of activity impairment during the course of antidepressant treatment can help inform clinical decision-making.

Mediating Effects of Self-Efficacy, Benefits and Barriers on the Association between Peer and Parental Factors and Physical Activity among Adolescent Girls with a Lower Educational Level.

PubMed

Verloigne, Maite; Cardon, Greet; De Craemer, Marieke; D'Haese, Sara; De Bourdeaudhuij, Ilse

2016-01-01

The prevalence of physical activity among lower educated adolescent girls is low, suggesting it is important to have insights into the complex processes that may underlie their physical activity levels. Therefore, this study aimed to examine the mediating effects of self-efficacy, perceived benefits and barriers on the associations between peer and parental variables and physical activity among lower educated adolescent girls. In total, 226 girls (mean age 16.0±1.0 years; 53% technical education; 47% vocational education) from a convenience sample of 6 secondary schools in Flanders, Belgium, completed a questionnaire on their total physical activity level and related peer and parental variables (i.e. modeling of physical activity, co-participation in physical activities and encouragement to be active) and personal variables (i.e. self-efficacy to be active, and specific perceived benefits of physical activity and specific barriers to be active). Mediating effects were tested using MacKinnon's product-of-coefficients test based on multilevel linear regression analyses. Higher peer and parental modeling, co-participation and encouragement were significantly related to a higher physical activity level among adolescent girls (p<0.05). Self-efficacy, the perceived benefits of having fun, being around friends or meeting new people, and not being bored and the perceived barrier of not liking physical activity mediated several associations between peer and parental variables and girls' physical activity, with some of the mediated proportions exceeding 60%. This study contributed to a better understanding of the complexity of how parental and peer factors work together with personal factors to influence the physical activity levels of adolescent girls with a lower educational level. Interventions should involve both peers and parents, as they may influence girls' physical activity both directly and indirectly through the internalisation of several personal variables, such as self-efficacy to be active and the perceived benefit of having fun.

Impact of Urban Sprawl on Overweight, Obesity, and Physical Activity in Sydney, Australia

PubMed Central

Garden, Frances L.

2008-01-01

Obesity and inadequate physical activity are major risk factors for many diseases. The built environment plays an important role in influencing participation in physical activity. We aimed to determine whether urban sprawl in Sydney, Australia is associated with overweight/obesity and levels of physical activity. We used a cross-sectional multilevel study design to relate urban sprawl (based on population density) measured at an area level to overweight/obesity and levels of physical activity measured at an individual level whilst controlling for individual and area level covariates in metropolitan Sydney. Individual level data were obtained from the 2002 and 2003 New South Wales Population Health Survey. We had information on 7,290 respondents. The mean population density was 2,168 persons per square kilometer (standard deviation = 1,741, range = 218–7,045). After controlling for individual and area level covariates, for an inter-quartile increase in sprawl, the odds of being overweight was 1.26 (95% CI = 1.10–1.44), the odds of being obese was 1.47 (95% CI = 1.24–1.75), the odds of inadequate physical activity was 1.38 (95% CI = 1.21–1.57), and the odds of not spending any time walking during the past week was 1.58 (95% CI = 1.28–1.93). Living in more sprawling suburbs increases the risk of overweight/obesity and inadequate physical activity despite the relatively low levels of urban sprawl in metropolitan Sydney. Modifications to the urban environment to increase physical activity may be worthwhile. PMID:19052877

[Characteristics of social activity of the elderly who belong to senior citizens].

PubMed

Takahashi, Mihoko; Shibazaki, Satomi; Nagai, Masaki

2003-10-01

The purpose of this study was to clarify environmental conditions determining the social activities of the elderly, by analyzing levels of activity in individuals belonging to clubs for senior citizens. In 1998, we conducted a survey of over 10,000 elderly subjects, 65 years of age or older, who belonged to 228 clubs for senior citizens in a region of Saitama Prefecture, using a 'Check list' developed for self-evaluation of social activities. The proportions of 'active' and 'inactive' seniors, as judged by the 'Check list' for each of the four different aspects of social activities (1. individual activities, 2. social participation/volunteering, 3. education/training, 4. employment), were compared with those of the standard elderly population. Two hundred and seven clubs for senior citizens (90.8%) participated in this study. About 82.0% of the members of each club filled out the 'Check list'. High levels as compared to the standard population were demonstrated for two aspects of social activity: individual activity and social participation/volunteering. Women had higher levels of both types of social activity than men. Men aged 74 years or younger had lower than average levels for three aspects of social activity: social participation/volunteering, education/training, and employment. Members who resided in urban areas with easy access had higher levels of individual activity, social participation/volunteering and education/training. On the other hand, those residing in suburbs with large spaces for agriculture had higher levels for employment. Our results for social activities of elderly subjects belonging to clubs for senior citizens indicate that strong correlations exist with environmental conditions, including communication facilities and local or industrial structure.

A survey of core and support activities of communicable disease surveillance systems at operating-level CDCs in China.

PubMed

Xiong, Weiyi; Lv, Jun; Li, Liming

2010-11-17

In recent years, problems like insufficient coordination, low efficiency, and heavy working load in national communicable disease surveillance systems in China have been pointed out by many researchers. To strengthen the national communicable disease surveillance systems becomes an immediate concern. Since the World Health Organization has recommended that a structured approach to strengthen national communicable disease surveillance must include an evaluation to existing systems which usually begins with a systematic description, we conducted the first survey for communicable disease surveillance systems in China, in order to understand the situation of core and support surveillance activities at province-level and county-level centers for disease control and prevention (CDCs). A nationwide survey was conducted by mail between May and October 2006 to investigate the implementation of core and support activities of the Notifiable Disease Reporting System (NDRS) and disease-specific surveillance systems in all of the 31 province-level and selected 14 county-level CDCs in Mainland China The comments on the performance of communicable disease surveillance systems were also collected from the directors of CDCs in this survey. The core activities of NDRS such as confirmation, reporting and analysis and some support activities such as supervision and staff training were found sufficient in both province-level and county-level surveyed CDCs, but other support activities including information feedback, equipment and financial support need to be strengthened in most of the investigated CDCs. A total of 47 communicable diseases or syndromes were under surveillance at province level, and 20 diseases or syndromes at county level. The activities among different disease-specific surveillance systems varied widely. Acute flaccid paralysis (AFP), measles and tuberculosis (TB) surveillance systems got relatively high recognition both at province level and county level. China has already established a national communicable disease surveillance framework that combines NDRS and disease-specific surveillance systems. The core and support activities of NDRS were found sufficient, while the implementation of those activities varied among different disease-specific surveillance systems.

Does similarity in educational level between health promotion volunteers and local residents affect activity involvement of the volunteers?

PubMed

Murayama, Hiroshi; Taguchi, Atsuko; Murashima, Sachiyo

2012-01-01

This study examined whether similarity in educational level, as a socioeconomic background factor, between health promotion volunteers (HPVs) and residents in the district where HPVs work encourages the volunteers' involvement in providing activities. Cross-sectional questionnaire survey. A total of 512 HPVs in a Japanese city with 5 districts. We focused on the number of activities related to working as an HPV as an aspect of involvement in the HPV role. HPV individual educational level was collected from a questionnaire. District educational level was obtained from the Japanese census database. Of 512 questionnaires, 363 were returned and used for the analysis. Multiple regression analysis stratified by district educational level indicated that a higher educational level in HPVs was significantly associated with a greater number of self-motivated activities in the districts with a higher educational level, although the association between a lower HPV educational level and more activity involvement was not found in districts with a lower educational level. It is important to consider similarity in educational level, as a socioeconomic status factor, between HPVs and the districts in which they will work when recruiting new members and when allocating HPVs to work areas. © 2011 Wiley Periodicals, Inc.

Physical activity during work and leisure show contrasting associations with fear-avoidance beliefs: cross-sectional study among more than 10,000 wage earners of the general working population.

PubMed

Tribian, Annika; Vinstrup, Jonas; Sundstrup, Emil; Jay, Kenneth; Bös, Klaus; Andersen, Lars L

2018-01-26

The association between different types of physical activity and fear-avoidance beliefs remains unclear. This study investigates the association between work-related and leisure-time physical activity with fear-avoidance beliefs in the general working population. Currently employed wage earners (n=10,427) from the 2010 round of the Danish Work Environment Cohort Study replied to questions about work, lifestyle and health. General linear models controlling for lifestyle, psychosocial work factors, education, pain, medication-use and chronic diseases tested associations of work-related and leisure-time physical activity (explanatory variables) with fear-avoidance beliefs (outcome variable, scale 0-100). The level of fear-avoidance was 41.7 (SD 27.3), 38.0 (SD 26.9) and 54.3 (SD 27.7) among the general working population, a subgroup of pain-free individuals, and a subgroup with back disease, respectively. In the general working population, the level of fear-avoidance among those with low, moderate and high physical activity during leisure were 47 [95% confidence intervals (CI) 45-49], 44 (95% CI 42-46) and 43 (95% CI 41-45), and physical activity at work were 40 (95% CI 39-42), 44 (95% CI 42-46) and 49 (95% CI 48-51), respectively. Individuals with back disease and a high level of physical activity at work showed the overall highest level of fear-avoidance whereas pain-free individuals with a low level of physical activity at work showed the overall lowest level of fear-avoidance. Physical activity during work and leisure shows contrasting associations with fear-avoidance beliefs. While high physical activity during leisure is associated with lower levels, high physical activity at work is associated with higher levels of fear-avoidance. The present results may reflect some deeply rooted negative beliefs about pain and work in the population. On the societal level, campaigns may be a possible way forward as these have shown to improve beliefs about musculoskeletal pain and work.

The impact of pregnancy on physical activity level.

PubMed

Fell, Deshayne B; Joseph, K S; Armson, B Anthony; Dodds, Linda

2009-09-01

The purpose of this study was to compare women's levels of physical activity during early pregnancy and during the year before pregnancy, and to identify characteristics associated with discontinuing sports and exercise among women previously active during the year before pregnancy. Data collected from 1,737 women enrolled in a prospective cohort study and who had no contraindications for exercise were included in this analysis. Measures of physical activity (including household and care-giving activities, active living and sports and exercise activities) during early pregnancy were compared to the year before pregnancy. Log binomial regression was used to identify factors associated with discontinuing sports and exercise during pregnancy. There was a statistically significant decrease in all summary measures of physical activity during early pregnancy. The largest decreases were observed in sports and exercise activity. Among women active before pregnancy, age <35 years, multiparity, less than university education, pre-pregnancy body mass index (BMI) > or = 30 kg/m(2) and lower levels of pre-pregnancy exercise were associated with discontinuing sports and exercise activities during pregnancy. Most women reduced their physical activity level during the first 20 weeks of pregnancy compared with their level of activity during the year prior to pregnancy, particularly for sports and exercise, although a small proportion of women in this study actually increased their activity in this area during early pregnancy. Participation in sports and exercise activity during pregnancy is potentially modifiable and could favorably impact perinatal health and maternal post-partum weight. The results of this study suggests that pregnancy is an event that leads to a decrease in physical activity.

[Effect of UV-radiation on the level of ascorbic acid, SH-groups, and activity of glutathione reductase in the eye lens].

PubMed

Byshneva, L N; Senchuk, V V

2002-01-01

The effect of UV radiation in vitro on the level of ascorbate, SH-groups and glutathione reductase activity in the soluble fraction of bovine eye lens was studied. UV-Irradiation increased NADPH-oxidoreductase activity, the level of ascorbate oxidation and decreased the content of SH-groups and activity of glutathione reductase. Significant activation of the NADPH-oxidoreductase activity in the presence of ascorbate and Cu2+ was observed after UV-irradiation. It is suggested that ascorbate may play an important role in the UV-induced lens pathology.

Comparative study of the efficacy of pulsed electromagnetic field and low level laser therapy on mitogen-activated protein kinases.

PubMed

El-Makakey, Ayman M; El-Sharaby, Radwa M; Hassan, Mohammed H; Balbaa, Alaa

2017-03-01

Mitogen-Activated Protein Kinases (MAPKs) consist of three major signaling members: extracellular signal-regulated kinase (ERK), p38 and C-JUN N-terminal kinase (JNK). We investigated physiological effects of Pulsed Electromagnetic Field Therapy (PEMFT) and Low Level Laser Therapy (LLLT) on human body, adopting the expression level of mitogen-activated protein kinases as an indicator via assessment of the activation levels of three major families of MAPKS, ERK, p38 and JNK in the peripheral lymphocytes of patients before and after the therapies. Assessment for the expression levels of MAPKs families' were done, in the peripheral lymphocytes of patients recently have appendectomy, using flow cytometric analysis of multiple signaling pathways, pre and post LLLT and PEMFT application (twice daily for 6 successive days) on the appendectomy wound. There were non-significant differences in the expression levels of MAPKs families' pre- therapies application. But there were significant increase in the ERK expression levels post application of LLLT compared to its pre application (p<0.01). Also, there was significant increase in the ERK, p38 and C-Jun N terminal expression level values post application of PEMFT compared to its pre application expression levels (p<0.01 for each). The present study demonstrates that PEMFT has a powerful healing effect more than LLLT as it increase the activation of ERK, P38 and C-Jun-N Terminal while LLLT only increase the activation of ERK. LLLT has more potent pain decreasing effect than PEMFT as it does not activate P38 pathway like PEMFT.

The Effects of Altered Membrane Cholesterol Levels on Sodium Pump Activity in Subclinical Hypothyroidism.

PubMed

Roy, Suparna; Dasgupta, Anindya

2017-03-01

Metabolic dysfunctions characteristic of overt hypothyroidism (OH) start at the early stage of subclinical hypothyroidism (SCH). Na⁺/K⁺-ATPase (the sodium pump) is a transmembrane enzyme that plays a vital role in cellular activities in combination with membrane lipids. We evaluated the effects of early changes in thyroid hormone and membrane cholesterol on sodium pump activity in SCH and OH patients. In 32 SCH patients, 35 OH patients, and 34 euthyroid patients, sodium pump activity and cholesterol levels in red blood cell membranes were measured. Serum thyroxine (T₄) and thyroid stimulating hormone (TSH) levels were measured using enzyme-linked immunosorbent assays. Differences in their mean values were analysed using post hoc analysis of variance. We assessed the dependence of the sodium pump on other metabolites by multiple regression analysis. Sodium pump activity and membrane cholesterol were lower in both hypothyroid groups than in control group, OH group exhibiting lower values than SCH group. In SCH group, sodium pump activity showed a significant direct dependence on membrane cholesterol with an inverse relationship with serum TSH levels. In OH group, sodium pump activity depended directly on membrane cholesterol and serum T₄ levels. No dependence on serum cholesterol was observed in either case. Despite the presence of elevated serum cholesterol in hypothyroidism, membrane cholesterol contributed significantly to maintain sodium pump activity in the cells. A critical reduction in membrane cholesterol levels heralds compromised enzyme activity, even in the early stage of hypothyroidism, and this can be predicted by elevated TSH levels alone, without any evident clinical manifestations. Copyright © 2017 Korean Endocrine Society

Activation of β-adrenoceptor facilitates active avoidance learning through enhancement of glutamate levels in the hippocampal dentate gyrus.

PubMed

Lv, Jing; Feng, Hao; Chen, Ling; Wang, Wei-Yao; Yue, Xue-Ling; Jin, Qing-Hua

2017-10-18

Long-term potentiation (LTP) is widely accepted as the best studied model for neurophysiological mechanisms that could underlie learning and memory formation. Despite a number of studies indicating that β-adrenoceptors in the hippocampal dentate gyrus (DG) is involved in the modulation of learning and memory as well as LTP, few studies have used glutamate release as a visual indicator in awake animals to explore the role of β-adrenoceptors in learning-dependent LTP. Therefore, in the present study, the effects of propranolol (an antagonist of β-adrenoceptor) and isoproterenol (an agonist of β-adrenoceptor) on extracellular concentrations of glutamate and amplitudes of field excitatory postsynaptic potential were measured in the DG region during active avoidance learning in freely moving conscious rats. In the control group, the glutamate level in the DG was significantly increased during the acquisition of active avoidance behavior and returned to basal level following extinction training. In propranolol group, antagonism of β-adrenoceptors in the DG significantly reduced the change in glutamate level, and the acquisition of the active avoidance behavior was significantly inhibited. In contrast, the change in glutamate level was significantly enhanced by isoproterenol, and the acquisition of the active avoidance behavior was significantly accelerated. Furthermore, in all groups, the changes in glutamate level were accompanied by corresponding changes in field excitatory postsynaptic potential amplitude and active avoidance behavior. Our results suggest that activation of β-adrenoceptors in the hippocampal DG facilitates active avoidance learning by modulations of glutamate level and synaptic efficiency in rats.

INFLUENCE OF DIFFERENT LEVELS OF SPORTS ACTIVITIES ON THE QUALITY OF LIFE AFTER THE RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT.

PubMed

Ninković, Srđan; Avramov, Snežana; Harhaji, Vladimir; Obradović, Mirko; Vranješ, Miodrag; Milankov, Miroslav

2015-01-01

The goal of this study was to examine the nature and presence of influence of different levels of sports activity on the life quality of the patients a year after the reconstruction of anterior cruciate ligament. The study included 185 patients operated at the Department of Orthopedic Surgery and Traumatology of the Clinical Centre of Vojvodina, who were followed for twelve months. Data were collected using the modified Knee Injury and Osteoarthritis Outcome Score questionnaire which included the Lysholm scale. This study included 146 male and 39 female subjects. The reconstruction of anterior cruciate ligament was equally successful in both gender groups. In relation to different types of sports activity, there were no differences in the overall life quality measured by the questionnaire and its subscales, regardless of the level (professional or recreational). However, regarding the level of sports activities, there were differences among the subjects engaged in sports activities at the national level as compared with those going in for sports activities at the recreational level, and particularly in comparison with physically inactive population. A significant correlation was not found by examining the aforementioned relationship between sports activities. This study has shown that the overall life quality a year after the reconstruction of the anterior cruciate ligament does not differ in relation to either the gender of the subjects or the type of sports activity, while the level of sports activity does have some influence on the quality of life. Professional athletes have proved to train significantly more intensively after this reconstruction than those going in for sports recreationally.

Relationship between physical activity level and psychosocial and socioeconomic factors and issues in children and adolescents with asthma: a scoping review.

PubMed

Westergren, Thomas; Berntsen, Sveinung; Ludvigsen, Mette Spliid; Aagaard, Hanne; Hall, Elisabeth O C; Ommundsen, Yngvar; Uhrenfeldt, Lisbeth; Fegran, Liv

2017-08-01

Asthma is a heterogeneous chronic airway disease which may reduce capability for physical activity. In healthy peers, physical activity is influenced by psychosocial and socioeconomic factors. Knowledge about the role of these factors has not been mapped in children and adolescents with asthma. The main objective of this scoping review was to identify psychosocial and socioeconomic factors associated with physical activity level in children and adolescents with asthma in the literature. The specific objectives were to map the instruments used to measure these factors, report on the construction and validation of these instruments, map psychosocial and socioeconomic issues related to physical activity level reported in qualitative studies, and identify gaps in knowledge about the relationship between psychosocial and socioeconomic factors and physical activity level in children and adolescents with asthma. Children and adolescents with asthma aged six to 18 years. Psychosocial and socioeconomic factors related to physical activity level and participation. All physical activity contexts. Quantitative and qualitative primary studies in English, with no date limit. The databases searched included nine major databases for health and sports science, and five databases for unpublished studies. After screening and identification of studies, the reference lists of all identified reports were searched, and forward citation searches were conducted using four databases. The following data were extracted: (a) relevant study characteristics and assessment of physical activity level, (b) instruments used to assess psychosocial and socioeconomic factors, (c) association between physical activity level and these factors, (d) construction and validation of instruments, and (e) psychosocial and socioeconomic issues related to physical activity participation. Twenty-one quantitative and 13 qualitative studies were included. In cross-sectional studies, enjoyment, physical self-concept, self-efficacy, attitudes and beliefs about physical activity and health, psychological distress, health-related quality of life, and social support were more often reported as being correlated with physical activity level. In three studies, the construct validity was assessed by factor analysis and construct reliability tests for the study population. Qualitative studies reported 10 issues related to physical activity participation, and capability and being like peers were most commonly reported. There was no direct evidence that qualitative research informed the development or adjustment of instruments in quantitative studies. Seven psychosocial factors correlated with physical activity level; capability and being like peers were the most commonly reported issues. Reports of the construction and validation of instruments were sparse.

Reticulocytes bearing C4d as biomarkers of disease activity for systemic lupus erythematosus.

PubMed

Liu, Chau-Ching; Manzi, Susan; Kao, Amy H; Navratil, Jeannine S; Ruffing, Margie J; Ahearn, Joseph M

2005-10-01

There is an urgent need for biomarkers with which to monitor disease activity in patients with systemic lupus erythematosus (SLE). We recently showed that abnormal levels of C4d, an activation-derived fragment of complement component C4, are deposited on the surface of erythrocytes from patients with SLE. This study focused on reticulocytes, the youngest and shortest-lived erythrocytes (lifespan 24-48 hours), with the objective of testing our hypothesis that when reticulocytes emerge from the bone marrow, they are immediately exposed to and acquire C4d at levels proportionate to the extent of complement activation at that time, thereby reflecting disease activity in SLE. We conducted a cross-sectional study of 156 patients with SLE, 140 patients with other diseases, and 159 healthy controls. Levels of C4d on the surface of reticulocytes were examined using a 2-color flow cytometric assay. The results were analyzed for correlations with SLE disease activity. A wide range of increased levels of reticulocyte C4d was specifically detected in SLE patients. These levels fluctuated in SLE patients and correlated with clinical disease activity, as determined by the Safety of Estrogens in Lupus Erythematosus: National Assessment (SELENA) version of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus Activity Measure (SLAM). Specifically, in cross-sectional analyses, patients with reticulocyte C4d levels in the highest quartile compared with those in the lowest quartile had significantly higher SELENA-SLEDAI (P = 0.00002) and SLAM (P = 0.02) scores. Longitudinal observation demonstrated that the reticulocyte C4d levels changed in relation to the clinical course in individual patients. These findings support our hypothesis that C4d-bearing reticulocytes may serve as biomarkers of disease activity in patients with SLE.

Maternal depressive symptoms and physical activity in very low-income children

PubMed Central

Fernald, Lia C.H.; Jones-Smith, Jessica C.; Ozer, Emily J.; Neufeld, Lynnette M.; DiGirolamo, Ann M.

2009-01-01

Objective To test the contribution of maternal depression during late infancy to physical activity in children five years later. Method Children (n=168) from very low-income households in semi-urban Mexico were assessed as toddlers (15 mo, Time 1) and at pre-school age (4–6 y, Time 2). Child low activity level (<20 minutes of activity daily for <7 d/wk) at Time 2 was the primary outcome measure and maternal depressive symptoms (Center for Epidemiologic Studies – Depression Scale) by self report at Time 1 was the primary independent variable. Covariates tested included child age, sex, BMI percentile, television viewing and behavior (Behavior Problem Index sub-scales), current maternal depressive symptoms, age, BMI and physical activity level, and family socio-economic status; all covariates were assessed at Time 2 except for socio-economic status. Results At 4–6 years old, 27.5% of children were categorized with low activity level. Exposure to high maternal depressive symptoms at child age 15 months was associated with an increased risk of having a low activity level at age 4–6 years (OR, 2.38; 95% CI, 1.05–5.40); results were unchanged with the inclusion of current maternal depressive symptoms. High child TV-viewing was significantly associated with low activity level (OR, 5.44; 95% CI, 2.06–14.3), but did not change the effect of maternal depressive symptoms in early childhood. Tests of mediation revealed that current child internalizing behavior, but not externalizing behavior, significantly attenuated the association between early high maternal depressive symptoms and later childhood activity level. Conclusion Exposure to maternal depressive symptoms in late infancy is a risk factor for low activity level in later childhood and the association may be mediated by child internalizing factors. PMID:18714208

Objectively measured physical activity in Brazilians with visual impairment: description and associated factors.

PubMed

Barbosa Porcellis da Silva, Rafael; Marques, Alexandre Carriconde; Reichert, Felipe Fossati

2017-05-19

Low level of physical activity is a serious health issue in individuals with visual impairment. Few studies have objectively measured physical activity in this population group, particularly outside high-income countries. The aim of this study was to describe physical activity measured by accelerometry and its associated factors in Brazilian adults with visual impairment. In a cross-sectional design, 90 adults (18-95 years old) answered a questionnaire and wore an accelerometer for at least 3 days (including one weekend day) to measure physical activity (min/day). Sixty percent of the individuals practiced at least 30 min/day of moderate-to-vigorous physical activity. Individuals who were blind were less active, spent more time in sedentary activities and spent less time in moderate and vigorous activities than those with low vision. Individuals who walked mainly without any assistance were more active, spent less time in sedentary activities and spent more time in light and moderate activities than those who walked with a long cane or sighted guide. Our data highlight factors associated with lower levels of physical activity in people with visual impairment. These factors, such as being blind and walking without assistance should be tackled in interventions to increase physical activity levels among visual impairment individuals. Implications for Rehabilitation Physical inactivity worldwide is a serious health issue in people with visual impairments and specialized institutions and public policies must work to increase physical activity level of this population. Those with lower visual acuity and walking with any aid are at a higher risk of having low levels of physical activity. The association between visual response profile, living for less than 11 years with visual impairment and PA levels deserves further investigations Findings of the present study provide reliable data to support rehabilitation programs, observing the need of taking special attention to the subgroups that are even more likely to be inactive.

An evaluation of serum soluble CD30 levels and serum CD26 (DPPIV) enzyme activity as markers of type 2 and type 1 cytokines in HIV patients receiving highly active antiretroviral therapy

PubMed Central

Keane, N M; Price, P; Lee, S; Stone, S F; French, M A

2001-01-01

This study evaluates serum CD26 (dipeptidyl peptidase IV, DPPIV) enzyme activity and serum levels of soluble CD30 as markers of T1 and T2 cytokine environments in HIV patients who achieved immune reconstitution after highly active antiretroviral therapy (HAART). Patients who had experienced inflammatory disease associated with pre-existent opportunistic infections after HAART (immune restoration diseases, IRD) were considered separately. Serum sCD30 levels and CD26 (DPPIV) enzyme activity were compared with IFN-γ production by PBMC cultured with cytomegalovirus (CMV) antigen in controls and patient groups. High sCD30 levels were associated with low IFN-γ production after antigenic stimulation in control subjects and, to a lesser extent, in immune reconstituted HIV patients. There was no association between serum CD26 (DPPIV) enzyme activity and IFN-γ production or sCD30 levels. Serum sCD30 levels and CD26 (DPPIV) enzyme activity were significantly increased in immune reconstituted patients with high HIV viral loads. Patients who had experienced CMV retinitis as an IRD had significantly higher sCD30 levels than all other patient groups. Hence, high sCD30 levels may be a marker of a T2 cytokine environment in HIV patients with immune reconstitution and are associated with higher HIV viral loads and a history of CMV associated IRD. PMID:11678906

Alcohol Attenuates Load-related Activation During a Working Memory Task: Relation to Level of Response to Alcohol

PubMed Central

Paulus, Martin P.; Tapert, Susan F.; Pulido, Carmen; Schuckit, Marc A.

2008-01-01

Background A low level of response to alcohol is a major risk factor for the development of alcohol dependence, but neural correlates of this marker are unclear. Method Ten healthy volunteers were classified by median split on level of response to alcohol and underwent 2 sessions of functional magnetic resonance imaging following ingestion of a moderate dose of alcohol and a placebo. The blood oxygen level–dependent activation to an event-related visual working memory test was examined. Results The subjects exhibited longer response latencies and more errors as a function of increasing working memory load and showed a load-dependent increase in activation in dorsolateral prefrontal cortex, posterior parietal cortex, and visual cortex. Alcohol did not affect performance (errors or response latency), but attenuated the working memory load–dependent activation in the dorsolateral prefrontal cortex. During the placebo condition, individuals with a low level of response to alcohol showed greater activation in dorsolateral prefrontal cortex and posterior parietal cortex than those with a high level of response to alcohol. During the alcohol condition, groups showed similar attenuation of load-dependent brain activation in these regions. Conclusion Low-level responders relative to high-level responders exhibited an increased working memory load–dependent activation in dorsolateral prefrontal cortex and posterior parietal cortex when not exposed to alcohol. This increase in brain response was attenuated in low-level responders after ingesting a moderate dose of alcohol. PMID:16899039

White blood cell counts mediate the effects of physical activity on prostate-specific antigen levels.

PubMed

Loprinzi, Paul D; Richart, Sarah M

2014-09-01

The purpose of this study was to examine whether white blood cell (WBC) level mediated the relationship between physical activity and prostate-specific antigen (PSA) levels. Data from the 2003-2006 National Health and Nutrition Examination Survey were used; 1,726 U.S. adult men (aged 40 years or older) provided complete data on the study variables. Participants wore an ActiGraph 7164 accelerometer for a 7-day period to measure their physical activity behavior, and PSA and WBC levels were obtained from a blood sample. After adjustments, results showed that moderate-to-vigorous physical activity (MVPA) was inversely associated with WBC count (b = - .03; 95% CI [ - 0.04, - 0.006; p = .01), and WBC count (b = .10; 95% CI [0.009, 0.18; p = .04) was positively associated with PSA. Both the Sobel (coef. = - .004, SE = .002; z = - 2.0; p = .03) and the Aroian (coef. = - .004, SE = .002; z = - 1.9; p = .03) tests demonstrated that WBC mediated the relationship between physical activity and PSA. Additionally, among 107 participants with prostate cancer, survivors engaging in more MVPA had lower levels of WBC (b = - .04; 95% CI [ - 0.09, - 0.0009; p = .04). Conclusion Physical activity may influence PSA levels through WBC modulation; however, future research is needed to determine the direction of causality. Additionally, prostate cancer survivors engaging in higher levels of MVPA had lower levels of WBC, underscoring the importance of promoting physical activity among prostate cancer survivors.

Salivary Platelet Activating Factor Levels in Periodontal Disease

DTIC Science & Technology

1991-05-01

Factor Levels in Periodontal Disease 6. AUTHOR(S) Martha L. Garito, Major 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATO;N...ABSTRACT 98 0801 SALIVARY PLATELET ACTIVATING FACTOR LEVELS IN PERIODONTAL DISEASE A THESIS Presented to the Faculty of The University of Texas Graduate...B.S., D.M.D. San Antonio, Texas May 1991 SALIVARY PLATELET ACTIVATING FACTOR LEVELS IN PERIODONTAL DISEASE Martha Laura Gar’to APPROVED: - Supervising

RAVEN Quality Assurance Activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cogliati, Joshua Joseph

2015-09-01

This report discusses the quality assurance activities needed to raise the Quality Level of Risk Analysis in a Virtual Environment (RAVEN) from Quality Level 3 to Quality Level 2. This report also describes the general RAVEN quality assurance activities. For improving the quality, reviews of code changes have been instituted, more parts of testing have been automated, and improved packaging has been created. For upgrading the quality level, requirements have been created and the workflow has been improved.

Oxidative stress markers in aqueous humor of patients with senile cataracts.

PubMed

Sawada, Hideko; Fukuchi, Takeo; Abe, Haruki

2009-01-01

To investigate the levels of oxidative stress markers in human eyes with senile cataracts. We conducted a retrospective, case-controlled study of 57 patients with senile cataracts. To assess oxidative stress markers in the eye, we measured the enzymatic activities of superoxide dismutase (SOD) and catalase (CAT) as well as the total protein levels in aqueous humor. In aqueous humor, SOD and CAT activity levels were 0.133 +/- 0.020 and 1.223 +/- 0.081 U/ml, respectively; protein levels were 2.372 +/- 0.166 mg/ml (means +/- SEM). We observed a significant increase in SOD activity and the protein level in progressed nuclear cataracts. No significant age-associated difference in antioxidant enzyme levels was detected. Significant increases in the levels of SOD activity and total protein correlated with the severity of the cataract but not with patient age, suggesting that progressed cataract is associated with molecules leaking from the lens capsule.

Relationship between observational learning and health belief with physical activity among adolescents girl in Isfahan, Iran.

PubMed

Rostamian, Marzieh; Kazemi, Ashraf

2016-01-01

Physical activities among adolescents affects health during pubescence and adolescence and decrease in physical activities among adolescents has become a global challenge. The aim of the present study was to define the relation between the level of physical activity among adolescent girls and their health beliefs as personal factor and level of observational learning as environmental factor. The present study was a cross-sectional study that was conducted on 400 students aged from 11 to 19 years in Isfahan, Iran. Information regarding the duration of physical activity with moderate/severe intensity was measured in four dimensions of leisure time (exercising and hiking), daily activities, and transportation-related activities using the International Physical Activity questionnaire. Health belief structures included perceived sensitivity, intensity of perceived threat, perceived benefits, and barriers and self-efficacy; observational learning was measured using a researcher-made questionnaire. Results showed that perceived barriers, observational learning, and level of self-efficacy were related to the level of physical activity in all dimensions. In addition, the level of physical activity at leisure time, transportation, and total physical activity were dependent on the intensity of perceived threats ( P < 0.05). This study showed that the intensity of perceived threats, perceived barriers and self-efficacy structures, and observational learning are some of the factors related to physical activity among adolescent girls, and it is possible that by focusing on improving these variables through interventional programs physical activity among adolescent girls can be improved.

Serum decoy receptor 3 levels are associated with the disease activity of MPO-ANCA-associated renal vasculitis.

PubMed

Maruyama, Hiroshi; Hirayama, Kouichi; Nagai, Miho; Ebihara, Itaru; Shimohata, Homare; Kobayashi, Masaki

2016-10-01

Type 17 T-helper (Th17) cells have been suggested to be involved in the pathogenesis of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Th17 cell proliferation is promoted by tumor necrosis factor (TNF)-like ligand 1A (TL1A), which binds to death receptor 3 (DR3) expressed on Th17 cells. Decoy receptor 3 (DcR3) is known to block the TL1A-DR3 pathway by binding TL1A. To evaluate the Th17-TL1A systems as disease activity markers in AAV, we investigated the serum levels of TL1A and DcR3 in AAV patients. Serum IL-17, IL-23, TL1A, and DcR3 were measured by ELISA in 24 AAV patients with microscopic polyangiitis before the initial treatment, 24 AAV patients during remission, and 20 control subjects. There were no significant differences in serum IL-17, IL-23, and TL1A levels among the active-vasculitis patients, inactive-vasculitis patients, and controls. The mean serum DcR3 level was significantly higher in the active-vasculitis patients than in the inactive-vasculitis patients and controls (P < 0.0001, respectively). There were significant positive correlations between the serum DcR3 levels and Birmingham Vasculitis Activity Score (BVAS), myeloperoxidase (MPO)-ANCA titers, white blood cell counts, serum creatinine levels, and serum C-reactive protein levels. In a multiple regression analysis, there was a significant positive correlation between the serum DcR3 level and BVAS (β = 0.650, P = 0.0462). The mean BVAS level was significantly higher in the active-vasculitis patients with high serum DcR3 levels than in those with the low serum DcR3 levels (P = 0.0202). The serum level of DcR3 may be a useful marker for disease activity in AAV.

Physical activity levels of older adults receiving a home care service.

PubMed

Burton, Elissa; Lewin, Gill; Boldy, Duncan

2013-04-01

The 3 study objectives were to compare the activity levels of older people who had received a restorative home care service with those of people who had received "usual" home care, explore the predictors of physical activity in these 2 groups, and determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1,490 clients who had been referred for a home care service between 2006 and 2009. Older people who had received a restorative care service were more active than those who had received usual care (p = .049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression, were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.

Fitness levels and physical activity among class A drug users entering prison.

PubMed

Fischer, Jan; Butt, Christine; Dawes, Helen; Foster, Charlie; Neale, Joanne; Plugge, Emma; Wheeler, Carly; Wright, Nat

2012-12-01

Physical activity could benefit drug users' physiological and mental health. Previous research has suggested that physical activity levels change when drug users enter prison. Twenty-five class A drug users who were new to prison answered physical activity and drug use cross-sectional questionnaires, took a submaximal fitness test and wore a pedometer for 1 week. Participants' mean aerobic capacity was estimated as 49 mls O2/kg/min (±12 SD). Their mean self-reported walking distance outside of prison was 4.67 miles on an average day (±4.14 SD). Pedometer data suggest they walked a mean of 1.8 miles/day in prison. Many class A drug users entering prison had high levels of fitness and physical activity before admission, often gained from walking. Walking activity reduced when they entered prison, posing a challenge to maintaining healthy activity levels.

Self-efficacy and physical activity in adolescent and parent dyads.

PubMed

Rutkowski, Elaine M; Connelly, Cynthia D

2012-01-01

The study examined the relationships between self-efficacy and physical activity in adolescent and parent dyads. A cross-sectional, correlational design was used to explore the relationships among levels of parent physical activity, parent-adolescent self-efficacy, and adolescent physical activity. Descriptive and multivariate regression analyses were conducted in a purposive sample of 94 adolescent/parent dyads. Regression results indicated the overall model significantly predicted adolescent physical activity (R(2) = .20, R(2)(adj) = .14, F[5, 70]= 3.28, p= .01). Only one of the five predictor variables significantly contributed to the model. Higher levels of adolescent self-efficacy was positively related to greater levels of adolescent physical activity (β= .29, p= .01). Practitioners are encouraged to examine the level of self-efficacy and physical activity in families in an effort to develop strategies that impact these areas and ultimately to mediate obesity-related challenges in families seeking care. © 2011, Wiley Periodicals, Inc.

The contribution of former work-related activity levels to predict physical activity and sedentary time during early retirement: moderating role of educational level and physical functioning.

PubMed

Van Dyck, Delfien; Cardon, Greet; Deforche, Benedicte; De Bourdeaudhuij, Ilse

2015-01-01

The transition to retirement introduces a decline in total physical activity and an increase in TV viewing time. Nonetheless, as more time becomes available, early retirement is an ideal stage to implement health interventions. Therefore, knowledge on specific determinants of physical activity and sedentary time is needed. Former work-related physical activity has been proposed as a potential determinant, but concrete evidence is lacking. The aim of this study was to examine if former work-related sitting, standing, walking or vigorous activities predict physical activity and sedentary time during early retirement. Additionally, moderating effects of educational level and physical functioning were examined. In total, 392 recently retired Belgian adults (>6 months, <5 years) completed the International Physical Activity Questionnaire, the SF-36 Health Survey and a questionnaire on sociodemographics and former work-related activities. Generalized linear regression analyses were conducted in R. Moderating effects were examined by adding cross-products to the models. More former work-related sitting was predictive of more screen time during retirement. Lower levels of former work-related vigorous activities and higher levels of former work-related walking were associated with respectively more cycling for transport and more walking for transport during retirement. None of the predictors significantly explained passive transportation, cycling and walking for recreation, and leisure-time moderate-to-vigorous physical activity during retirement. Several moderating effects were found, but the direction of the interactions was not univocal. Former-work related behaviors are of limited importance to explain physical activity during early retirement, so future studies should focus on other individual, social and environmental determinants. Nonetheless, adults who previously had a sedentary job had higher levels of screen time during retirement, so this is an important subgroup to focus on during interventions. Because of the inconsistent moderating effects of educational level and physical functioning, no clear recommendations can be formulated.

The Contribution of Former Work-Related Activity Levels to Predict Physical Activity and Sedentary Time during Early Retirement: Moderating Role of Educational Level and Physical Functioning

PubMed Central

Van Dyck, Delfien; Cardon, Greet; Deforche, Benedicte; De Bourdeaudhuij, Ilse

2015-01-01

Background The transition to retirement introduces a decline in total physical activity and an increase in TV viewing time. Nonetheless, as more time becomes available, early retirement is an ideal stage to implement health interventions. Therefore, knowledge on specific determinants of physical activity and sedentary time is needed. Former work-related physical activity has been proposed as a potential determinant, but concrete evidence is lacking. The aim of this study was to examine if former work-related sitting, standing, walking or vigorous activities predict physical activity and sedentary time during early retirement. Additionally, moderating effects of educational level and physical functioning were examined. Methods In total, 392 recently retired Belgian adults (>6 months, <5 years) completed the International Physical Activity Questionnaire, the SF-36 Health Survey and a questionnaire on sociodemographics and former work-related activities. Generalized linear regression analyses were conducted in R. Moderating effects were examined by adding cross-products to the models. Results More former work-related sitting was predictive of more screen time during retirement. Lower levels of former work-related vigorous activities and higher levels of former work-related walking were associated with respectively more cycling for transport and more walking for transport during retirement. None of the predictors significantly explained passive transportation, cycling and walking for recreation, and leisure-time moderate-to-vigorous physical activity during retirement. Several moderating effects were found, but the direction of the interactions was not univocal. Conclusions Former-work related behaviors are of limited importance to explain physical activity during early retirement, so future studies should focus on other individual, social and environmental determinants. Nonetheless, adults who previously had a sedentary job had higher levels of screen time during retirement, so this is an important subgroup to focus on during interventions. Because of the inconsistent moderating effects of educational level and physical functioning, no clear recommendations can be formulated. PMID:25826218

Promoting physical activity at the pre-school playground: the effects of providing markings and play equipment.

PubMed

Cardon, Greet; Labarque, Valery; Smits, Dirk; De Bourdeaudhuij, Ilse

2009-04-01

We aimed to investigate the effects of providing play equipment and markings at the pre-school playground on physical activity engagement levels. We performed a cluster randomised control trial. In November and December 2007, a convenience sample of 40 public pre-schools in Flanders, Belgium, was randomly assigned to one of the following conditions: 1) in 10 pre-schools play equipment was provided, 2) in 10 pre-schools markings were painted on the playground, 3) in 10 schools play equipment was provided and markings were painted, 4) 10 schools served as a control condition. Accelerometer-based physical activity levels during recess were evaluated at baseline and 4 to 6 weeks after the implementation of the intervention in 583 children (52% boys; mean age 5.3 years, SD 0.4). At baseline pre-schoolers spent only 11.2% (average: 4.7 min) of recess time in moderate to vigorous activity, while 61.3% (average: 25.7 min) was spent in sedentary activity. The interventions were not effective in increasing the average activity levels or the percentages of engagement in moderate or vigorous activity, or in decreasing sedentary time. Providing playground markings or play equipment is not sufficient to increase activity levels and decrease levels of sedentary activity during pre-school recess. More activating supervision and the inclusion of more structured physical activity seem needed.

Compendium of Interdisciplinary Activities for an Introductory Course in Communication Systems at the Secondary Level.

ERIC Educational Resources Information Center

Lasko, David J.

This compendium of interdisciplinary learning activities is designed to assist technology education instructors who are conducting an introductory secondary-level course in communication technology. The 12 activities, which are sequenced from introductory, low-cost activities to more advanced and more involved activities, deal with the following…

Effect of Learning Activity on Students' Motivation, Physical Activity Levels and Effort/Persistence

ERIC Educational Resources Information Center

Gao, Zan; Lee, Amelia M.; Xiang, Ping; Kosma, Maria

2011-01-01

The type of learning activity offered in physical education may influence students' motivational beliefs, physical activity participation and effort/persistence in class. However, most empirical studies have focused on the individual level rather than on the learner-content interactions. Accordingly, the potential effects of learning activities on…

Serum Levels of Soluble CD26/Dipeptidyl Peptidase-IV in Type 2 Diabetes Mellitus and Its Association with Metabolic Syndrome and Therapy with Antidiabetic Agents in Malaysian Subjects.

PubMed

Ahmed, Radwan H; Huri, Hasniza Zaman; Al-Hamodi, Zaid; Salem, Sameer D; Muniandy, Sekaran

2015-01-01

A soluble form of CD26/dipeptidyl peptidase-IV (sCD26/DPP-IV) induces DPP-IV enzymatic activity that degrades incretin. We investigated fasting serum levels of sCD26/DPP-IV and active glucagon-like peptide-1 (GLP-1) in Malaysian patients with type 2 diabetes mellitus (T2DM) with and without metabolic syndrome (MetS), as well as the associations between sCD26/DPP-IV levels, MetS, and antidiabetic therapy. We assessed sCD26/DPP-IV levels, active GLP-1 levels, body mass index (BMI), glucose, insulin, A1c, glucose homeostasis indices, and lipid profiles in 549 Malaysian subjects (including 257 T2DM patients with MetS, 57 T2DM patients without MetS, 71 non-diabetics with MetS, and 164 control subjects without diabetes or metabolic syndrome). Fasting serum levels of sCD26/DPP-IV were significantly higher in T2DM patients with and without MetS than in normal subjects. Likewise, sCD26/DPP-IV levels were significantly higher in patients with T2DM and MetS than in non-diabetic patients with MetS. However, active GLP-1 levels were significantly lower in T2DM patients both with and without MetS than in normal subjects. In T2DM subjects, sCD26/DPP-IV levels were associated with significantly higher A1c levels, but were significantly lower in patients using monotherapy with metformin. In addition, no significant differences in sCD26/DPP-IV levels were found between diabetic subjects with and without MetS. Furthermore, sCD26/DPP-IV levels were negatively correlated with active GLP-1 levels in T2DM patients both with and without MetS. In normal subjects, sCD26/DPP-IV levels were associated with increased BMI, cholesterol, and LDL-cholesterol (LDL-c) levels. Serum sCD26/DPP-IV levels increased in T2DM subjects with and without MetS. Active GLP-1 levels decreased in T2DM patients both with and without MetS. In addition, sCD26/DPP-IV levels were associated with Alc levels and negatively correlated with active GLP-1 levels. Moreover, metformin monotherapy was associated with reduced sCD26/DPP-IV levels. In normal subjects, sCD26/DPP-IV levels were associated with increased BMI, cholesterol, and LDL-c.

Cancer-related fatigue and physical activity among premenopausal cervical and endometrial cancer survivors in Japan.

PubMed

Obama, Kyoko; Maru, Mitsue; Maeda, Rumi; Kubota, Toshiro

2015-09-30

To examine the relationship between cancer-related fatigue (CRF) and physical activity in daily living in premenopausal disease-free cervical and endometrial cancer survivors. A physical activity monitor was used to collect objective data on daily physical activity. CRF and related variables were measured using self-report scales in a cross-sectional manner. The average age was 44.9 years among 64 women. The higher CRF group comprised 22 women (34%), 10% of whom had severe fatigue. The participants had higher physical activity levels compared with the findings in previous studies, and reported an average of 40 min/day of moderate to vigorous activity. Moderate to vigorous levels of physical activity were derived from essential social activities rather than leisure time exercise. There were no significant differences in physical activity levels between the lower and higher CRF groups. Our study results suggested that the higher level of physical activity in daily living itself had no relationship with decreasing CRF among premenopausal cervical and endometrial cancer survivors. It would be better to focus on cognitive and psychological factors before introducing physical activity programs and be careful of the characteristics of the participants' physical activity among this population in daily basis.

Tests for the measurement of factor VII-activating protease (FSAP) activity and antigen levels in citrated plasma, their correlation to PCR testing, and utility for the detection of the Marburg I-polymorphism of FSAP.

PubMed

Stephan, Sina; Schwarz, Herbert; Borchert, Anja; Bussfeld, Delia; Quak, Elfriede; Simshaeuser-Knaub, Beate; Teigelkamp, Stefan; Behrens, Fritz; Vitzthum, Frank

2008-01-01

The single nucleotide Marburg I (MRI) polymorphism of the factor VII-activating protease (FSAP) gene, the prourokinase-activating activity of FSAP, and antigen levels of FSAP in plasma have been associated with incidence and progression of carotid stenosis and venous thromboembolism. However, more information on the extent of these associations, potential further ones, and respective clinical utilities remain to be determined. At present, testing is performed mainly by PCR assays based on probes or SYBR Green I. Some studies include testing for antigen levels of total FSAP and its ability to activate prourokinase. To test large cohorts, it is beneficial to rely on assays that are cost-effective, reliable, easy to use, rapid to perform, and that may eventually be automated. In addition, it appears advantageous to use functional tests or tests that determine antigen levels as they may relate more closely to the phenotype than the genotype does. Tests for the measurements of antigen levels of FSAP and its prourokinase-activating activity were improved and performance characteristics assessed. To determine the FSAP genotypes, an amplification created restriction site (ACRS) PCR test was developed. Key performance characteristics of the FSAP activity and antigen tests were as follows: measuring range: 350-1400 mPEU/mL and 1.8-120 ng/mL, total coefficients of variation (CV): 5%-20% and 5%-14%, within-run CV: 4%-11% and 2.3%-12%, and run-to-run CV: 2%-17% and 4.3%-8.3%, respectively. The ratio of the activity and antigen level of FSAP correctly identified the FSAP genotypes of 126 samples tested. The ACRS PCR test is useful for laboratories that do not have the equipment to perform probe or SYBR Green I based real-time PCR. Furthermore, the tests developed for the determination of FSAP activity and antigen levels are convenient for determining clinical correlations, even for large population studies. The ratio of activity and antigen level of FSAP appears to be a promising and efficient alternative to molecular diagnostic techniques to detect the MRI polymorphism of FSAP.

Induction of antioxidant enzyme activity and lipid peroxidation level in ion-beam-bombarded rice seeds

NASA Astrophysics Data System (ADS)

Semsang, Nuananong; Yu, LiangDeng

2013-07-01

Low-energy ion beam bombardment has been used to mutate a wide variety of plant species. To explore the indirect effects of low-energy ion beam on biological damage due to the free radical production in plant cells, the increase in antioxidant enzyme activities and lipid peroxidation level was investigated in ion-bombarded rice seeds. Local rice seeds were bombarded with nitrogen or argon ion beams at energies of 29-60 keV and ion fluences of 1 × 1016 ions cm-2. The activities of the antioxidant enzymes; superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), dehydroascorbate reductase (DHAR), glutathione reductase (GR), glutathione S-transferase (GST) and lipid peroxidation level were assayed in the germinated rice seeds after ion bombardment. The results showed most of the enzyme activities and lipid peroxidation levels in both the argon and nitrogen bombarded samples were higher than those in the natural control. N-ion bombardment could induce higher levels of antioxidant enzyme activities in the rice samples than the Ar-ion bombardment. Additional effects due to the vacuum condition were found to affect activities of some antioxidant enzymes and lipid peroxidation level. This study demonstrates that ion beam bombardment and vacuum condition could induce the antioxidant enzyme activity and lipid peroxidation level which might be due to free radical production in the bombarded rice seeds.

Midlife Physical Activity and Mobility in Older Age

PubMed Central

Patel, Kushang V.; Coppin, Antonia K.; Manini, Todd M.; Lauretani, Fulvio; Bandinelli, Stefania; Ferrucci, Luigi; Guralnik, Jack M.

2009-01-01

Background Among older adults, loss of mobility represents a critical stage in the disablement process, whereby the risk for disability is significantly increased. Physical activity is a modifiable risk factor that is associated with reduced risk of losing mobility in older adulthood; however, few studies have examined physical activity performed earlier in life in relation to mobility later in life. Methods Data from a population-based study of 1155 adults aged 65 years and older living in the Chianti region of Italy in 1998–2000 were analyzed in 2005 and 2006. Participants retrospectively recalled their physical activity levels in midlife and underwent mobility testing and medical examination. Two objective mobility outcomes were examined as a function of past physical activity: the Short Physical Performance Battery (SPPB) and the ability to walk 400 meters. Results Older Italian adults (mean age 74.8, standard deviation 7.3) who engaged in higher levels of physical activity in midlife were significantly more likely to perform better on the SPPB than individuals who were less physically active in midlife. In addition, failure to complete the 400-meter walk test was significantly less likely among physically active men (Level II) (odds ratio [OR]=0.37, 95% confidence interval [CI]=0.15–0.93) and very active men (Level III) (OR=0.23, 95% CI=0.09–0.63) when compared to men who were less active (Level I) in the past (p for trend, 0.008). These associations remained after adjustment for demographic factors, medical conditions, and physiologic impairments. Conclusions Older adults who reported higher levels of physical activity in midlife had better mobility in old age than less physically active ones. PMID:16905032

Auto-induction for high level production of biologically active reteplase in Escherichia coli.

PubMed

Fathi-Roudsari, Mehrnoosh; Maghsoudi, Nader; Maghsoudi, Amirhossein; Niazi, Sepideh; Soleiman, Morvarid

2018-06-07

Reteplase is a third generation tissue plasminogen activator (tPA) with a modified structure and prolonged half-life in comparison to native tPA. As a non-glycosylated protein, reteplase is expressed in Escherichia coli. Due to presence of several disulfide bonds, high level production of reteplase is complicated and needs extra steps for conversion to biologically active form. Auto-induction represents a method for high-yield growth of bacterial cells and higher expression of recombinant proteins. Here we have tried to optimize the auto-induction procedure for soluble and active expression of reteplase in E. coli. Results showed that using auto-induction strategy at 37 °C, Rosetta-gami (DE3) had the highest level of active and soluble reteplase production in comparison to E. coli strains BL21 (DE3), and Shuffel T7. Temperature dominantly affected the level of active reteplase production. Decreasing the temperature to 25 and 18 °C increased the level of active reteplase by 20 and 60%, respectively. The composition of auto-induction medium also dramatically changed the active production of reteplase in cytoplasm. Using higher enriched auto-induction medium, super broth base including trace elements, significantly increased biologically active reteplase by 30%. It is demonstrated here that auto-induction is a powerful method for expression of biologically active reteplase in oxidative cytoplasm of Rosetta-gami. Optimizing expression condition by decreasing temperature and using an enriched auto-induction medium resulted in at least three times higher level of active reteplase production. Production of correctly folded and active reteplase in spite of its complex structure helps for removal of inefficient and cumbersome step of refolding. Copyright © 2018. Published by Elsevier Inc.

Time course of EEG background activity level before spontaneous awakening in infants.

PubMed

Zampi, Chiara; Fagioli, Igino; Salzarulo, Piero

2002-12-01

This research aimed to investigate the time course of the cortical activity level preceding spontaneous awakening as a function of age and state. Two groups of infants (1-4 and 9-14 weeks of age) were continuously monitored by polygraphic recording and behavioural observation during the night. The electroencephalographic (EEG) activity recorded by the C3-O1 lead was analysed through an automatic analysis method which provides, for each 30-s epoch, a single measure, time domain based, of the EEG synchronization. The EEG parameter values were computed in the 6 min preceding each awakening out of non-rapid eye movement (NREM) sleep and out of rapid eye movement (REM) sleep. The EEG background activity level did not change in the minutes preceding awakening out of REM sleep. Awakening out of NREM sleep was preceded by a change of EEG activity level in the direction of higher activation with different time course according to the age. Both REM and NREM sleep results suggest that a high level of EEG activity is a prerequisite for the occurrence of a spontaneous awakening.

Immunity to Escherichia coli in pigs: Serum Gamma Globulin Levels, Indirect Hemagglutinating Antibody Titres and Bactericidal Activity Against E. coli in pigs up to five Weeks of Age

PubMed Central

Wilson, M. R.; Svendsen, J.

1972-01-01

Serum gamma globulin levels, indirect hemagglutinating antibody titres and bactericidal activity against the 0149:K91;K88ac:H10 Serotype of Escherichia coli were determined in pigs up to five weeks of age from vaccinated and non-vaccinated sows. Gamma globulin levels at two days of age were approximately twice adult levels, by three weeks of age they were one quarter of adult levels and remained so until five weeks of age. Indirect hemagglutinating antibody activity was highest at two days of age, fell until three weeks of age and then rose. Little or no indirect hemagglutinating antibody activity was detected in sera taken at two days of age from pigs from non-vaccinated sows. Only three of 26 two day old pigs had demonstrable bactericidal activity; by three weeks of age 16 of 26 had bactericidal activity. Serum from piglets of vaccinated sows had no more bactericidal activity than did sera from non-vaccinated sows. PMID:4110608

Digital Daily Cycles of Individuals

NASA Astrophysics Data System (ADS)

Aledavood, Talayeh; Lehmann, Sune; Saramäki, Jari

2015-10-01

Humans, like almost all animals, are phase-locked to the diurnal cycle. Most of us sleep at night and are active through the day. Because we have evolved to function with this cycle, the circadian rhythm is deeply ingrained and even detectable at the biochemical level. However, within the broader day-night pattern, there are individual differences: e.g., some of us are intrinsically morning-active, while others prefer evenings. In this article, we look at digital daily cycles: circadian patterns of activity viewed through the lens of auto-recorded data of communication and online activity. We begin at the aggregate level, discuss earlier results, and illustrate differences between population-level daily rhythms in different media. Then we move on to the individual level, and show that there is a strong individual-level variation beyond averages: individuals typically have their distinctive daily pattern that persists in time. We conclude by discussing the driving forces behind these signature daily patterns, from personal traits (morningness/eveningness) to variation in activity level and external constraints, and outline possibilities for future research.

What do we mean by prediction in language comprehension?

PubMed Central

Kuperberg, Gina R.; Jaeger, T. Florian

2016-01-01

We consider several key aspects of prediction in language comprehension: its computational nature, the representational level(s) at which we predict, whether we use higher level representations to predictively pre-activate lower level representations, and whether we ‘commit’ in any way to our predictions, beyond pre-activation. We argue that the bulk of behavioral and neural evidence suggests that we predict probabilistically and at multiple levels and grains of representation. We also argue that we can, in principle, use higher level inferences to predictively pre-activate information at multiple lower representational levels. We also suggest that the degree and level of predictive pre-activation might be a function of the expected utility of prediction, which, in turn, may depend on comprehenders’ goals and their estimates of the relative reliability of their prior knowledge and the bottom-up input. Finally, we argue that all these properties of language understanding can be naturally explained and productively explored within a multi-representational hierarchical actively generative architecture whose goal is to infer the message intended by the producer, and in which predictions play a crucial role in explaining the bottom-up input. PMID:27135040

Acoustical conditions for speech communication in active elementary school classrooms

NASA Astrophysics Data System (ADS)

Sato, Hiroshi; Bradley, John

2005-04-01

Detailed acoustical measurements were made in 34 active elementary school classrooms with typical rectangular room shape in schools near Ottawa, Canada. There was an average of 21 students in classrooms. The measurements were made to obtain accurate indications of the acoustical quality of conditions for speech communication during actual teaching activities. Mean speech and noise levels were determined from the distribution of recorded sound levels and the average speech-to-noise ratio was 11 dBA. Measured mid-frequency reverberation times (RT) during the same occupied conditions varied from 0.3 to 0.6 s, and were a little less than for the unoccupied rooms. RT values were not related to noise levels. Octave band speech and noise levels, useful-to-detrimental ratios, and Speech Transmission Index values were also determined. Key results included: (1) The average vocal effort of teachers corresponded to louder than Pearsons Raised voice level; (2) teachers increase their voice level to overcome ambient noise; (3) effective speech levels can be enhanced by up to 5 dB by early reflection energy; and (4) student activity is seen to be the dominant noise source, increasing average noise levels by up to 10 dBA during teaching activities. [Work supported by CLLRnet.

Expression levels of chaperones influence biotransformation activity of recombinant Escherichia coli expressing Micrococcus luteus alcohol dehydrogenase and Pseudomonas putida Baeyer-Villiger monooxygenase.

PubMed

Baek, A-Hyong; Jeon, Eun-Yeong; Lee, Sun-Mee; Park, Jin-Byung

2015-05-01

We demonstrated for the first time that the archaeal chaperones (i.e., γ-prefoldin and thermosome) can stabilize enzyme activity in vivo. Ricinoleic acid biotransformation activity of recombinant Escherichia coli expressing Micrococcus luteus alcohol dehydrogenase and the Pseudomonas putida KT2440 Baeyer-Villiger monooxygenase improved significantly with co-expression of γ-prefoldin or recombinant themosome originating from the deep-sea hyperthermophile archaea Methanocaldococcus jannaschii. Furthermore, the degree of enhanced activity was dependent on the expression levels of the chaperones. For example, whole-cell biotransformation activity was highest at 12 µmol/g dry cells/min when γ-prefoldin expression level was approximately 46% of the theoretical maximum. This value was approximately two-fold greater than that in E. coli, where the γ-prefoldin expression level was zero or set to the theoretical maximum. Therefore, it was assumed that the expression levels of chaperones must be optimized to achieve maximum biotransformation activity in whole-cell biocatalysts. © 2014 Wiley Periodicals, Inc.

Depletion of GGA3 stabilizes BACE and enhances β-secretase activity

PubMed Central

Tesco, Giuseppina; Koh, Young Ho; Kang, Eugene; Cameron, Andrew; Das, Shinjita; Sena-Esteves, Miguel; Hiltunen, Mikko; Yang, Shao-Hua; Zhong, Zhenyu; Shen, Yong; Simpkins, James; Tanzi, Rudolph E.

2007-01-01

Summary Beta-site APP-cleaving enzyme (BACE) is required for production of the Alzheimer's disease (AD)-associated Aβ protein. BACE levels are elevated in AD brain, and increasing evidence reveals BACE as a stress-related protease that is upregulated following cerebral ischemia. However, the molecular mechanism responsible is unknown. We show that increases in BACE and β-secretase activity are due to post-translational stabilization following caspase activation. We also found that during cerebral ischemia, levels of GGA3, an adaptor protein involved in BACE trafficking, are reduced, while BACE levels are increased. RNAi silencing of GGA3 also elevated levels of BACE and Aβ. Finally, in AD brain samples, GGA3 protein levels were significantly decreased and inversely correlated with increased levels of BACE. In summary, we have elucidated a novel GGA3-dependent mechanism regulating BACE levels and β-secretase activity. This mechanism may explain increased cerebral levels of BACE and Aβ following cerebral ischemia and in AD. PMID:17553422

Increasing physical activity, but persisting social gaps among middle-aged people: trends in Northern Sweden from 1990 to 2007.

PubMed

Ng, Nawi; Söderman, Kerstin; Norberg, Margareta; Öhman, Ann

2011-01-01

Physical activity is identified as one important protective factor for chronic diseases. Physical activity surveillance is important in assessing healthy population behaviour over time. Many countries lack population trends on physical activity. To present trends in physical activity levels in Västerbotten County, Sweden and to evaluate physical activity among women and men with various educational levels. Population-based cross-sectional and panel data from the Västerbotten Intervention Programme (VIP) during 1990-2007 were used. All individuals in Västerbotten County who turned 40, 50, or 60 years old were invited to their local primary health care for a health screening. Physical activity during commuting, recreational activities, physical exercise, and socio-demographic data were collected using a self-administered questionnaire. Respondents were categorised as sedentary, moderate physically active, or physically active. The prevalences of physically active behaviours increased from 16 to 24.2% among men and from 12.6 to 30.4% among women. Increases are observed in all educational groups, but gaps between educational groups widened recently. The level of sedentary behaviour was stable over the time period studied. The 10-year follow-up data show that the prevalences of physically active behaviours increased from 15.8 to 21.4% among men and 12.7 to 23.3% among women. However, 10.2% of men and 3.8% of women remained sedentary. Despite the promising evidence of increasing physical activity levels among the population in Västerbotten County, challenges remain for how to reduce the stable levels of sedentary behaviours in some subgroups. Persisting social gaps in physical activity levels should be addressed further. An exploration of people's views on engaging in physical activity and barriers to doing so will allow better formulation of targeted interventions within this population. Global Health Action 2011. © 2011 N. Ng et al.

Association of baseline level of physical activity and its temporal changes with incident hypertension and diabetes mellitus.

PubMed

Lee, Jong-Young; Ryu, Seungho; Sung, Ki-Chul

2018-01-01

Background The association between baseline and temporal changes in physical activity and incident hypertension or diabetes mellitus in initially non-hypertensive or non-diabetic subjects is rarely known. Methods Among individuals who underwent consecutive comprehensive health screenings, their physical activity level was measured using a self-reported international physical activity questionnaire. First, subjects were classified into four categories: no regular physical activity with a sedentary lifestyle; minimal physical activity (<75 min/week); insufficient physical activity (≥75 min but <150 min/week); and sufficient physical activity (≥150 min/week). Second, subjects were sub-grouped, based on temporal changes in physical activity level between baseline and consecutive follow-up: increase, no change, and decrease. Results Finally, among 174,314 subjects (mean age 36.7 ± 6.9 years), 5544 (3.18%) and 21,276 (12.2%) developed incident diabetes mellitus and arterial hypertension, respectively. After a multivariate adjustment, sufficient baseline physical activity was associated with significantly lower risk for incident hypertension (hazard ratio 0.89; 95% confidence interval (CI) 0.81 to 0.97), but the difference was not significant, and showed a lower trend in diabetes mellitus incidence (hazard ratio 0.87; 95% CI 0.69 to 1.04) in reference to no regular physical activity group. Regardless of the baseline physical activity level, subjects with a temporal increase in physical activity showed significantly decreased risk for incident hypertension (hazard ratio 0.93; 95% CI 0.87 to 0.99) and diabetes mellitus (hazard ratio 0.83; 95% CI 0.74 to 0.92) compared with those with a temporal decrease in their physical activity level. Conclusion Both sufficient baseline physical activity level and its temporal increase were associated with a lower risk of incident hypertension and diabetes mellitus in a large, relatively healthy, cohort.

Differences in Physical Activity Levels between Urban and Rural School Children in Cyprus

ERIC Educational Resources Information Center

Loucaides, Constantinos A.; Chedzoy, Sue M.; Bennett, Neville

2004-01-01

This study attempted to examine differences in physical activity levels between urban and rural primary school children. The sample consisted of 256 Greek-Cypriot children and their parents from two schools representing urban areas and three schools representing rural areas. Children's activity levels were assessed for 4 weekdays in the winter and…

Aerobic Physical Activity and the Leadership of Principals

ERIC Educational Resources Information Center

Kiser, Kari

2016-01-01

The purpose of this study was to explore if there was a connection between regular aerobic physical activity and the stress and energy levels of principals as they reported it. To begin the research, the current aerobic physical activity level of principals was discovered. Additionally, the energy and stress levels of the principals who do engage…

Levels of Engagement and Barriers to Physical Activity in a Population of Adults with Learning Disabilities

ERIC Educational Resources Information Center

Hawkins, Andrew; Look, Roger

2006-01-01

This study examined levels of, and barriers to, physical activity in a population of 19 adults with learning disabilities living in community supported accommodation, using diary records and semi-structured interviews with staff. The levels of physical activity were higher in the sample population than previous figures for adults with learning…

Men on the Move: A Pilot Program to Increase Physical Activity among African American Men

ERIC Educational Resources Information Center

Griffith, Derek M.; Allen, Julie Ober; Johnson-Lawrence, Vicki; Langford, Aisha

2014-01-01

Despite the important contribution increasing physical activity levels may play in reducing chronic disease morbidity and mortality, there is a paucity of interventions and research indicating how to improve physical activity levels in African American men. "Men on the Move" was a pilot study to increase African American men's levels of…

Variation in the activities of late stage filaggrin processing enzymes, calpain-1 and bleomycin hydrolase, together with pyrrolidone carboxylic acid levels, corneocyte phenotypes and plasmin activities in non-sun-exposed and sun-exposed facial stratum corneum of different ethnicities.

PubMed

Raj, N; Voegeli, R; Rawlings, A V; Summers, B; Munday, M R; Lane, M E

2016-12-01

Knowledge of the ethnic differences and effects of photodamage on the relative amounts of natural moisturizing factor (NMF) together with filaggrin processing enzymes in facial stratum corneum is limited. Our aim was to characterize the activities of calpain-1 (C-1), bleomycin hydrolase (BH) and the levels of pyrrolidone carboxylic acid (PCA) as a marker for total NMF levels and to relate them to plasmin activities and corneocyte maturation. Enzyme activities, PCA levels and corneocyte maturation were determined from facial tape strippings of photoexposed cheek and photoprotected post-auricular areas (PA) of healthy Caucasian (C), Black African (BA) and albino African (AA) female subjects living in South Africa. PCA concentration levels were of the order AA > BA > C subjects, and the highest activities of BH were present in the AA subjects. BH activities were greater on the photoexposed sites for the BA and C subjects, but they were only numerically elevated in the AA subjects. Photoprotected sites had an increase in C-1 activity in pigmented groups (C and BA), whereas in the AA subjects, the opposite was measured. Plasmin activities were greater on the cheek compared with the PA site for the AA and C subjects, but the activity was low in the BA subjects. In both test sites, the AA, but not the BA and C subjects, had smaller, parakeratotic and less mature corneocytes. Variation in PCA levels has been found for different ethnic groups in this study (AA > BA > C subjects). The values in the AA subjects are surprising as one might expect that the lack of pigmentation, and thereby increased photodamage, might lead to lower levels. Increased BH, but not C-1 activity, was observed in the AA subjects indicating that BH is associated with PCA production to a greater extent. Surprisingly, corneocyte maturation is still impaired with elevated PCA levels in AA subjects. The higher levels of plasmin and BH activities on the cheeks, especially for AA and C subjects, suggest that they can be used as markers for epidermal photodamage. © 2016 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

A school-level analysis of adolescent extracurricular activity, delinquency, and depression: the importance of situational context.

PubMed

Guest, Andrew M; McRee, Nick

2009-01-01

In this article we investigate the extent to which the relationship between extracurricular activities and youth development depends on situational contexts. Using a national sample including 13,466 youths in grades 7-12 across 120 schools, we conduct school-level analyses of the association between extracurricular activities, delinquency, and depression. Three main findings are reported. First, we observe near-normal distributions across schools in the proportions of delinquent or depressed youths involved in extracurricular activities, illustrating that extracurricular activities can be positive, neutral, or negative settings for youth development. Second, within individual schools we fail to uncover consistent associations in the propensity of delinquent or depressed youth to be involved with different types of extracurricular activities. Third, standard macro-level context variables do not explain the observed variations within or between schools. The results suggest that the relationships between extracurricular activities, delinquent conduct and depressive symptoms among youth ultimately depend more upon micro-level contextual factors than the type or content of the activities themselves.

Neuropeptide Levels as well as Neprilysin Activity Decrease in Renal Cell Carcinoma.

PubMed

Erin, Nuray; İpekçi, Tümay; Akkaya, Bahar; Özbudak, İrem Hicran; Baykara, Mehmet

2016-12-01

Calcitonin Gene-related Peptide (CGRP), Vasoactive Intestinal Peptide (VIP) and Substance P (SP) are sensory neuropeptides which may alter cancer growth through modulation of chronic inflammation. We recently reported that SP suppresses breast cancer growth and metastasis through neuroimmune modulation. These neuropeptides are hydrolyzed by Neprilysin (NEP) to bioactive fragments. Decreased activity of NEP was reported in clear cell and chromophobe type renal cell carcinoma (RCC). It is however not known how the levels of neuropeptides hydrolyzed with NEP changes in RCC. Decrease activity of SP and CGRP containing sensory nerve endings was previously reported to increase cancer metastasis in animal models. It is however not known how peptidergic nerve endings are altered in RCC. Hence we here evaluated the levels of neuronal and non-neuronal neuropeptides and NEP activity in RCC including papillary type as well as neighboring uninvolved kidney. A cross-sectional study was conducted in 57 patients undergoing radical nephrectomy and diagnosed with RCC. NEP activity, levels and expression were determined using flourogenic substrate, western blot and qPCR respectively in freshly-frozen tissues. Immunohistochemical analyses were also performed. Neuronal and non-neuronal levels of CGRP, SP and VIP levels were determined using two-step acetic acid extraction. Levels and activity of NEP were markedly decreased in RCC regardless of subtype. Similar levels of VIP were detected in first and second extractions. VIP levels were higher in clear cell and papillary RCC compared to nearby kidney tissue. VIP levels of neighboring kidney tissue of papillary type RCC was significantly lower compared to kidney samples from clear cell RCC. CGRP levels were higher in second extraction. Similar to VIP levels, CGRP levels of neighboring kidney tissue from clear cell and chromophobe type RCC was significantly lower compared to corresponding tumor samples, an effect observed in the second extraction. VIP and CGRP levels of nearby kidney tissue varied subtype dependently demonstrating that different subtypes of RCC alter their local environment differently. Furthermore NEP-induce hydrolysis of VIP creates selective VPAC-1 receptor agonist which has anti-proliferative and anti-inflammatory effects. Hence loss of NEP activity may prevent anti-tumoral effects of VIP on RCC.

Exercise, nutrition, and homocysteine.

PubMed

Joubert, Lanae M; Manore, Melinda M

2006-08-01

Homocysteine is an independent cardiovascular disease (CVD) risk factor modifiable by nutrition and possibly exercise. While individuals participating in regular physical activity can modify CVD risk factors, such as total blood cholesterol levels, the impact physical activity has on blood homocysteine concentrations is unclear. This review examines the influence of nutrition and exercise on blood homocysteine levels, the mechanisms of how physical activity may alter homocysteine levels, the role of homocysteine in CVD, evidence to support homocysteine as an independent risk factor for CVD, mechanisms of how homocysteine increases CVD risk, and cut-off values for homocysteinemia. Research examining the impact of physical activity on blood homocysteine levels is equivocal, which is partially due to a lack of control for confounding variables that impact homocysteine. Duration, intensity, and mode of exercise appear to impact blood homocysteine levels differently, and may be dependent on individual fitness levels.

Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study.

PubMed

De Craemer, M; De Decker, E; De Bourdeaudhuij, I; Verloigne, M; Duvinage, K; Koletzko, B; Ibrügger, S; Kreichauf, S; Grammatikaki, E; Moreno, L; Iotova, V; Socha, P; Szott, K; Manios, Y; Cardon, G

2014-08-01

Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers. © 2014 World Obesity.

Satisfaction with daily occupations amongst asylum seekers in Denmark.

PubMed

Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente; Amris, Kirstine; Eklund, Mona

2015-05-01

The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level. A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills. The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found. Asylum seekers experience a low level of satisfaction with daily occupations, both at arrival and after 10 months in an asylum centre. There is a need for further research and development of occupation-focused rehabilitation methods for the asylum seeker population.

Distinct effects of thrombopoietin depending on a threshold level of activated Mpl in BaF-3 cells.

PubMed

Millot, Gaël A; Vainchenker, William; Duménil, Dominique; Svinarchuk, Fédor

2002-06-01

Thrombopoietin (TPO) plays a critical role in megakaryopoiesis through binding to its receptor Mpl. This involves activation of various intracellular signaling pathways, including phosphoinositide 3-kinase (PI3K) and the mitogen-activated protein kinase (MAPK) pathways. Their precise role in TPO-mediated proliferation, survival and differentiation is not fully understood. In the present study, we show that TPO induces different biological responses in Mpl-transduced BaF-3 cells, depending on the cell surface density of Mpl and the resulting activation level of signaling pathways. TPO mediates cell proliferation in cells expressing high levels of Mpl but only mediates survival without proliferation in cells expressing low levels of the receptor. By using the kinase inhibitors PD98059 and LY294002, we further showed that the activation level of the PI3K and MAPK p42/44 pathways is a determining factor for the proliferative effect. In cells expressing low levels of Mpl, the survival effect was strongly dependent on the activation level of the PI3K/AKT, but not the MAPK p42/44 pathway. Moreover, this effect was correlated with the phosphorylation level of BAD but not with the expression level of Bcl-X(L). However, PI3K pathway inhibition did not increase apoptosis when BaF-3 cells proliferated in response to TPO, indicating a compensating mechanism from other Mpl signaling pathways in this case.

Attempting to validate the overtriage/undertriage matrix at a Level I trauma center

PubMed Central

Davis, James W.; Dirks, Rachel C.; Sue, Lawrence P.; Kaups, Krista L.

2017-01-01

BACKGROUND The Optimal Resources Document mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the overtriage/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different, and Matrix does not discriminate the needs or outcomes of these different groups of patients. METHODS Trauma registry data, from January 2013 to December 2015, at a Level I trauma center, were reviewed. Overtriage and undertriage rates were calculated by Matrix. Patients with Injury Severity Score (ISS) of 16 or greater were classified by activation level (full, limited, consultation), and triage category by Matrix. Patients in the limited activation and consultation groups were compared with patients with full activation by demographics, injuries, initial vital signs, procedures, delays to procedure, intensive care unit admission, length of stay, and mortality. RESULTS Seven thousand thirty-one patients met activation criteria. Compliance with American College of Surgeons tiered activation criteria was 99%. The Matrix overtriage rate was 45% and undertriage was 24%. Of 2,282 patients with an ISS of 16 or greater, 1,026 were appropriately triaged (full activation), and 1,256 were undertriaged. Undertriaged patients had better Glasgow Coma Scale score, blood pressure, and base deficit than patients with full activation. Intensive care unit admission, hospital stays, and mortality were lower in the undertriaged group. The undertriaged group required fewer operative interventions with fewer delays to procedure. CONCLUSION Despite having an ISS of 16 or greater, patients with limited activations were dissimilar to patients with full activation. Level of activation and triage are not equivalent. The American College of Surgeons Committee on Trauma full and tiered activation criteria are a robust means to have the appropriate personnel present based on the available prehospital information. Evaluation of the process of care, regardless of level of activation, should be used to evaluate trauma center performance. LEVEL OF EVIDENCE Therapeutic and care management, level III. PMID:29189678

Presenteeism, stress resilience, and physical activity in older manual workers: a person-centred analysis.

PubMed

Thogersen-Ntoumani, Cecilie; Black, Julie; Lindwall, Magnus; Whittaker, Anna; Balanos, George M

2017-12-01

This study used a person-centred approach to explore typologies of older manual workers based on presenteeism, stress resilience, and physical activity. Older manual workers ( n  = 217; 69.1% male; age range 50-77; M age = 57.11 years; SD = 5.62) from a range of UK-based organisations, representing different manual job roles, took part in the study. A cross-sectional survey design was used. Based on the three input variables: presenteeism, stress resilience and physical activity, four distinct profiles were identified on using Latent Profile Analysis. One group ('High sport/exercise and well-functioning'; 5.50%) engaged in high levels of sport/exercise and exhibited low levels of stress resilience and all types of presenteeism. Another profile ('Physically burdened'; 9.70%) reported high levels of work and leisure-time physical activity, low stress resilience, as well as high levels of presenteeism due to physical and time demands. A 'Moderately active and functioning' group (46.50%) exhibited moderate levels on all variables. Finally, the fourth profile ('Moderately active with high presenteeism'; 38.20%) reported engaging in moderate levels of physical activity and had relatively high levels of stress resilience, yet also high levels of presenteeism. The profiles differed on work affect and health perceptions largely in the expected directions. There were no differences between the profiles in socio-demographics. These results highlight complex within-person interactions between presenteeism, stress resilience, and physical activity in older manual workers. The identification of profiles of older manual workers who are at risk of poor health and functioning may inform targeted interventions to help retain them in the workforce for longer.

Feasibility online survey to estimate physical activity level among the students studying professional courses: a cross-sectional online survey.

PubMed

Sudha, Bhumika; Samuel, Asir John; Narkeesh, Kanimozhi

2018-02-01

The aim of the study was to estimate the physical activity (PA) level among the professional college students in North India. One hundred three professional college students in the age group of 18-25 years were recruited by simple random sampling for this cross-sectional online survey. The survey was advertised on the social networking sites (Facebook, WhatsApp) through a link www.surveymonkey.com/r/MG-588BY. A Short Form of International Physical Activity Questionnaire was used for this survey study. The questionnaire included total 8 questions on the basis of previous 7 days. The questionnaire consists of 3 main categories which were vigorous, moderate and high PA. Time spent in each activity level was multiplied with the metabolic equivalent of task (MET), which has previously set to 8.0 for vigorous activity, 4.0 for moderate activity, 3.3 for walking, and 1.5 for sitting. By multiplying MET with number of days and minutes performed weekly, amount of each activity level was calculated and measured as MET-min/wk. Further by adding MET minutes for each activity level, total MET-min/wk was calculated. Total number of 100 students participated in this study, and it was shown that all professional course students show different levels in PA. The total PA level among professional college students, which includes, physiotherapy, dental, medical, nursing, lab technician, pharmacy, management, law, engineering, were 434.4 (0-7,866), 170.3 (0-1,129), 87.7 (0-445), 102.8 (0-180), 469 (0-1,164), 0 (0-0), 645 (0-1,836), 337 (0-1,890), 396 (0-968) MET-min/wk respectively. PA levels among professional college students in North India have been established.

Self-esteem and stress coping among proficiency certificate level nursing students in nursing campus Maharajgunj and Lalitpur Nursing Campus.

PubMed

Shrestha, T

2013-09-01

Nursing requires high self-esteem and effective coping strategies for the quality of health services that they deliver. Self -esteem and stress coping mechanism developed during education period is foundation for professional practice. So, this study was conducted to identify self-esteem, coping activities, and their relationship. Descriptive cross sectional study was conducted among 287 PCL nursing students currently studying in different level in nursing campuses of the Institute of Medicine during June and July 2013. Self administered semi structured questionnaire and rating scales were used for the data collection. Findings showed that 21 (7.31%), 194 (67.5%), and 67 (23.34%), students had have very high, high and moderate, self-esteem and only five (1.74%) have low self-esteem.The difference in self-esteem level was insignificant with the level of the students. Students most frequently used problem focused (3.36±0.54) followed by emotion focused (3.04±0.45) and avoidance coping activities (2.91±0.63). The relationship of use of coping activities and level of students was statistically insignificant. Self-esteem level had positive relation with problem focused and emotion focused coping activities (Pearson r: 0.114 and 0.118), though the correlation was significant with emotion focused coping activities only. Bicytopenia and pancytopenia were seen in two cases each of myelodysplastic syndrome. Chronic myeloid leukemia and Non-Hodgkin lymphoma showed anemia and pancytopenia respectively. Majority of PCL nursing students have high level of self-esteem. They used problem focused coping activities most however, use of it decreased with increased level of students. Students with high self -esteem used problem focused followed by emotion focused coping activities. Students should be encouraged to use problem focused coping activities.

Shoulder Activity Level is Associated With Type of Employment and Income in the Normative Population Without Shoulder Disorders.

PubMed

Brophy, Robert H; Lin, Kenneth M; Skillington, S Andrew; Hepper, C Tate; Smith, Matthew V

2016-10-01

Socioeconomic variables influence various healthcare issues in different ways. The effect of socioeconomic variables on the shoulder has not been well studied. Because activity level, defined by how much a patient actually does, is an important patient outcome measure and prognostic factor for the shoulder, studying its association with occupation and income will advance our understanding of how these variables relate to shoulder disorders, treatments, and outcomes. We asked: (1) Does shoulder activity score correlate with income level, stratified by gender? (2) Do different employment groups-heavy, moderate, light, student, retired-have different shoulder activity scores, as stratified by gender? (3) Is type of sports participation (contact or overhead) associated with income level, employment type, race, or household size? A survey collected the Brophy and Marx shoulder activity score and demographic information, such as age, gender, race, income, type of employment, and household size from 1625 individuals 18 years and older with no current or previous shoulder pain or injury who are members of a research panel matched to the United States population by age, gender, household income and size, race/ethnicity, and geography. Men and women were analyzed separately. Activity level was controlled for age. Shoulder activity correlated with income level among men (R = 0.03; p < 0.001) and women (R = 0.06; p = 0.0002). For men, heavy employment had the highest Shoulder Activity Scale (SAS) level (12.1 ± 4.9), which was more than SAS levels in sedentary (9.1 ± 4.5; mean difference, 3.0; 95% CI, 2.5-3.6; p = 0.001), student (8.8 ± 5.1; mean difference, 3.3; 95% CI, 3.0-3.7; p = 0.007), retired (8.0 ± 4.6; mean difference, 4.1; 95% CI, 3.6-4.7; p = 0.0001), and not working (7.5 ± 5.3; mean difference, 4.6; 95% CI, 4.6-4.6; p < 0.001) categories; similarly, for women, heavy employment had the highest SAS level (12.0 ± 5.8). However, as there were few women working in heavy labor, the only significant difference in women was between moderate employment (8.8 ± 4.2) and sedentary employment (7.0 ± 4.1; mean difference, 1.8; 95% CI, 1.6-1.9; p = 0.0015). Participation in contact (19.9% vs 12.0%; p = 0.006) and overhead sports (25.2% vs 14.2%; p < 0.001) was greater among males with higher incomes. Shoulder activity level is related to the socioeconomic factors of income and type of employment. Heavy laborers have higher shoulder activity level, likely directly related to their work. Individuals with higher incomes also have higher shoulder activity level, probably attributable to recreation as evidenced by their greater participation in contact and overhead sports. Independent of the underlying cause, these patients probably are more likely to seek treatment for shoulder disorders and may be more challenging to treat because of their elevated activity level. Future research should focus on how elevated activity level in these populations affects their risk for shoulder disorders, and their use of and outcomes from treatment for these disorders. Level IV, prognostic study.

[Impact of level of physical activity on healthcare utilization among Korean adults].

PubMed

Kim, Jiyun; Park, Seungmi

2012-04-01

This study was done to identify the impact of physical activity on healthcare utilization among Korean adults. Drawing from the 2008 Korean National Health and Nutrition Examination Survey (NHANES IV-2), data from 6,521 adults who completed the Health Interview and Health Behavior Surveys were analyzed. Association between physical activity and healthcare utilization was tested using the χ²-test. Multiple logistic regression analysis was used to calculate the odds ratios of using outpatient and inpatient healthcare for different levels of physical activity after adjusting for predisposing, enabling, and need factors. A generalized linear model applying a negative binomial distribution was used to determine how the level of physical activity was related to use of outpatient and inpatient healthcare. Physically active participants were 16% less likely to use outpatient healthcare (OR, 0.84; 95% CI, 0.74-0.97) and 23% less likely to use inpatient healthcare (OR, 0.77; 95% CI, 0.63-0.93) than physically inactive participants. Levels of outpatient and inpatient healthcare use decreased as levels of physical activity increased, after adjusting for relevant factors. An independent association between being physically active and lower healthcare utilization was ascertained among Korean adults indicating a need to develop nursing intervention programs that encourage regular physical activity.

Racial/Ethnic and Income Differences in Obesity Among Older Adults: The Role of Leisure-time Physical Activity and Neighborhood Social Cohesion.

PubMed

Yu, Chia-Yuan

2017-03-01

Few studies have examined the associations among social cohesion, physical activity, and obesity in older adults. This study explored the influences of social cohesion and leisure-time physical activity on obesity in older adults, and tested whether these relationships varied by race/ethnicity and income level. A cross-sectional analysis of adults in the 2013 National Health Interview Study (NHIS) who were over 65 years of age (N = 7714) was used. Logistic regressions were performed to examine the impacts of social cohesion and physical activity on obesity, and the relative risks (RR) were reported. The median age was 73 years old, and 59.8% of respondents were female; 23.8% met the recommended level of moderate physical activity. Neighborhood social cohesion was not associated with obesity for older adults. Meeting the recommended level of vigorous physical activity was related to a lower probability of obesity only for older Hispanic adults (RR = 0.41, 95% CI: 0.31 to 0.50), while older adults were less likely to be obese if they met the recommended level of moderate physical activity. Increasing the level of physical activity may profoundly reduce the probability of obesity for older adults. Moreover, the results implied the need for future physical activity interventions for minorities.

Rate of antioxidant degradation and color variations in dehydrated apples as related to water activity.

PubMed

Lavelli, Vera; Vantaggi, Claudia

2009-06-10

Dehydrated apples were studied to evaluate the effects of water activity on the stability of their antioxidants and color. Apples were freeze-dried, ground, then equilibrated, and stored at eight water activity levels, ranging from 0.058 to 0.747, at 40 degrees C. Their contents of hydroxycinnamic acids, dihydrochalcones, catechin, epicatechin, polymeric flavan-3-ols, and hydroxymethylfurfural, their antioxidant activity values, and their Hunter colorimetric parameters were analyzed at different storage times. Antioxidant degradation followed pseudo-first-order kinetics and was accelerated by increasing the water activity. The order of antioxidant stability in the products at water activity levels below 0.316 was catechin, epicatechin, and ascorbic acid < total procyanidins < dihydrochalcones and p-coumaric acid < chlorogenic acid; however, in the products at water activity levels above 0.316, the degradation of all antioxidants was very fast. The hydroxymethylfurfural formation rate increased exponentially during storage, especially at high water activity levels. The antioxidant activity of the dehydrated apples decreased during storage, consistent with antioxidant loss. The variations of the colorimetric parameters, namely, lightness (L*), redness (a*), and yellowness (b*), followed pseudo-zero-order kinetics and were accelerated by increasing water activity. All analytical indices indicated that the dehydrated apples were stable at water activity levels below 0.316, with the degradation rate accelerating upon exposure to higher relative humidities. Above 0.316, a small increase in water activity of the product would sharply increase the degradation rate constants for both antioxidant and color variations.

Association of daily physical activity level with health-related factors by gender and age-specific differences among Korean adults based on the sixth (2014-2015) Korea national health and nutrition examination survey

PubMed

Chung, Nana; Park, Hun-Young; Park, Mi-Young; Hwang, Yoon-Young; Lee, Chi-Ho; Han, Jin-Soo; So, Jaemoo; Kim, Jisu; Park, Jonghoon; Lim, Kiwon

2017-06-30

This study examined the effects of daily physical activity level on health-related factors according to gender and identified age-specific differences among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), we selected adults aged 19-64 years who participated in both a health examination and health interview survey. The study included 6,457 participants 19-64 years of age (2,611 men, 3,846 women). Assessment of the differences in health-related factors according to age and physical activity in men and women by repeated two-way analysis of variance (ANOVA) revealed significant interaction effects on total cholesterol (TC) and triglyceride (TG) levels and diastolic blood pressure (DBP) in male participants, but there were no significant interaction effects for any health-related factors in female participants. The group of female participants aged 40-64 years with daily physical activity levels over 200 kcal showed a significantly increased prevalence of 46% for dyslipidemia compared to that in female participants with daily physical activity levels below 200 kcal. Physical activity was positively correlated with weight and high-density lipoprotein cholesterol (HDL-C) levels in men 19-39 years of age, compared to weight, waist circumference (WC), body mass index (BMI), and DBP in men 40-64 years of age, and weight, WC, BMI, glycated hemoglobin (HbA1c) and triglyceride (TG) levels in women 19-39 years of age. In women 40- 64 years of age, physical activity was especially significantly positively correlated with weight, BMI, HDL-C and negatively correlated with fasting glucose and TG levels. In male and female participants, the 40-64-year age group showed negative results for health-related factors compared to those in the 19-39-year age group. The higher the weight, WC, BMI, the higher is the physical activity level. Physical activity levels were significantly positively correlated with health-related variables. ©2017 The Korean Society for Exercise Nutrition

Association of daily physical activity level with health-related factors by gender and age-specific differences among Korean adults based on the sixth (2014-2015) Korea national health and nutrition examination survey

PubMed Central

Chung, Nana; Park, Hun-Young; Park, Mi-Young; Hwang, Yoon-Young; Lee, Chi-Ho; Han, Jin-Soo; So, Jaemoo; Kim, Jisu; Park, Jonghoon; Lim, Kiwon

2017-01-01

[Purpose] This study examined the effects of daily physical activity level on health-related factors according to gender and identified age-specific differences among Korean adults. [Methods] Using data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), we selected adults aged 19-64 years who participated in both a health examination and health interview survey. The study included 6,457 participants 19-64 years of age (2,611 men, 3,846 women). [Results] Assessment of the differences in health-related factors according to age and physical activity in men and women by repeated two-way analysis of variance (ANOVA) revealed significant interaction effects on total cholesterol (TC) and triglyceride (TG) levels and diastolic blood pressure (DBP) in male participants, but there were no significant interaction effects for any health-related factors in female participants. The group of female participants aged 40-64 years with daily physical activity levels over 200 kcal showed a significantly increased prevalence of 46% for dyslipidemia compared to that in female participants with daily physical activity levels below 200 kcal. Physical activity was positively correlated with weight and high-density lipoprotein cholesterol (HDL-C) levels in men 19-39 years of age, compared to weight, waist circumference (WC), body mass index (BMI), and DBP in men 40-64 years of age, and weight, WC, BMI, glycated hemoglobin (HbA1c) and triglyceride (TG) levels in women 19-39 years of age. In women 40- 64 years of age, physical activity was especially significantly positively correlated with weight, BMI, HDL-C and negatively correlated with fasting glucose and TG levels. [Conclusion] In male and female participants, the 40-64-year age group showed negative results for health-related factors compared to those in the 19-39-year age group. The higher the weight, WC, BMI, the higher is the physical activity level. Physical activity levels were significantly positively correlated with health-related variables. PMID:28715884

Daily Physical Activity Assessed by a Triaxial Accelerometer Is Beneficially Associated with Waist Circumference, Serum Triglycerides, and Insulin Resistance in Japanese Patients with Prediabetes or Untreated Early Type 2 Diabetes.

PubMed

Hamasaki, Hidetaka; Noda, Mitsuhiko; Moriyama, Sumie; Yoshikawa, Reo; Katsuyama, Hisayuki; Sako, Akahito; Mishima, Shuichi; Kakei, Masafumi; Ezaki, Osamu; Yanai, Hidekatsu

2015-01-01

To investigate the association between daily physical activity and metabolic risk factors in Japanese adults with prediabetes or untreated early type 2 diabetes (T2D). Daily physical activity level was measured using a triaxial accelerometer. We assessed correlations between physical activity level and waist circumference, blood pressure, fasting levels of plasma glucose, serum triglycerides, and insulin and homeostasis model assessment-insulin resistance (HOMA-IR). A total of 80 patients were studied. After adjustment for age and body mass index, in all subjects, physical activity level was negatively associated with waist circumference (β = -0.124, P = 0.018) and fasting serum triglycerides (β = -0.239, P = 0.035), insulin (β = -0.224, P = 0.022). In men, physical activity level was negatively associated with systolic blood pressure (β = -0.351, P = 0.044), fasting plasma glucose (β = -0.369, P = 0.025) and insulin (β = -0.362, P = 0.012), and HOMA-IR (β = -0.371, P = 0.011). No significant associations were found between physical activity level and metabolic risk factors in women. Objectively measured daily physical activity is beneficially associated with waist circumference, serum triglycerides, and insulin resistance in individuals with prediabetes or untreated early T2D. (This trial is registered with UMIN000015774.).

Antidepressant-Like Activity of the Ethanolic Extract from Uncaria lanosa Wallich var. appendiculata Ridsd in the Forced Swimming Test and in the Tail Suspension Test in Mice

PubMed Central

Hsu, Lieh-Ching; Ko, Yu-Jen; Cheng, Hao-Yuan; Chang, Ching-Wen; Lin, Yu-Chin; Cheng, Ying-Hui; Hsieh, Ming-Tsuen; Peng, Wen Huang

2012-01-01

This study investigated the antidepressant activity of ethanolic extract of U. lanosa Wallich var. appendiculata Ridsd (ULEtOH) for two-weeks administrations by using FST and TST on mice. In order to understand the probable mechanism of antidepressant-like activity of ULEtOH in FST and TST, the researchers measured the levels of monoamines and monoamine oxidase activities in mice brain, and combined the antidepressant drugs (fluoxetine, imipramine, maprotiline, clorgyline, bupropion and ketanserin). Lastly, the researchers analyzed the content of RHY in the ULEtOH. The results showed that ULEtOH exhibited antidepressant-like activity in FST and TST in mice. ULEtOH increased the levels of 5-HT and 5-HIAA in cortex, striatum, hippocampus, and hypothalamus, the levels of NE and MHPG in cortex and hippocampus, the level of NE in striatum, and the level of DOPAC in striatum. Two-week injection of IMI, CLO, FLU and KET enhanced the antidepressant-like activity of ULEtOH. ULEtOH inhibited the activity of MAO-A. The amount of RHY in ULEtOH was 17.12 mg/g extract. Our findings support the view that ULEtOH exerts antidepressant-like activity. The antidepressant-like mechanism of ULEtOH may be related to the increase in monoamines levels in the hippocampus, cortex, striatum, and hypothalamus of mice. PMID:22567032

Do patients with ewing's sarcoma continue with sports activities after limb salvage surgery of the lower extremity?

PubMed

Hobusch, Gerhard Martin; Lang, Nikolaus; Schuh, Reinhard; Windhager, Reinhard; Hofstaetter, Jochen Gerhard

2015-03-01

Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. The aims of the study were to answer the following questions: (1) Which sports activity levels and what types of sports can be expected in the long term after tumor reconstruction? (2) Which frequency durations are patients with Ewing's sarcoma able to perform in long-term followup after local control? (3) Do surgical complications affect sports activity level? Thirty patients (13 females, 17 males; mean age, 18 ± 8 years; range, 2-36 years at diagnosis; mean followup 16 ± 6 years [minimum, 5 years]) were included. Tumors were located in the pelvis, femur, tibia, and fibula. Surgical procedures included surgical resections alone (n = 8), surgical resection with biological reconstruction (n = 9), or endoprosthetic reconstruction (n = 13). We assessed UCLA sports activity levels, kinds of sports as well as the frequency per week and the duration of each training unit at long term (minimum followup, 5 years). In long-term followup 83% patients (25 of 30) were performing athletic activity regularly. The hours/week of sports depended on type of surgery and were highest after resections in the pelvis and femur (5.8) and were lowest after megaprosthetic reconstruction of the pelvis (1.0). Patients undergoing biologic reconstructions were able to perform high-impact sports. UCLA sports activity levels were high after joint-preserving vascularized fibula for tibia reconstruction (7.4) and after megaprosthetic reconstruction of the lower extremity (6.3-6.4) and were low after tumors located in the fibula (4.2). Complications during followup did not significantly influence sports activity in long-term survivors. Long-term survivors can achieve high levels of sports activity in many instances. Tumor sites are associated with the postoperative sports activity levels. This information can help surgeons counsel patients in terms of athletic expectations after limb salvage reconstruction for patients with Ewing's sarcoma. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

The intensity of physical activity influences bone mineral accrual in childhood: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark

PubMed Central

2013-01-01

Background Studies indicate genetic and lifestyle factors can contribute to optimal bone development. In particular, the intensity level of physical activity may have an impact on bone health. This study aims to assess the relationship between physical activity at different intensities and Bone Mineral Content (BMC), Bone Mineral Density (BMD) and Bone Area (BA) accretion. Methods This longitudinal study is a part of The CHAMPS study-DK. Whole-body DXA scans were performed at baseline and after two years follows up. BMC, BMD, and BA were measured. The total body less head (TBLH) values were used. Physical activity (PA) was recorded by accelerometers (ActiGraph, model GT3X). Percentages of different PA intensity levels were calculated and log odds of two intensity levels of activity relative to the third level were calculated. Multilevel regression analyses were used to assess the relationship between the categories of physical activity and bone traits. Results Of 800 invited children, 742 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow up. Complete datasets were obtained in 602/742 (81%) children. Mean (range) of age was 11.5 years (9.7-13.9). PA at different intensity levels was for boys and girls respectively, sedentary 62% and 64%, low 29% for both genders and moderate to high 9% and 7% of the total time. Mean (range) BMC, BMD, and BA was 1179 g (563–2326), 0.84 g/cm2 (0.64-1.15) and 1393 cm2 (851–2164), respectively. Valid accelerometer data were obtained for a mean of 6.1 days, 13 hours per day. Conclusions There 7was a positive relationship between the log odds of moderate to high-level PA versus low level activity and BMC, BMD and BA. Children with an increased proportion of time in moderate to high-level activity as opposed to sedentary and low-level activity achieved positive effects on BMC, BMD and BA. PMID:23452342

Development of a Compendium of Energy Expenditures for Youth

PubMed Central

Ridley, Kate; Ainsworth, Barbara E; Olds, Tim S

2008-01-01

Background This paper presents a Compendium of Energy Expenditures for use in scoring physical activity questionnaires and estimating energy expenditure levels in youth. Method/Results Modeled after the adult Compendium of Physical Activities, the Compendium of Energy Expenditures for Youth contains a list of over 200 activities commonly performed by youth and their associated MET intensity levels. A review of existing data collected on the energy cost of youth performing activities was undertaken and incorporated into the compendium. About 35% of the activity MET levels were derived from energy cost data measured in youth and the remaining MET levels estimated from the adult compendium. Conclusion The Compendium of Energy Expenditures for Youth is useful to researchers and practitioners interested in identifying physical activity and energy expenditure values in children and adolescents in a variety of settings. PMID:18782458

Habitual physical activity and estradiol levels in women of reproductive age.

PubMed

Jasienska, Grazyna; Ziomkiewicz, Anna; Thune, Inger; Lipson, Susan F; Ellison, Peter T

2006-10-01

Variation in the risk of breast cancer observed among women and among populations may be explained by variation in lifetime exposure to estrogens. The suppressive effect of exercise on estradiol levels in women is well documented, but it is unknown whether habitual (i.e. typical daily) physical activity has a similar effect. Epidemiological data suggest that physical activity is one of the few modifiable factors capable of reducing the risk of breast cancer in women. We investigated whether variation in the amount of habitual activity corresponds to variation in estradiol levels in women of reproductive age. One hundred and thirty-nine regularly menstruating women 24-37 years of age collected daily saliva samples for one complete menstrual cycle and kept a daily log of physical activity. Saliva samples were analyzed for concentration of estradiol. We observed a negative relationship between habitual physical activity and salivary levels of estradiol. Mean estradiol was 21.1 pmol/l in the low, 17.9 pmol/l in the moderate and 16.6 pmol/l in the high activity group (all pairwise differences were statistically significant at P<0.009). A strong association exists between physical activity and levels of estradiol among women of reproductive age. A modern lifestyle, characterized by reduced physical activity, may therefore contribute to a rise in the levels of estradiol produced during menstrual cycles and thus to higher cumulative lifetime exposure to estradiol, resulting in a higher risk of breast cancer.

Physical Activity and Quality of Life in Adults With Spinal Cord Injury

PubMed Central

Stevens, Sandy L; Caputo, Jennifer L; Fuller, Dana K; Morgan, Don W

2008-01-01

Background/Objective: To document the relationship between level of physical activity and quality of life in persons with spinal cord injury. Design: Cross-sectional investigation. Participants/Methods: Men (n = 32) and women (n = 30) with complete and incomplete spinal cord lesions below C6 volunteered to participate in this study. The average length of time since the onset of disability was 9 years (range, 1.5–40 years). Using an interview-formatted survey (Quality of Well-Being Scale), a measure of quality of life was obtained for each participant. Physical activity levels were determined using the Physical Activity Scale for Individuals with Physical Disabilities. Results: A strong positive association (r = 0.75; P < 0.05) was observed between level of physical activity and quality of life. Multiple regression analysis also showed that when level of physical activity, anatomical location of the injury, completeness of injury, and time since injury were used as explanatory variables, level of physical activity was the only significant predictor of quality of life, accounting for 56% of the total variation in quality of life. Conclusions: Results from this study show that a significant and moderately strong positive relationship exists between level of physical activity and quality of life in adults with spinal cord injury. From a clinical perspective, these findings suggest that interventions aimed at promoting physical activity may be effective in improving quality of life in this population. PMID:18959354

Phosphoglycolate phosphatase and 2,3-diphosphoglycerate in red cells of normal and anemic subjects.

PubMed

Somoza, R; Beutler, E

1983-10-01

Red cell phosphoglycolate phosphatase (PGP) and 2,3-diphosphoglycerate (2,3-DPG) were investigated in normal and anemic patients and rabbits. In hemolytic anemia and blood-loss anemia, characterized by a young red cell population, there was an increase in both phosphoglycolate phosphatase activity and 2,3-diphosphoglycerate levels. In aplastic anemia, the phosphoglycolate phosphatase activity was normal, but the 2,3-diphosphoglycerate values were nonetheless increased. Thus, no relationship was found between phosphoglycolate phosphatase activity and 2,3-diphosphoglycerate levels. The lack of correlation between the activity of phosphoglycolate phosphatase and 2,3-DPG levels suggests that modulation of phosphoglycolate phosphatase activity does not control the level of 2,3-DPG in erythrocytes.

The Devon Active Villages Evaluation (DAVE) trial of a community-level physical activity intervention in rural south-west England: a stepped wedge cluster randomised controlled trial.

PubMed

Solomon, Emma; Rees, Tim; Ukoumunne, Obioha C; Metcalf, Brad; Hillsdon, Melvyn

2014-07-18

The majority of adults are not meeting the guidelines for physical activity despite activity being linked with numerous improvements to long-term health. In light of this, researchers have called for more community-level interventions. The main objective of the present study was to evaluate whether a community-level physical activity intervention increased the activity levels of rural communities. 128 rural villages (clusters) were randomised to receive the intervention in one of four time periods between April 2011 and December 2012. The Devon Active Villages intervention provided villages with 12 weeks of physical activity opportunities for all age groups, including at least three different types of activities per village. Each village received an individually tailored intervention, incorporating a local needs-led approach. Support was provided for a further 12 months following the intervention. The evaluation study used a stepped wedge cluster randomised controlled trial design. All 128 villages were measured at each of five data collection periods using a postal survey. The primary outcome of interest was the proportion of adults reporting sufficient physical activity to meet internationally recognised guidelines. Minutes spent in moderate-and-vigorous activity per week was analysed as a secondary outcome. To compare between intervention and control modes, random effects linear regression and marginal logistic regression models were implemented for continuous and binary outcomes respectively. 10,412 adults (4693 intervention, 5719 control) completed the postal survey (response rate 32.2%). The intervention did not increase the odds of adults meeting the physical activity guideline (adjusted OR 1.02, 95% CI: 0.88 to 1.17; P = 0.80), although there was weak evidence of an increase in minutes of moderate-and-vigorous-intensity activity per week (adjusted mean difference = 171, 95% CI: -16 to 358; P = 0.07). The ineffectiveness of the intervention may have been due to its low penetration-only 16% of intervention mode participants reported awareness of the intervention and just 4% reported participating in intervention events. A community-level physical activity intervention providing tailored physical activity opportunities to rural villages did not improve physical activity levels in adults. Greater penetration of such interventions must be achieved if they are to increase physical activity prevalence at the community level. Current Controlled Trials ISRCTN37321160.

Capturing system level activities and impacts of mental health consumer-run organizations.

PubMed

Janzen, Rich; Nelson, Geoffrey; Hausfather, Nadia; Ochocka, Joanna

2007-06-01

Since the 1970s mental health consumer-run organizations have come to offer not only mutual support, but they have also adopted agendas for broader social change. Despite an awareness of the need for system level efforts that create supportive environments for their members, there has been limited research demonstrating how their system level activities can be documented or their impacts evaluated. The purpose of this paper is to feature a method of evaluating systems change activities and impacts. The paper is based on a longitudinal study evaluating four mental health consumer-run organizations in Ontario, Canada. The study tracked system level activities and impacts using both qualitative and quantitative methodologies. The article begins by describing the development and implementation of these methods. Next it offers a critical analysis of the methods used. It concludes by reflecting on three lessons learned about capturing system level activities and impacts of mental health consumer-run organizations.

Neuroprotective effects of Ganoderma lucidum polysaccharides against traumatic spinal cord injury in rats.

PubMed

Gokce, Emre Cemal; Kahveci, Ramazan; Atanur, Osman Malik; Gürer, Bora; Aksoy, Nurkan; Gokce, Aysun; Sargon, Mustafa Fevzi; Cemil, Berker; Erdogan, Bulent; Kahveci, Ozan

2015-11-01

Ganoderma lucidum (G. lucidum) is a mushroom belonging to the polyporaceae family of Basidiomycota and has widely been used as a traditional medicine for thousands of years. G. lucidum has never been studied in traumatic spinal cord injury. The aim of this study is to investigate whether G. lucidum polysaccharides (GLPS) can protect the spinal cord after experimental spinal cord injury. Rats were randomized into five groups of eight animals each: control, sham, trauma, GLPS, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only a laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analysed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test. After traumatic spinal cord injury, increases in caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. After the administration of GLPS, decreases were observed in tissue caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. Furthermore, GLPS treatment showed improved results in histopathological scores, ultrastructural scores, and functional tests. Biochemical, histopathological, and ultrastructural analyses and functional tests reveal that GLPS exhibits meaningful neuroprotective effects against spinal cord injury. Copyright © 2015 Elsevier Ltd. All rights reserved.

76 FR 24038 - Agency Information Collection Activities: Proposed Collection; Comment Request, 1660-NEW; Level 1...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

...] Agency Information Collection Activities: Proposed Collection; Comment Request, 1660-NEW; Level 1 Assessment and Level III Evaluations for the Center for Domestic Preparedness (CDP) AGENCY: Federal Emergency...; OMB No. 1660-NEW; FEMA Form 092-0-2, Level 1 Assessment Form; FEMA Form 092-0-2A, Level 3 Evaluation...

STAT3 activation is associated with cerebrospinal fluid interleukin-10 (IL-10) in primary central nervous system diffuse large B cell lymphoma.

PubMed

Mizowaki, Takashi; Sasayama, Takashi; Tanaka, Kazuhiro; Mizukawa, Katsu; Takata, Kumi; Nakamizo, Satoshi; Tanaka, Hirotomo; Nagashima, Hiroaki; Nishihara, Masamitsu; Hirose, Takanori; Itoh, Tomoo; Kohmura, Eiji

2015-09-01

Signal transducers and activators of transcription 3 (STAT3) are activated by various cytokines and oncogenes; however, the activity and pathogenesis of STAT3 in diffuse large B cell lymphoma of the central nervous system have not been thoroughly elucidated. We investigated the phosphorylation levels of STAT3 in 40 specimens of primary central nervous system diffuse large B-cell lymphoma (PCNS DLBCL) and analyzed the association between phsopho-STAT3 (pSTAT3) expression and cerebrospinal fluid (CSF) concentration of interleukin-10 (IL-10) or IL-6. Immunohistochemistry and Western blot analysis revealed that most of the specimens in PCNS DLBCL expressed pSTST3 protein, and a strong phosphorylation levels of STAT3 was statistically associated with high CSF IL-10 levels, but not with CSF IL-6 levels. Next, we demonstrated that recombinant IL-10 and CSF containing IL-10 induced the phosphorylation of STAT3 in PCNS DLBCL cells. Furthermore, molecular subtype classified by Hans' algorithm was correlated with pSTAT3 expression levels and CSF IL-10 levels. These results suggest that the STAT3 activity is correlated with CSF IL-10 level, which is a useful marker for STAT3 activity in PCNS DLBCLs.

Protective effect of betaine against burn-induced pulmonary injury in rats.

PubMed

Şehirli, Ahmet Özer; Satılmış, Burcu; Tetik, Şermin; Çetinel, Şule; Yeğen, Berrak; Aykaç, Aslı; Şener, Göksel

2016-09-01

This study was designed to determine possible protective effect of betaine treatment against oxidative injury in pulmonary tissue induced with thermal trauma. Under ether anesthesia, shaved dorsum of Wistar albino rats was exposed to a 90°C water bath for 10 seconds to induce burn injury. Betaine was administered orally (250 mg/kg) for a period of 21 days before burn injury, and single dose of betaine was administered after thermal injury. Control group rats were exposed to 25°C water bath for 10 seconds. Upon conclusion of experiment, rats were decapitated and blood was collected for analysis of pro-inflammatory cytokines and lactate dehydrogenase (LDH) activity. Lung tissue samples were taken to determine malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO), and Na+/K+-ATPase activity, in addition to histological analysis. Burn injury caused significant increase in both cytokine levels and LDH activity. In lung samples, raised MDA levels, MPO activity, and reduced GSH levels and Na+/K+-ATPase activity were found due to burn injury. Treatment of rats with betaine significantly restored GSH level and Na+/K+-ATPase activity, and decreased MDA level and MPO activity. According to the findings of the present study, betaine significantly diminishes burn-induced damage in tissue.

Effect of Leisure Activities on Inflammation and Cognitive Function in an Aging Sample

PubMed Central

Friedman, Elliot; Quinn, Jill; Chen, Ding-Geng (Din); Mapstone, Mark

2012-01-01

Cardiovascular disease risk factors (CVDRFs) increase the risk of dementia. The purpose of this study was to examine whether leisure activities (mental, physical, and social activities) modified the effect of CVDRFs on inflammatory markers and cognitive function in middle and old age. A secondary-data analysis study was conducted using data from 405 middle-age participants (40 –59 years) and 342 old-age participants (60 – 84 years) who participated in the Survey of Midlife Development in the United States. CVDRFs were obtained from a combination of self-report medical history and blood-based biomarkers. Three CVDRF groups (≤1, 2, and ≥3 CVDRFs) were identified. More CVDRFs were significantly associated with higher levels of inflammatory markers in both age groups, and associated with lower levels of executive function in the old age group. CVDRFs were not related to the frequency of leisure activities in either age group. After controlling for covariates, higher levels of physical activities were significantly associated with lower levels of inflammatory markers, and higher levels of mental activities were associated with higher levels of cognitive function. In the old age group, physical activities also moderated the effect of CVDRFs on episodic memory, and mental activities moderated the effect of CVDRFs on interleukin-6. Multiple CVDRFs may be associated with poorer cognitive function and higher inflammatory markers, but middle-age and older adults with CVDRFs may not engage in frequent physical and cognitive activities that may be protective. It is important to develop strategies to facilitate engagement in these activities from midlife. PMID:22377120

[Association between type 2 diabetes and physical activity in individuals with family history of diabetes].

PubMed

Petermann, Fanny; Díaz-Martínez, Ximena; Garrido-Méndez, Álex; Leiva, Ana María; Martínez, María Adela; Salas, Carlos; Poblete-Valderrama, Felipe; Celis-Morales, Carlos

To investigate whether the association between type 2 diabetes (T2D) and family history of diabetes is modified by the levels of physical activity in the Chilean population. In this study were included 5129 participants from the cross-sectional 2009-2010 National Health Survey. Physical activity level was assessed using the Global Physical Activity Questionnaire and family history of T2D, through self-reporting. The association between diabetes, family history of diabetes and physical activity was determined using logistic regression. The odds of developing T2D in people with family history of this pathology is high, independent of their levels of physical activity and adiposity. Both men and women with family history of T2D have a higher probability of developing T2D. The odds ratio for having T2D was 5,49 (95%CI: 3,85-7,84; p <0,0001) in women, and 8,16 (95%CI: 4,96-13,4; p <0,0001) in men with family history of T2D and low levels of physical activity in comparison to those with high levels of physical activity and without a family history. Given the elevated risk of developing T2D presented by individuals with a family history of this pathology, and the effect of physical activity in reducing such risk, people with family history of diabetes may need higher levels of physical activity to attenuate their susceptibility to T2D. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of current physical activity on affective response to exercise: physical and social-cognitive mechanisms.

PubMed

Magnan, Renee E; Kwan, Bethany M; Bryan, Angela D

2013-01-01

Affective responses during exercise are often important determinants of exercise initiation and maintenance. Current physical activity may be one individual difference that is associated with the degree to which individuals have positive (or negative) affective experiences during exercise. The objective of this study was to explore physical and cognitive explanations of the relationship between current activity status (more versus less active) and affective response during a 30-minute bout of moderate-intensity exercise. Participants reported their current level of physical activity, exercise self-efficacy and affect during a 30-minute bout of moderate-intensity exercise. More active individuals experienced higher levels of positive affect and tranquillity and lower levels of negative affect and fatigue during exercise. Multivariate models for each affective state indicated separate processes through which physical activity may be associated with changes in affect during exercise. These models indicate that affect experienced during physical activity is related to the current activity level and these relationships can be partially explained by the physical and cognitive factors explored in this study. Recommendations for future research to elucidate whether positive affective response to physical activity improves as a function of becoming more active over time are discussed.

Cultivating an Aesthetic Sensibility and Activism: Everyday Aesthetics and Environmental Education

ERIC Educational Resources Information Center

Hurren, Wanda

2017-01-01

The place of activism in environmental education is an ongoing conversation among educators. In this article I highlight an area that has received minimal attention within that conversation: aesthetics and activism. While activism can be enacted at the personal and public levels, I focus on the personal level of activism as I discuss links between…

32 CFR 637.7 - Drug enforcement activities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... USACIDC at the local level. Enforcement activities will be coordinated with the USACIDC at the local level... 32 National Defense 4 2011-07-01 2011-07-01 false Drug enforcement activities. 637.7 Section 637.7... CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.7 Drug enforcement activities...

Alterations of the levels of primary antioxidant enzymes in different grades of human astrocytoma tissues.

PubMed

Yen, Hsiu-Chuan; Lin, Chih-Lung; Chen, Bing-Shian; Chen, Chih-Wei; Wei, Kuo-Chen; Yang, Mei-Lin; Hsu, Jee-Ching; Hsu, Yung-Hsing

2018-06-03

Malignant astrocytoma is the most commonly occurring brain tumor in humans. Oxidative stress is implicated in the development of cancers. Superoxide dismutase 2 (SOD2) was found to exert tumor suppressive effect in basic research, but increased SOD2 protein level was associated with higher aggressiveness of human astrocytomas. However, studies reporting alterations of antioxidant enzymes in human astrocytomas often employed less accurate methods or included different types of tumors. Here we analyzed the mRNA levels, activities, and protein levels of primary antioxidant enzymes in control brain tissues and various grades of astrocytomas obtained from 40 patients. SOD1 expression, SOD1 activity, and SOD1 protein level were lower in Grade IV astrocytomas. SOD2 expression was lower in low-grade (Grades I and II) and Grade III astrocytomas than in controls, but SOD2 expression and SOD2 protein level were higher in Grade IV astrocytomas than in Grade III astrocytomas. Although there was no change in SOD2 activity and a lower activity of citrate synthase (CS), the MnSOD:CS ratio increased in Grade IV astrocytomas compared with controls and low-grade astrocytomas. Furthermore, SOD1 activity, CS activity, SOD1 expression, GPX4 expression, and GPX4 protein level were inversely correlated with the malignancy, whereas catalase activity, catalase protein, SOD2 protein level, and the SOD2:CS ratio were positively correlated with the degree of malignancy. Lower SOD2:CS ratio was associated with poor outcomes for Grade IV astrocytomas. This is the first study to quantify changes of various primary antioxidant enzymes in different grades of astrocytomas at different levels concurrently in human astrocytomas.

Effect of blanching treatments on antioxidant activity of frozen green capsicum (Capsicum annuum L. var bell pepper) using radical scavenging activity (DPPH) assay

NASA Astrophysics Data System (ADS)

Azizzuddin, Norafida; Abdullah, Aminah

2016-11-01

Blanching treatments are needed to deactivate enzymes in frozen vegetables. Antioxidant activity using DPPH radical scavenging activity assay were evaluated in steaming, boiling water, and microwave blanching at different temperature, time and microwave power level on frozen green capsicum. Green capsicum was chosen for frozen treatment compared to other capsicum with different maturity index because of the firm texture. The objective of this study was to compare the antioxidant activity of frozen green capsicum between conventional and Oxi Count Kit® assay for DPPH radical scavenging activity. Results showed frozen green capsicum blanched using microwave at high level/90 seconds (sample J) contained higher level of DPPH in both conventional method and Oxi Count Kit® compared to other treatments. However, there were no significant differences between sample J and fresh sample (sample A). Overall, the sequences from highest to lowest in blanching treatments for both DPPH conventional method, and DPPH Oxi Count Kit® were J (microwave high level/90 seconds) > A (Fresh) > H (Microwave Medium Level/120 seconds) > D (Boiling Water 80°C/150 seconds) > K (Microwave High Level/120 seconds) > I (Microwave Medium Level/150 seconds) > F (Microwave Low Level/150 seconds)> B (Steam 100°C/150 seconds) > E (Boiling Water 100°C /120 seconds) > G (Microwave Low Level /180 seconds)> C (Steam 100°C/180 seconds). Almost all frozen green capsicum samples showed no significant differences for comparison between test using DPPH conventional method and Oxi Count Kit®. Frozen storage for 0, and 3rd months showed no significant differences which indicate no changes on antioxidant activity during frozen storage at -18°C.

Activity and circadian rhythm influence synaptic Shank3 protein levels in mice.

PubMed

Sarowar, Tasnuva; Chhabra, Resham; Vilella, Antonietta; Boeckers, Tobias M; Zoli, Michele; Grabrucker, Andreas M

2016-09-01

Various recent studies revealed that the proteins of the Shank family act as major scaffold organizing elements in the post-synaptic density of excitatory synapses and that their expression level is able to influence synapse formation, maturation and ultimately brain plasticity. An imbalance in Shank3 protein levels has been associated with a variety of neuropsychological and neurodegenerative disorders including autism spectrum disorders and Phelan-McDermid syndrome. Given that sleep disorders and low melatonin levels are frequently observed in autism spectrum disorders, and that circadian rhythms may be able to modulate Shank3 signaling and thereby synaptic function, here, we performed in vivo studies on CBA mice using protein biochemistry to investigate the synaptic expression levels of Shank3α during the day in different brain regions. Our results show that synaptic Shank3 protein concentrations exhibit minor oscillations during the day in hippocampal and striatal brain regions that correlate with changes in serum melatonin levels. Furthermore, as circadian rhythms are tightly connected to activity levels in mice, we increased physical activity using running wheels. The expression of Shank3α increases rapidly by induced activity in thalamus and cortex, but decreases in striatum, superimposing the circadian rhythms of different brain regions. We conclude that synaptic Shank3 proteins build highly dynamic platforms that are modulated by the light:dark cycles but even more so driven by activity. Using wild-type CBA mice, we show that Shank3 is a highly dynamic and activity-regulated protein at synapses. In the hippocampus, changes in synaptic Shank3 levels are influenced by circadian rhythm/melatonin concentration, while running activity increases and decreases levels of Shank3 in the cortex and striatum respectively. © 2016 International Society for Neurochemistry.

Royal Jelly Reduces Cholesterol Levels, Ameliorates Aβ Pathology and Enhances Neuronal Metabolic Activities in a Rabbit Model of Alzheimer's Disease.

PubMed

Pan, Yongming; Xu, Jianqin; Chen, Cheng; Chen, Fangming; Jin, Ping; Zhu, Keyan; Hu, Chenyue W; You, Mengmeng; Chen, Minli; Hu, Fuliang

2018-01-01

Alzheimer's disease (AD) is the most common form of dementia characterized by aggregation of amyloid β (Aβ) and neuronal loss. One of the risk factors for AD is high cholesterol levels, which are known to promote Aβ deposition. Previous studies have shown that royal jelly (RJ), a product of worker bees, has potential neuroprotective effects and can attenuate Aβ toxicity. However, little is known about how RJ regulates Aβ formation and its effects on cholesterol levels and neuronal metabolic activities. Here, we investigated whether RJ can reduce cholesterol levels, regulate Aβ levels and enhance neuronal metabolic activities in an AD rabbit model induced by 2% cholesterol diet plus copper drinking water. Our results suggest that RJ significantly reduced the levels of plasma total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C), and decreased the level of Aβ in rabbit brains. RJ was also shown to markedly ameliorate amyloid deposition in AD rabbits from Aβ immunohistochemistry and thioflavin-T staining. Furthermore, our study suggests that RJ can reduce the expression levels of β-site APP cleaving enzyme-1 (BACE1) and receptor for advanced glycation end products (RAGE), and increase the expression levels of low density lipoprotein receptor-related protein 1 (LRP-1) and insulin degrading enzyme (IDE). In addition, we found that RJ remarkably increased the number of neurons, enhanced antioxidant capacities, inhibited activated-capase-3 protein expression, and enhanced neuronal metabolic activities by increasing N-acetyl aspartate (NAA) and glutamate and by reducing choline and myo-inositol in AD rabbits. Taken together, our data demonstrated that RJ could reduce cholesterol levels, regulate Aβ levels and enhance neuronal metabolic activities in AD rabbits, providing preclinical evidence that RJ treatment has the potential to protect neurons and prevent AD.

Association of MAOA, 5-HTT, and NET promoter polymorphisms with gene expression and protein activity in human placentas

PubMed Central

Zhang, Huiping; Smith, Graeme N.; Liu, Xudong

2010-01-01

Monoamine oxidase A (MAOA) and the transporters for serotonin (5-HTT) and norepinephrine (NET) may play important roles in regulating maternal monoamine neurotransmitters transferred across the placenta to the fetus. We investigated whether promoter polymorphisms in MAOA (uVNTR), 5-HTT (5-HTTLPR), and NET (NETpPR AAGG4) could influence gene expression and protein activity in human placentas. Normal term human placentas (n = 73) were collected, and placental MAOA, 5-HTT, and NET mRNA levels and protein activity were determined. The mRNA levels or protein activities were compared between different genotype groups. Placentas hemizygous (male fetus) or homozygous (female fetus) for MAOA uVNTR 4-repeat allele had significantly higher MAOA mRNA levels than those hemizygous or homozygous for the 3-repeat allele (P = 0.001). However, no significant difference in MAOA enzyme activity was found for these two groups of genotypes (P = 0.161). Placentas with the 5-HTTLPR short (S)-allele (S/S+S/L) had significantly lower 5-HTT mRNA levels and serotonin uptake rate than those homozygous for the long (L)-allele (L/L) (mRNA: P < 0.001; serotonin transporting activity: P < 0.001). Placentas homozygous for the NET AAGG4 L4 allele had significantly higher NET mRNA levels, as well as dopamine and norepinephrine uptake rates, than those with the S4/L4 genotype (mRNA: P < 0.001; dopamine transporting activity: P = 0.012; norepinephrine transporting activity: P = 0.011). These findings suggest that the three promoter polymorphisms of MAOA, 5-HTT, and NET influence gene expression levels and protein activity of these genes in human placentas, potentially leading to different fetal levels of maternal monoamine neurotransmitters, which may have an impact on fetal neurodevelopment. PMID:20332182

Association of MAOA, 5-HTT, and NET promoter polymorphisms with gene expression and protein activity in human placentas.

PubMed

Zhang, Huiping; Smith, Graeme N; Liu, Xudong; Holden, Jeanette J A

2010-06-01

Monoamine oxidase A (MAOA) and the transporters for serotonin (5-HTT) and norepinephrine (NET) may play important roles in regulating maternal monoamine neurotransmitters transferred across the placenta to the fetus. We investigated whether promoter polymorphisms in MAOA (uVNTR), 5-HTT (5-HTTLPR), and NET (NETpPR AAGG(4)) could influence gene expression and protein activity in human placentas. Normal term human placentas (n = 73) were collected, and placental MAOA, 5-HTT, and NET mRNA levels and protein activity were determined. The mRNA levels or protein activities were compared between different genotype groups. Placentas hemizygous (male fetus) or homozygous (female fetus) for MAOA uVNTR 4-repeat allele had significantly higher MAOA mRNA levels than those hemizygous or homozygous for the 3-repeat allele (P = 0.001). However, no significant difference in MAOA enzyme activity was found for these two groups of genotypes (P = 0.161). Placentas with the 5-HTTLPR short (S)-allele (S/S+S/L) had significantly lower 5-HTT mRNA levels and serotonin uptake rate than those homozygous for the long (L)-allele (L/L) (mRNA: P < 0.001; serotonin transporting activity: P < 0.001). Placentas homozygous for the NET AAGG(4) L(4) allele had significantly higher NET mRNA levels, as well as dopamine and norepinephrine uptake rates, than those with the S(4)/L(4) genotype (mRNA: P < 0.001; dopamine transporting activity: P = 0.012; norepinephrine transporting activity: P = 0.011). These findings suggest that the three promoter polymorphisms of MAOA, 5-HTT, and NET influence gene expression levels and protein activity of these genes in human placentas, potentially leading to different fetal levels of maternal monoamine neurotransmitters, which may have an impact on fetal neurodevelopment.

Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis.

PubMed

Lin, Chung-Wei Christine; McAuley, James H; Macedo, Luciana; Barnett, Dominique C; Smeets, Rob J; Verbunt, Jeanine A

2011-03-01

It is often assumed that patients with pain-related disability due to low back pain (LBP) will have reduced physical activity levels, but recent studies have provided results that challenge this assumption. The aim of our systematic review was to examine the relationship between physical activity and disability in LBP. The literature search included 6 electronic databases and the reference list of relevant systematic reviews and studies to May 2010. To be included, studies had to measure both disability (eg, with the Roland Morris Disability Questionnaire) and physical activity (eg, by accelerometry) in patients with non-specific LBP. Two independent reviewers screened search results and extracted data, and authors were contacted for additional data. Correlation coefficients were pooled using the random-effects model. The search identified 3213 records and 18 studies were eligible for inclusion. The pooled results showed a weak relationship between physical activity and disability in acute or subacute (<3months) LBP (r=-0.08, 95% confidence interval=-0.17 to 0.002), and a moderate and negative relationship in chronic (>3months) LBP (r=-0.33, 95% confidence interval=-0.51 to -0.15). That is, persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability. Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity. Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability. Persons with chronic back pain with high levels of disability will likely have low levels of physical activity. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

The effect of different physical activity levels on muscle fiber size and type distribution of lumbar multifidus. A biopsy study on low back pain patient groups and healthy control subjects.

PubMed

Mazis, N; Papachristou, D J; Zouboulis, P; Tyllianakis, M; Scopa, C D; Megas, P

2009-12-01

Previous studies examining the multifidus fiber characteristics among low back pain (LBP) patients have not considered the variable of physical activity. The present study sought to investigate the muscle fiber size and type distribution of the lumbar multifidus muscle among LBP patient groups with different physical activity levels and healthy controls. Sixty-four patients were assigned to one of three groups named according to the physical activity level, determined for each patient by the International Physical Activity Questionnaire. These were low (LPA), medium (MPA) and high (HPA) physical activity groups. A control group comprising of 17 healthy individuals was also recruited. Muscle biopsy samples were obtained from the multifidus muscle at the level L4-L5. contrast with the control group, LBP patient groups showed a significantly higher Type II fiber distribution as well as reduced diameter in both fiber types (P<0.05). The physical activity level did not have an effect on multifidus characteristics since no significant differences were observed in fiber type and diameter (P>0.05) among LPA, MPA and HPA patient groups. Various pathological conditions were detected which were more pronounced in LBP groups compared to the control (P<0.05). Males had a larger fiber diameter compared to females for both fiber types (P<0.05). The results showed that the level of physical activity did not affect muscle fiber size and type distribution among LBP patients groups. These findings suggest that not only inactivity but also high physical activity levels can have an adverse effect on the multifidus muscle fiber characteristics.

Physical activity but not sedentary activity is reduced in primary Sjögren's syndrome.

PubMed

Ng, Wan-Fai; Miller, Ariana; Bowman, Simon J; Price, Elizabeth J; Kitas, George D; Pease, Colin; Emery, Paul; Lanyon, Peter; Hunter, John; Gupta, Monica; Giles, Ian; Isenberg, David; McLaren, John; Regan, Marian; Cooper, Annie; Young-Min, Steven A; McHugh, Neil; Vadivelu, Saravanan; Moots, Robert J; Coady, David; MacKay, Kirsten; Dasgupta, Bhaskar; Sutcliffe, Nurhan; Bombardieri, Michele; Pitzalis, Costantino; Griffiths, Bridget; Mitchell, Sheryl; Miyamoto, Samira Tatiyama; Trenell, Michael

2017-04-01

The aim of the study was to evaluate the levels of physical activity in individuals with primary Sjögren's syndrome (PSS) and its relationship to the clinical features of PSS. To this cross-sectional study, self-reported levels of physical activity from 273 PSS patients were measured using the International Physical Activity Questionnaire-short form (IPAQ-SF) and were compared with healthy controls matched for age, sex and body mass index. Fatigue and other clinical aspects of PSS including disease status, dryness, daytime sleepiness, dysautonomia, anxiety and depression were assessed using validated tools. Individuals with PSS had significantly reduced levels of physical activity [median (interquartile range, IQR) 1572 (594-3158) versus 3708 (1732-8255) metabolic equivalent of task (MET) × min/week, p < 0.001], but similar levels of sedentary activity [median (IQR) min 300 (135-375) versus 343 (223-433) (MET) × min/week, p = 0.532] compared to healthy individuals. Differences in physical activity between PSS and controls increased at moderate [median (IQR) 0 (0-480) versus 1560 (570-3900) MET × min/week, p < 0.001] and vigorous intensities [median (IQR) 0 (0-480) versus 480 (0-1920) MET × min/week, p < 0.001]. Correlation analysis revealed a significant association between physical activity and fatigue, orthostatic intolerance, depressive symptoms and quality of life. Sedentary activity did not correlate with fatigue. Stepwise linear regression analysis identified symptoms of depression and daytime sleepiness as independent predictors of levels of physical activity. Physical activity is reduced in people with PSS and is associated with symptoms of depression and daytime sleepiness. Sedentary activity is not increased in PSS. Clinical care teams should explore the clinical utility of targeting low levels of physical activity in PSS.

A Synthesis of Solar Cycle Prediction Techniques

NASA Technical Reports Server (NTRS)

Hathaway, David H.; Wilson, Robert M.; Reichmann, Edwin J.

1999-01-01

A number of techniques currently in use for predicting solar activity on a solar cycle timescale are tested with historical data. Some techniques, e.g., regression and curve fitting, work well as solar activity approaches maximum and provide a month-by-month description of future activity, while others, e.g., geomagnetic precursors, work well near solar minimum but only provide an estimate of the amplitude of the cycle. A synthesis of different techniques is shown to provide a more accurate and useful forecast of solar cycle activity levels. A combination of two uncorrelated geomagnetic precursor techniques provides a more accurate prediction for the amplitude of a solar activity cycle at a time well before activity minimum. This combined precursor method gives a smoothed sunspot number maximum of 154 plus or minus 21 at the 95% level of confidence for the next cycle maximum. A mathematical function dependent on the time of cycle initiation and the cycle amplitude is used to describe the level of solar activity month by month for the next cycle. As the time of cycle maximum approaches a better estimate of the cycle activity is obtained by including the fit between previous activity levels and this function. This Combined Solar Cycle Activity Forecast gives, as of January 1999, a smoothed sunspot maximum of 146 plus or minus 20 at the 95% level of confidence for the next cycle maximum.

Comparison of parameters of bone profile and homocysteine in physically active and non-active postmenopausal females.

PubMed

Tariq, Sundus; Lone, Khalid Parvez; Tariq, Saba

2016-01-01

Optimal physical activity is important in attaining a peak bone mass. Physically active women have better bone mineral density and reduce fracture risk as compared to females living a sedentary life. The objective of this study was to compare parameters of bone profile and serum homocysteine levels in physically active and non-active postmenopausal females. In this cross sectional study postmenopausal females between 50-70 years of age were recruited and divided into two groups: Physically inactive (n=133) performing light physical activity and Physically active (n=34) performing moderate physical activity. Physical activity (in metabolic equivalents), bone mineral density and serum homocysteine levels were assessed. Spearman's rho correlation was applied to observe correlations. Two independent sample t test and Mann Whitney U test were applied to compare groups. P-value ≤ 0.05 was taken statistically significant. Parameters of bone profile were significantly higher and serum homocysteine levels were significantly lower in postmenopausal females performing moderate physical activity as compared to females performing light physical activity. Homocysteine was not significantly related to T-score and Z-score in both groups. Improving physical activity could be beneficial for improving the quality of bone, decreasing fracture risk and decreasing serum homocysteine levels.

Estimation of physical activity by different questionnaires in overweight subjects and patients with Type 2 diabetes mellitus: relationship with anthropometric and metabolic variables.

PubMed

Babić, Z; Deskin, M; Muacević-Katanec, D; Erdeljić, V; Misigoj-Duraković, M; Metelko, Z

2004-10-01

This study assessed the level of physical activity in overweight and obese subjects, and overweight and obese patients with Type 2 diabetes mellitus (T2DM). It also compared their physical activity level with that of the general population and investigated benefits of physical activity on anthropometric and metabolic parameters and blood pressure in the studied groups of patients using Baecke's questionnaire and the Lipid Research Clinics Physical Activity (LRC PA) questionnaire. The two questionnaires were also compared in the evaluation of benefits. Physical activity level and other parameters (body weight, body height, body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, lipoprotein and creatinine concentrations in the blood, concentration of fasting glucose and HbA1c in the blood, albuminuria-to-creatinuria ratio) of 136 subjects and their relationships were investigated during their out-patient visits. No difference in physical activity level was found among the four groups of investigated patients. The comparison between the level of physical activity in the investigated patients and the general population obtained by Baecke's questionnaire revealed a lower sports index in all groups of investigated men and obese women with diabetes mellitus. Our results confirm the benefit of physical activity on a high number of investigated parameters in the studied patients. The Baecke's questionnaire was found to estimate the effects of physical activity on metabolic and anthropometric parameters, as well as blood pressure, better than the LRC PA questionnaire, especially the two-point scoring system. LRC PA and especially Baecke's questionnaires are valuable aids in the estimation of physical activity level and its benefits in overweight and obese patients and patients with T2DM.

Associations of B cell-activating factor (BAFF) and anti-BAFF autoantibodies with disease activity in multi-ethnic Asian systemic lupus erythematosus patients in Singapore.

PubMed

Howe, H S; Thong, B Y H; Kong, K O; Chng, H H; Lian, T Y; Chia, F L; Tay, K S S; Lau, T C; Law, W G; Koh, E T; Leung, B P

2017-09-01

To measure the levels of B cell-activating factor (BAFF) and endogenous anti-BAFF autoantibodies in a cohort of multi-ethnic Asian systemic lupus erythematosus (SLE) patients in Singapore, to determine their correlation with disease activity. Serum samples from 121 SLE patients and 24 age- and sex-matched healthy controls were assayed for BAFF and anti-BAFF immunoglobulin (Ig)G antibody levels by enzyme-linked immunosorbent assay (ELISA). The lowest reliable detection limit for anti-BAFF-IgG antibody levels was defined as 2 standard deviations (s.d.) from blank. Correlation of serum BAFF and anti-BAFF IgG levels with disease activity [scored by SLE Activity Measure revised (SLAM-R)], and disease manifestations were determined in these 121 patients. SLE patients had elevated BAFF levels compared to controls; mean 820 ± 40 pg/ml and 152 pg ± 45/ml, respectively [mean ± standard error of the mean (s.e.m.), P < 0·01], which were correlated positively with anti-dsDNA antibody levels (r = 0·253, P < 0·03), and SLAM-R scores (r = 0·627, P < 0·01). In addition, SLE patients had significantly higher levels of anti-BAFF IgG, which were correlated negatively with disease activity (r = -0·436, P < 0·01), levels of anti-dsDNA antibody (r = -0·347, P < 0·02) and BAFF (r = -0·459, P < 0·01). The majority of patients in this multi-ethnic Asian SLE cohort had elevated levels of BAFF and anti-BAFF antibodies. Anti-BAFF autoantibody levels correlated negatively with clinical disease activity, anti-dsDNA and BAFF levels, suggesting that they may be disease-modifying. Our results provide further information about the complexity of BAFF pathophysiology in different SLE disease populations and phenotypes, and suggest that studies of the influence of anti-cytokine antibodies in different SLE populations will be required when selecting patients for trials using targeted anti-cytokine therapies. © 2017 British Society for Immunology.

Schoolyard physical activity in 14-year-old adolescents assessed by mobile GPS and heart rate monitoring analysed by GIS.

PubMed

Fjørtoft, Ingunn; Löfman, Owe; Halvorsen Thorén, Kine

2010-11-01

Environmental settings seem to influence the activity patterns of children in neighbourhoods and schoolyards, the latter being an important arena to promote physical activity (PA) in school children. New technology has made it possible to describe free-living PA in interaction with the environment. This study focused on how schoolyard environments influenced the activity patterns and intensity levels in 14-year-old children and whether PA levels in adolescents complied with official recommendations. Another objective was to introduce methodology of using a mobile global positioning system (GPS) device with synchronous heart rate (HR) recordings as a proxy for PA level and a geographical information system (GIS) for spatial analyses. The sample constituted of 81 children (aged 14 years) from two schools. Movement patterns and activity levels were recorded during lunch break applying a GPS Garmin Forerunner 305 with combined HR monitoring and analysed in a GIS by an overlaid grid and kriging interpolation. Spatial data from GPS recordings showed particular movement patterns in the schoolyards. Low activity levels (mean HR < 120 bpm) dominated in both schools with no gender differences. Activities located to a handball goal area showed the highest monitored HR (>160 bpm) with higher intensity in girls than in boys. Movement patterns and PA generated in GIS for visualisation and analysis enabled direct and realistic description of utilising of schoolyard facilities and activity levels. Linking GPS data and PA levels to spatial structures made it possible to visualise the environmental interaction with PA and which environments promoted low or high PA.

A multi-level examination of school programs, policies and resources associated with physical activity among elementary school youth in the PLAY-ON study

PubMed Central

2010-01-01

Background Given the decline in physical activity (PA) levels among youth populations it is vital to understand the factors that are associated with PA in order to inform the development of new prevention programs. Many studies have examined individual characteristics associated with PA among youth yet few have studied the relationship between the school environment and PA despite knowing that there is variability in student PA levels across schools. Methods Using multi-level logistic regression analyses we explored the school- and student-level characteristics associated with PA using data from 2,379 grade 5 to 8 students attending 30 elementary schools in Ontario, Canada as part of the PLAY-Ontario study. Results Findings indicate that there was significant between-school random variation for being moderately and highly active; school-level differences accounted for 4.8% of the variability in the odds of being moderately active and 7.3% of the variability in the odds of being highly active. Students were more likely to be moderately active if they attended a school that used PA as a reward and not as discipline, and students were more likely to be highly active if they attended a school with established community partnerships. Important student characteristics included screen time sedentary behaviour, participating in team sports, and having active friends. Conclusion Future research should evaluate if the optimal population level impact for school-based PA promotion programming might be achieved most economically if intervention selectively targeted the schools that are putting students at the greatest risk for inactivity. PMID:20181010

Interaction between organophosphate pesticide exposure and PON1 activity on thyroid function

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lacasana, Marina, E-mail: marina.lacasana.easp@juntadeandalucia.e; CIBER de Epidemiologia y Salud Publica; Lopez-Flores, Inmaculada

Organophosphate pesticides are widely used in agricultural purposes. Recently, a few studies have demonstrated the ability of these chemicals to alter the function of the thyroid gland in human. Moreover, the paraoxonase-1 enzyme (PON1) plays an important role in the toxicity of some organophosphate pesticides, with low PON1 activity being associated with higher pesticide sensitivity. This study evaluates the interaction between exposure to organophosphate compounds and PON1 enzyme activity on serum levels of TSH and thyroid hormones in a population of workers occupationally exposed to pesticides. A longitudinal study was conducted on a population of floriculture workers from Mexico, duringmore » two periods of high and low-intensity levels of pesticide application. A structured questionnaire was completed by workers containing questions on sociodemographic characteristics and other variables of interest. Urine and blood samples were taken, and biomarkers of exposure (dialkylphosphates), susceptibility (PON1 polymorphisms and activity) and effect (thyroid hormone levels) were determined. Interaction between dialkylphosphates and PON1 polymorphisms or PON1 activity on hormone levels was evaluated by generalized estimating equation (GEE) models. A significant interaction was found between serum diazoxonase activity and total dialkylphosphates ({Sigma}DAP) on TSH levels. Thus, when PON1 activity was increased we observed a decrease in the percentage of variation of TSH level for each increment in one logarithmic unit of the {Sigma}DAP levels. This interaction was also observed with the PON1{sub 192}RR genotype. These results suggest a stronger association between organophosphate pesticides and thyroid function in individuals with lower PON1 activity.« less

Cytochrome P450 1A2 (CYP1A2) activity, mammographic density, and oxidative stress: a cross-sectional study

PubMed Central

Hong, Chi-Chen; Tang, Bing-Kou; Rao, Venketeshwer; Agarwal, Sanjiv; Martin, Lisa; Tritchler, David; Yaffe, Martin; Boyd, Norman F

2004-01-01

Introduction Mammographically dense breast tissue is a strong predictor of breast cancer risk, and is influenced by both mitogens and mutagens. One enzyme that is able to affect both the mitogenic and mutagenic characteristics of estrogens is cytochrome P450 1A2 (CYP1A2), which is principally responsible for the metabolism of 17β-estradiol. Methods In a cross-sectional study of 146 premenopausal and 149 postmenopausal women, we examined the relationships between CYP1A2 activity, malondialdehyde (MDA) levels, and mammographic density. In vivo CYP1A2 activity was assessed by measuring caffeine metabolites in urine. Levels of serum and urinary MDA, and MDA–deoxyguanosine adducts in DNA were measured. Mammograms were digitized and measured using a computer-assisted method. Results CYP1A2 activity in postmenopausal women, but not in premenopausal women, was positively associated with mammographic density, suggesting that increased CYP1A2 activity after the menopause is a risk factor for breast cancer. In premenopausal women, but not in postmenopausal women, CYP1A2 activity was positively associated with serum and urinary MDA levels; there was also some evidence that CYP1A2 activity was more positively associated with percentage breast density when MDA levels were high, and more negatively associated with percentage breast density when MDA levels were low. Conclusion These findings provide further evidence that variation in the activity level of enzymes involved in estrogen metabolism is related to levels of mammographic density and potentially to breast cancer risk. PMID:15217501

Self-reported physical activity and lung function two months after cardiac surgery--a prospective cohort study.

PubMed

Jonsson, Marcus; Urell, Charlotte; Emtner, Margareta; Westerdahl, Elisabeth

2014-03-28

Physical activity has well-established positive health-related effects. Sedentary behaviour has been associated with postoperative complications and mortality after cardiac surgery. Patients undergoing cardiac surgery often suffer from impaired lung function postoperatively. The association between physical activity and lung function in cardiac surgery patients has not previously been reported. Patients undergoing cardiac surgery were followed up two months postoperatively. Physical activity was assessed on a four-category scale (sedentary, moderate activity, moderate regular exercise, and regular activity and exercise), modified from the Swedish National Institute of Public Health's national survey. Formal lung function testing was performed preoperatively and two months postoperatively. The sample included 283 patients (82% male). Two months after surgery, the level of physical activity had increased (p < 0.001) in the whole sample. Patients who remained active or increased their level of physical activity had significantly better recovery of lung function than patients who remained sedentary or had decreased their level of activity postoperatively in terms of vital capacity (94 ± 11% of preoperative value vs. 91 ± 9%; p = 0.03), inspiratory capacity (94 ± 14% vs. 88 ± 19%; p = 0.008), and total lung capacity (96 ± 11% vs. 90 ± 11%; p = 0.01). An increased level of physical activity, compared to preoperative level, was reported as early as two months after surgery. Our data shows that there could be a significant association between physical activity and recovery of lung function after cardiac surgery. The relationship between objectively measured physical activity and postoperative pulmonary recovery needs to be further examined to verify these results.

Relationship between observational learning and health belief with physical activity among adolescents girl in Isfahan, Iran

PubMed Central

Rostamian, Marzieh; Kazemi, Ashraf

2016-01-01

Background: Physical activities among adolescents affects health during pubescence and adolescence and decrease in physical activities among adolescents has become a global challenge. The aim of the present study was to define the relation between the level of physical activity among adolescent girls and their health beliefs as personal factor and level of observational learning as environmental factor. Materials and Methods: The present study was a cross-sectional study that was conducted on 400 students aged from 11 to 19 years in Isfahan, Iran. Information regarding the duration of physical activity with moderate/severe intensity was measured in four dimensions of leisure time (exercising and hiking), daily activities, and transportation-related activities using the International Physical Activity questionnaire. Health belief structures included perceived sensitivity, intensity of perceived threat, perceived benefits, and barriers and self-efficacy; observational learning was measured using a researcher-made questionnaire. Results: Results showed that perceived barriers, observational learning, and level of self-efficacy were related to the level of physical activity in all dimensions. In addition, the level of physical activity at leisure time, transportation, and total physical activity were dependent on the intensity of perceived threats (P < 0.05). Conclusions: This study showed that the intensity of perceived threats, perceived barriers and self-efficacy structures, and observational learning are some of the factors related to physical activity among adolescent girls, and it is possible that by focusing on improving these variables through interventional programs physical activity among adolescent girls can be improved. PMID:28194200

Methods for measuring serum activity levels of the 192 Q and R isoenzymes of paraoxonase 1 in QR heterozygous individuals.

PubMed

Teiber, John F; Kramer, Gerald L; Haley, Robert W

2013-08-01

Paraoxonase 1 (PON1), an esterase that hydrolyzes toxic organophosphates and has antioxidative and antiatherogenic properties, contains a common polymorphism at position 192: glutamine (Q) or arginine (R). The Q and R isoenzymes exhibit different physical and protective properties. We describe 2 methods for quantifying their serum activity levels. We measured serum hydrolytic activity with paraoxon [paraoxonase (PXN) activity], phenylacetate [arylesterase (AE) activity], and diazoxon [diazoxonase (DZN) activity] with standard automated assays. We determined PON1 Q192R genotypes with PCR and Q192R phenotypes using the PXN/AE and PXN/DZN ratios. Interpolation equations were empirically derived to predict the percentage of total PON1 hydrolytic activity due to the Q isoenzyme (%Q) from the PXN/AE and PXN/DZN ratios; %R is 100 - %Q. We estimated Q and R isoenzyme activity levels in sera from 2095 veterans by multiplying AE activity, a measure of total PON1 hydrolytic activity, by %Q and %R. In all 2095 samples, the PXN/AE and PXN/DZN ratios predicted Q192R phenotypes with nearly identical accuracy (κ = 0.997). In the 925 QR heterozygotes, the 2 interpolation methods predicted Q and R isoenzyme activity levels with excellent agreement (intraclass correlation 0.94). After excluding a few genotype/phenotype-discordant samples, the percentage of total PON1 activity due to the Q isoenzyme ranged from 22% to 70%. These new interpolation methods allow accurate estimation of PON1 192 Q and R isoenzyme activity levels, increasing specificity and power for studying susceptibility to disease.

Correlation between the Physical Activity Level and Grade Point Averages of Faculty of Education Students

ERIC Educational Resources Information Center

Imdat, Yarim

2014-01-01

The aim of the study is to find the correlation that exists between physical activity level and grade point averages of faculty of education students. The subjects consist of 359 (172 females and 187 males) under graduate students To determine the physical activity levels of the students in this research, International Physical Activity…

How stable are physical activity habits among adults? The Doetinchem Cohort Study.

PubMed

Picavet, H Susan J; Wendel-vos, G C Wanda; Vreeken, Hilda L; Schuit, A Jantine; Verschuren, W Monique M

2011-01-01

Leisure time physical activity in compliance with recommended levels is associated with improved health and lower mortality, but little is known on whether these physical activity habits are stable among adults and what characteristics predict physical activity changes. Our objective was to determine change in the levels of leisure time physical activity among adults during a period of 10 yr. Detailed information on time spent on cycling, gardening, doing odd jobs, and sports from three measurement periods (1993-1997, 1998-2002, and 2003-2007) of the population-based Doetinchem Cohort Study was used to define being active: spending at least 3.5 h·wk(-1) on moderate to vigorous physical activities, an approximation of the Dutch recommended level. Almost one-third (31.4%) of the population were active at all three points in time, 3.6% were inactive, and 45.0% of the participants changed their level of physical activity, almost equally distributed over decreasers, increasers, and varying. Not smoking (odds ratio (OR) = 1.47, 95% confidence limits (CL) = 1.14-1.89) and high socioeconomic status (OR = 1.43, 95% CL = 1.07-1.92) were associated with staying active. Inactive men (OR = 0.73, 95% CL = 0.57-0.94) had the highest risk of staying inactive, whereas good perceived health was associated with becoming active (OR = 1.49, 95% CL = 1.09-2.03). The finding that, in a decade, almost half of the population changed from active to inactive or vice versa affects the interpretation of the long-term health effects of physical activity measured only once, and it stresses the importance of interventions not only in increasing physical activity levels but also in maintaining a physically active lifestyle.

Objectively measured physical activity in Danish after-school cares: Does sport certification matter?

PubMed

Domazet, S L; Møller, N C; Støckel, J T; Ried-Larsen, M

2015-12-01

Inactivity and more sedentary time predominate the daily activity level of many of today's children. In Denmark, certified sport after-school cares have been established in order to increase children's daily physical activity (PA) level. This cross-sectional study aimed to investigate the activity level among participants in certified sport after-school cares vs regular after-school cares. The study was carried out in 2011 in 10 after-school cares (5 sport/5 regular) throughout Denmark, whereof 475 children aged 5-11 years participated. PA level was assessed using Actigraph GT3X and GT3X+ activity monitors worn by the children for at least 8 consecutive days. Anthropometry and cardiorespiratory fitness were measured as well. A multivariate regression analysis was carried out to check for the differences in the PA level across the two care systems. However, there did not appear to be any differences in overall PA or in time-specific day parts (e.g., during after-school care). The activity levels were quite similar across after-school cares and were mutually high during time spent in the care facility. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Blood Glucose Levels and Problem Behavior

ERIC Educational Resources Information Center

Valdovinos, Maria G.; Weyand, David

2006-01-01

The relationship between varying blood glucose levels and problem behavior during daily scheduled activities was examined. The effects that varying blood glucose levels had on problem behavior during daily scheduled activities were examined. Prior research has shown that differing blood glucose levels can affect behavior and mood. Results of this…

Emergence of long-range correlations and bursty activity patterns in online communication

NASA Astrophysics Data System (ADS)

Panzarasa, Pietro; Bonaventura, Moreno

2015-12-01

Research has suggested that the activity occurring in a variety of social, economic, and technological systems exhibits long-range fluctuations in time. Pronounced levels of rapidly occurring events are typically observed over short periods of time, followed by long periods of inactivity. Relatively few studies, however, have shed light on the degree to which inhomogeneous temporal processes can be detected at, and emerge from, different levels of analysis. Here we investigate patterns of human activity within an online forum in which communication can be assessed at three intertwined levels: the micro level of the individual users; the meso level of discussion groups and continuous sessions; and the macro level of the whole system. To uncover the relation between different levels, we conduct a number of numerical simulations of a zero-crossing model in which users' behavior is constrained by progressively richer and more realistic rules of social interaction. Results indicate that, when users are solipsistic, their bursty behavior is not sufficient for generating heavy-tailed interevent time distributions at a higher level. However, when users are socially interdependent, the power spectra and interevent time distributions of the simulated and real forums are remarkably similar at all levels of analysis. Social interaction is responsible for the aggregation of multiple bursty activities at the micro level into an emergent bursty activity pattern at a higher level. We discuss the implications of the findings for an emergentist account of burstiness in complex systems.

Circadian force and EMG activity in hindlimb muscles of rhesus monkeys

NASA Technical Reports Server (NTRS)

Hodgson, J. A.; Wichayanuparp, S.; Recktenwald, M. R.; Roy, R. R.; McCall, G.; Day, M. K.; Washburn, D.; Fanton, J. W.; Kozlovskaya, I.; Edgerton, V. R.;

Serine protease allergen favours Th2 responses via PAR-2 and STAT3 activation in murine model.

PubMed

Agrawal, K; Arora, N

2018-03-01

Protease activity of Per a 10 favours Th2 responses by differential regulation of IL-12p70 and IL-23 cytokine subunits. This study aimed to elucidate the underlying mechanism of differential regulation of IL-12p70 and IL-23. PAR-2 activation was blocked in murine model by administering SAM11 before each sensitization. CD11c + p-STAT3 + cells were measured in lungs by flow cytometry. BMDCs were pretreated with SAM11 or isotype control or stattic and stimulated with Per a 10. p-STAT3 levels were measured using Western blot. Transcript levels of IL-12p35, IL-12/23p40 and IL-23p19 were measured using RT-PCR. Cytokine levels were analysed using ELISA. Protease activity of Per a 10 increased p-STAT3 levels in mouse lungs, which was reduced upon PAR-2 blockage. Percentage of p-STAT3 + CD11c + cells was higher in Per a 10-administered mice and was reduced upon PAR-2 blockage. IL-12p35 and IL-12p70 levels were higher, and IL-23p19 and IL-23 levels were lower in both SAM11-treated mice and BMDCs indicating a role of PAR-2-mediated signalling. IL-4, TSLP, IL-17A, EPO activity, total cell count and specific IgE and IgG1 levels were lower in SAM11-administered mice. Inhibiting STAT3 activation via stattic also leads to lower levels of IL-23p19 and IL-23 and higher levels of IL-12p35. Per a 10 leads to PAR-2 activation on BMDCs resulting in downstream activation of STAT3 to regulate the balance between IL-12/IL-23 subunits causing a cytokine milieu rich in IL-23 to favour Th2 polarization. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Age characteristics of changes in invertase activity of the mucous membrane of the small intestine

NASA Technical Reports Server (NTRS)

Rakhimov, K. R.; Aleksandrova, N. V.

1980-01-01

Rats of varying ages were subjected to stress from heat, cold, and hydrocortisone injection. Invertase activity in homogenates of small intestine mucous membranes was studied following sacrifice. Invertase activity was low in young animals, but increased sharply in 30 day old ones, remaining at a relatively constant level until old age. The study concludes that the stress hormone (corticosteroids, etc.) levels in the blood, which affects the formation of enteric enzyme levels and activities, and that age related peculiarities in invertase activity are a consequence of altered hormone status and epitheliocyte sensitivity.

Older adults' intrinsic and extrinsic motivation toward physical activity.

PubMed

Dacey, Marie; Baltzell, Amy; Zaichkowsky, Len

2008-01-01

To examine how motives discriminate 3 physical activity levels of inactive, active, and sustained maintainers. Six hundred forty-five adults (M age = 63.8) completed stage-of-change and Exercise Motivations Inventory (EMI-2) scales. Exploratory factor analysis established psychometric properties of the EMI-2 suitable for older adults. Six factors emerged in the EMI-2: health and fitness, social/emotional benefits, weight management, stress management, enjoyment, and appearance. Enjoyment contributed most to differentiating activity levels. Moderators of age and gender were delineated. Intrinsic motivation and self-determined extrinsic motivation distinguish older adults' activity levels.

Physical activity levels and participation in sport in Irish people with haemophilia.

PubMed

Sherlock, E; O'Donnell, J S; White, B; Blake, C

2010-01-01

Physical activity and sport are associated with a range of health and social benefits. The aim of this study was to assess the level of sports participation and physical activity of Irish people with haemophilia (PWH). A questionnaire was administered to Irish PWH attending the National Centre for Hereditary Coagulation Disorders over a 3-month period. This included the International Physical Activity Questionnaire (IPAQ) and the Haemophilia Activities List (HAL). Comparisons with EU average data from European Physical Activity Surveillance System for physical activity scores (IPAQ) were made using independent t-tests and percentage variance. Relationships between age, functional limitation (based on HAL) and IPAQ scores were tested with Pearson's correlation. Sixty-one questionnaires were completed, representing 12% of the Irish haemophilia population. Age ranged from 16 to 63; all levels of severity were included. Forty-six percent of Irish PWH achieved a high level of physical activity, but overall physical activity [total metabolic equivalents of task (MET) min] in the group was only 66% of the EU average. Elderly patients and those with more functional limitations (with lower HAL scores) were significantly less active. Sports participation levels were in line with other PWH at 66%. Although 55% reported bleeds resulting from sport and 31% reported having had a significant injury attributable to sport, overall sport was viewed in a positive light. Irish PWH are physically active and play a wide range of sports. Further efforts are needed to achieve optimal safety and to ensure that maximum benefit is gained.

Correlation between IL-17A/F, IL-23, IL-35 and IL-12/-23 (p40) levels in peripheral blood lymphocyte cultures and disease activity in Behcet's patients.

PubMed

Sonmez, Cemile; Yucel, Aysegul Atak; Yesil, Turan Hilmi; Kucuk, Hamit; Sezgin, Berna; Mercan, Ridvan; Yucel, Ahmet Eftal; Demirel, Gulderen Yanikkaya

2018-03-20

Behcet's disease is a chronic multisystemic disease with remissions and relapses. Several studies have shown that immune mechanisms play an important role in the development of the disease. In order to assess the association of disease activity with IL-17A/F, IL-23, IL-12/23 (p40) and IL-35 expression, we aimed to investigate production of these cytokines in peripheral blood mononuclear cells (PBMCs) from Behcet's patients and normal controls. Furthermore, we included Systemic Lupus Erythematosus (SLE) as disease control to evaluate the specificity of our data for immunopathogenesis of BD. Totally 15 active, 15 inactive Behcet's patients, 12 active and 12 inactive SLE patients and 12 healthy volunteers were enrolled in the study. Peripheral blood mononuclear cells were separated, lymphocyte cultures were performed and IL-17A/F, IL-12/23 p(40), IL-23, IL-35 cytokine levels were measured by ELISA in culture supernatants in the presence or absence of phytohemagglutinin (PHA) on time-dependent manner. IL-17 A/F levels increased parallel to IL-23 levels in Behcet's and SLE patients. Compared to healthy controls, IL-17 A/F levels were higher in active Behcet's and SLE patients; on the contrary, levels of IL-35 were lower. IL-17A/F, IL-12/23 (p40) and IL-23 levels were detectable most frequently in active Behcet's patients followed by active SLE patients. Our results indicate that IL-17 A/F, IL-23 and IL-12/23 (p40) may play role in the immunopathogenesis of BD so as Th17 and Th1 cell responses. Since IL-35 levels were lower in active Behcet's patients compared to inactive patients and healthy controls, there may be a plasticity between Th17 and Treg cells according to the state of disease activity.

National physical activity surveillance: Users of wearable activity monitors as a potential data source.

PubMed

Omura, John D; Carlson, Susan A; Paul, Prabasaj; Watson, Kathleen B; Fulton, Janet E

2017-03-01

The objective of this study was to assess usage patterns of wearable activity monitors among US adults and how user characteristics might influence physical activity estimates from this type of sample. We analyzed data on 3367 respondents to the 2015 HealthStyles survey, an annual consumer mail panel survey conducted on a nationwide sample. Approximately 1 in 8 respondents (12.5%) reported currently using a wearable activity monitor. Current use varied by sex, age, and education level. Use increased with physical activity level from 4.3% for inactive adults to 17.4% for active adults. Overall, 49.9% of all adults met the aerobic physical activity guideline, while this prevalence was 69.5% among current activity monitor users. Our findings suggest that current users of wearable activity monitors are not representative of the overall US population. Estimates of physical activity levels using data from wearable activity monitors users may be an overestimate and therefore data from users alone may have a limited role in physical activity surveillance.

Multi-level examination of correlates of active transportation to school among youth living within 1 mile of their school.

PubMed

Gropp, Kathleen M; Pickett, William; Janssen, Ian

2012-10-16

Active transportation to school is a method by which youth can build physical activity into their daily routines. We examined correlates of active transportation to school at both individual- (characteristics of the individual and family) and area- (school and neighborhood) levels amongst youth living within 1 mile (1.6 km) of their school. Using the 2009/10 Canadian Health Behaviour in School-Aged Children (HBSC) survey, we selected records of students (n = 3 997) from 161 schools that resided in an urban setting and lived within 1 mile from their school. Student records were compiled from: (1) individual-level HBSC student questionnaires; (2) area-level administrator (school) questionnaires; and (3) area-level geographic information system data sources. The outcome, active transportation to school, was determined via a questionnaire item describing the method of transportation that individual students normally use to get to school. Analyses focused on factors at multiple levels that potentially contribute to student decisions to engage in active transportation. Multi-level logistic regression analyses were employed. Approximately 18% of the variance in active transportation was accounted for at the area-level. Several individual and family characteristics were associated with engagement in active transportation to school including female gender (RR vs. males = 0.86, 95% CI: 0.80-0.91), having ≥2 cars in the household (RR vs. no cars = 0.87, 0.74-0.97), and family socioeconomic status (RR for 'not well off' vs. 'very well off' = 1.14, 1.01-1.26). Neighborhood characteristics most strongly related to active transportation were: the length of roads in the 1 km buffer (RR in quartile 4 vs. quartile 1 = 1.23, 1.00-1.42), the amount of litter in the neighborhood (RR for 'major problem' vs. 'no problem' = 1.47, 1.16-1.57), and relatively hot climates (RR in quartile 4 vs. quartile 1 = 1.33 CI, 1.05-1.53). Engagement in active transportation to school was related to multiple factors at multiple levels. We identified gender, perception of residential neighborhood safety, the percentage of streets with sidewalks, and the total length of roads as the most important correlates of active transportation to school.

Multi-level examination of correlates of active transportation to school among youth living within 1 mile of their school

PubMed Central

2012-01-01

Background Active transportation to school is a method by which youth can build physical activity into their daily routines. We examined correlates of active transportation to school at both individual- (characteristics of the individual and family) and area- (school and neighborhood) levels amongst youth living within 1 mile (1.6 km) of their school. Methods Using the 2009/10 Canadian Health Behaviour in School-Aged Children (HBSC) survey, we selected records of students (n = 3 997) from 161 schools that resided in an urban setting and lived within 1 mile from their school. Student records were compiled from: (1) individual-level HBSC student questionnaires; (2) area-level administrator (school) questionnaires; and (3) area-level geographic information system data sources. The outcome, active transportation to school, was determined via a questionnaire item describing the method of transportation that individual students normally use to get to school. Analyses focused on factors at multiple levels that potentially contribute to student decisions to engage in active transportation. Multi-level logistic regression analyses were employed. Results Approximately 18% of the variance in active transportation was accounted for at the area-level. Several individual and family characteristics were associated with engagement in active transportation to school including female gender (RR vs. males = 0.86, 95% CI: 0.80-0.91), having ≥2 cars in the household (RR vs. no cars = 0.87, 0.74-0.97), and family socioeconomic status (RR for ‘not well off’ vs. ‘very well off’ = 1.14, 1.01-1.26). Neighborhood characteristics most strongly related to active transportation were: the length of roads in the 1 km buffer (RR in quartile 4 vs. quartile 1 = 1.23, 1.00-1.42), the amount of litter in the neighborhood (RR for ‘major problem’ vs. ‘no problem’ = 1.47, 1.16-1.57), and relatively hot climates (RR in quartile 4 vs. quartile 1 = 1.33 CI, 1.05-1.53). Conclusion Engagement in active transportation to school was related to multiple factors at multiple levels. We identified gender, perception of residential neighborhood safety, the percentage of streets with sidewalks, and the total length of roads as the most important correlates of active transportation to school. PMID:23067247

Autoantibody levels in myositis patients correlate with clinical response during B cell depletion with rituximab.

PubMed

Aggarwal, Rohit; Oddis, Chester V; Goudeau, Danielle; Koontz, Diane; Qi, Zengbiao; Reed, Ann M; Ascherman, Dana P; Levesque, Marc C

2016-06-01

To determine the longitudinal trends in serum levels of four myositis-associated autoantibodies: anti-Jo-1, -transcription intermediary factor 1 γ (TIF1-γ), -signal recognition particle (SRP) and -Mi-2, after B cell depletion with rituximab, and to determine the longitudinal association of these autoantibody levels with disease activity as measured by myositis core-set measures (CSMs). Treatment-resistant adult and pediatric myositis subjects (n = 200) received rituximab in the 44-week Rituximab in Myositis Trial. CSMs [muscle enzymes, manual muscle testing (MMT), physician and patient global disease activity, HAQ, and extramuscular disease activity] were evaluated monthly and anti-Jo-1 (n = 28), -TIF1-γ (n = 23), -SRP (n = 25) and -Mi-2 (n = 26) serum levels were measured using validated quantitative ELISAs. Temporal trends and the longitudinal relationship between myositis-associated autoantibodies levels and CSM were estimated using linear mixed models. Following rituximab, anti-Jo-1 levels decreased over time (P < 0.001) and strongly correlated with all CSMs (P < 0.008). Anti-TIF1-γ levels also decreased over time (P < 0.001) and were only associated with HAQ, MMT and physician and patient global disease activity. Anti-SRP levels did not change significantly over time, but were significantly associated with serum muscle enzymes. Anti-Mi-2 levels significantly decreased over time and were associated with muscle enzymes, MMT and the physician global score. Anti-Jo-1, anti-TIF1-γ and anti-Mi-2 levels in myositis subjects decreased after B cell depletion and were correlated with changes in disease activity, whereas anti-SRP levels were only associated with longitudinal muscle enzyme levels. The strong association of anti-Jo-1 levels with clinical outcomes suggests that anti-Jo-1 autoantibodies may be a good biomarker for disease activity. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Changes in serum levels of lipopolysaccharides and CD26 in patients with Crohn's disease

PubMed Central

Kotze, Paulo Gustavo; Martinez, Carlos Augusto Real; Camargo, Michel Gardere; Guadagnini, Dioze; Calixto, Antonio Ramos; Vasques, Ana Carolina Junqueira; Ayrizono, Maria de Lourdes Setsuko; Geloneze, Bruno; Pareja, José Carlos; Saad, Mario José; Coy, Claudio Saddy Rodrigues

2017-01-01

Background/Aims Lipopolysaccharide (LPS) is a molecule formed by lipids and polysaccharides and is the major cell wall component of gram-negative bacteria. High LPS levels are known to block CD26 expression by activating Toll-like receptor 4. The aim of this study was to correlate the serum levels of LPS and CD26 in Crohn's disease (CD) patients with serum levels of C-reactive protein (CRP), interleukins, CD activity index, and tumor necrosis factor-α (TNF-α). Methods Serum samples were collected from 27 individuals (10 with active CD, 10 with inactive CD, and 7 controls) and the levels of LPS, CD26, TNF-α, interleukin-1β (IL-1β), IL-6, IL-17, and CRP were determined by enzyme-linked immunosorbent assay. The levels of LPS and CD26 were then tested for correlation with TNF-α, IL-1β, IL-6, IL-17, and CRP. Results Serum levels of LPS were significantly elevated in the active CD group (P=0.003). Levels of IL-1β (P=0.002), IL-6 (P=0.003), and IL-17 (P<0.001) were lower in the CD groups. Serum TNF-α levels were increased in the active CD group. The CRP levels were elevated in the CD groups when compared to controls (P<0.001). The CD26 levels were lower in the CD groups than in the control group (P<0.001). Among the variables analyzed, there was a correlation between LPS and CRP (r=−0.53, P=0.016) in the CD groups. Conclusions Individuals with CD exhibited higher serum levels of LPS varying from a 2- to 6-fold increase depending on disease activity, when compared with healthy controls. CD26 levels were lower in the CD groups. Both LPS and CD26 correlated with disease severity and serve as potential CD biomarkers. PMID:28670232

What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma?

PubMed

Hobusch, Gerhard M; Bollmann, Jakob; Puchner, Stephan E; Lang, Nikolaus W; Hofstaetter, Jochen G; Funovics, Philipp T; Windhager, Reinhard

2017-03-01

Limited information is available about sports activities of survivors after resection and reconstruction of primary malignant bone tumors with megaprostheses. Because patients often ask what activities are possible after treatment, objective knowledge about sports activities is needed to help assess the risks of sports participation and to help guide patients' expectations. The aims of this study were to evaluate (1) what proportion of patients with proximal-femoral megaprostheses placed as part of tumor reconstructions can perform sports; (2) what activity levels they achieved; and (3) whether sports activity levels are associated with an increased likelihood of revision. This retrospective study considered all 27 living patients in our institutional tumor registry with enduring proximal-femoral reconstructions performed more than 5 years ago who were between the ages of 11 and 49 years at the time of the reconstruction; seven were lost to followup and one was excluded because of paraplegia as a result of a car accident and another because of senile dementia; another two were excluded from statistics because of growing prostheses and skeletal immaturity at the time of followup, leaving 16 (11 male, five female) for analysis. Their mean age was 26 ± 12 years (range, 11-49 years) at surgery, and the mean followup was 18 ± 7 years (range, 5-27 years). Types of sports, frequency per week, duration of each sports session as well as the UCLA and modified Weighted Activity Score were assessed retrospectively by an independent assessor a median of 18 years (range, 5.3-27 years) after surgery. Patients recalled that preoperatively 14 were practicing sports 5 (± 4) hours/week. At followup, 11 of the patients were practicing one or more sports activities 2 (± 3) hours/week on a regular basis. The preoperative UCLA and modified Weighted Activity Score levels of 9 and 6 fell to levels of 6 (p = 0.005) and 3 (p = 0.025), respectively, at followup. With the numbers of patients available for study, we could not determine that prosthetic failures were associated with sport activity levels. Patients who survive primary malignant bone tumors in the proximal femur reconstructed by megaprostheses are able to perform some sports activities. The estimates of activity levels made in this study probably are best-case estimates, given that some patients were lost to followup; patients unaccounted for might not be doing as well as those represented here. Also, the degree to which sports participation influences implant durability remains, for the most part, unanswered; studies with more patients and longer followup will be needed to determine to what degree prosthesis survivorship relates to sporting activity levels. Most patients perform low-impact sports and at a lower level than they had preoperatively. Because this is a preliminary study of a select group of patients, further information is necessary to weight the benefits of higher sports activity levels against potential risks. If this can be confirmed in a larger number of patients, the information may guide surgeons in their discussion with patients preoperatively and give them some objective assessment of what to expect regarding sports activities. Level IV, therapeutic study.

Hydroxychloroquine Blood Levels in Systemic Lupus Erythematosus: Clarifying Dosing Controversies and Improving Adherence.

PubMed

Durcan, Laura; Clarke, William A; Magder, Laurence S; Petri, Michelle

2015-11-01

Hydroxychloroquine (HCQ) is used for its effect on systemic lupus erythematosus (SLE) disease activity and longterm benefits. This can be limited by adherence. One way to assess adherence is to measure blood levels. Conflicting data exist regarding blood levels and disease activity. There is disagreement about dosing; rheumatologists recommend weight-based dosing while some other specialists advocate height-based "ideal body weight" dosing. Patients were prescribed HCQ not exceeding 6.5 mg/kg (max 400 mg/day). In hemodialysis, the dose was 200 mg after each session, and in renal insufficiency it was 200 mg/day. Levels were measured at each visit with a therapeutic range of 500-2000 ng/ml. Patients were divided according to baseline blood level. To assess the effect of measurement and counseling on adherence, we compared the proportion of patients with a level of 500 ng/ml or higher based on the number of prior assessments. The proportion of patients with HCQ levels in the therapeutic range differed significantly by age, sex, and Vitamin D level. There was a trend toward lower levels with renal failure. Blood levels were similar regardless of height and ideal body weight. Comparing those with undetectable, subtherapeutic, and therapeutic levels, disease activity decreased (SLE Disease Activity Index 2.92, 2.36, and 2.20, p = 0.04 for trend). At first, 56% were therapeutic, and by the third measurement this increased to 80% (p ≤ 0.0001). There was a trend toward higher disease activity with lower HCQ levels. Renal failure dosing led to suboptimum levels. We show that weight-based dosing (max 400 mg daily) is appropriate and that height does not appear to influence levels. Measurement, counseling, and repeated testing can increase adherence rates.

Physical Activity and Its Correlates among Adults in Malaysia: A Cross-Sectional Descriptive Study.

PubMed

Cai Lian, Tam; Bonn, Gregory; Si Han, Yeoh; Chin Choo, Yap; Chee Piau, Wong

2016-01-01

Obesity and rates of non-communicable diseases linked to physical inactivity have increased dramatically in Malaysia over the past 20 years. Malaysia has also been identified as one of the least physically active countries in the world with over 60% of adults being essentially sedentary. This study examines the relationship of socio-demographic factors to physical activity among 770 adults from 3 Malaysian states. Physical activity levels were significantly related to ethnicity, gender, age, occupation and educational level. Controlling for inter-relationships among these variables; age, gender, Chinese ethnicity and education level were found to have unique effects on total physical activity, as well as moderate and vigorous exercise. As would be expected, younger people were more physically active, engaging more in both moderate and vigorous types of exercise and males were generally more active than females. Contrary to findings from many developed countries, however, more educated Malaysians were less likely to engage in all types of physical activity. Ethnic Chinese participants, and to a lesser degree Indians also consistently reported lower levels of activity. Possible intervention strategies are discussed that specifically target ethnic and cultural norms related to physical activity. Future research programs exploring barriers to participation and perceptions of physical activity, as well as programs to encourage active life styles among youths are also suggested.

Assessment of activity in Sarcoidosis. Sensitivity and specificity of 67Gallium scintigraphy, serum ACE levels, chest roentgenography, and blood lymphocyte subpopulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klech, H.; Kohn, H.; Kummer, F.

1982-12-01

The value of different factors are examined to assess activity in 60 patients with biopsy-proven sarcoidosis. In patients with active sarcoidosis (n . 35), /sup 67/Ga scans proved to be the most sensitive method (94 percent sensitivity), followed by serum angiotensin I converting enzyme (S-ACE) levels, chest x-ray films, and lymphocyte assays. In patients with peripheral pulmonary lesions, chest x-ray films failed in 32 percent of cases to document activity (68 percent sensitivity) whereas /sup 67/Ga scans and S-ACE levels remained to give reliable results. Despite poor specificity, negative /sup 67/Ga scans together with normal ACE levels have a highmore » predictive value for exclusion of active sarcoidosis. In patients with peripheral pulmonary lesions, chest roentgenography is of doubtful value for staging lung involvement and assessment of activity including monitoring and control of therapy.« less

Acoustic Aspects of Active-Twist Rotor Control

NASA Technical Reports Server (NTRS)

Booth, Earl R., Jr.; Wilbur, Matthew L.

2002-01-01

The use of an Active Twist Rotor system to provide both vibration reduction and performance enhancement has been explored in recent analytical and experimental studies. Effects of active-twist control on rotor noise, however, had not been determined. During a recent wind tunnel test of an active-twist rotor system, a set of acoustic measurements were obtained to assess the effects of active-twist control on noise produced by the rotor, especially blade-vortex interaction (BVI) noise. It was found that for rotor operating conditions where BVI noise is dominant, active-twist control provided a reduction in BVI noise level. This BVI noise reduction was almost, but not quite, as large as that obtained in a similar test using HHC. However, vibration levels were usually adversely affected at operating conditions favoring minimum BVI noise. Conversely, operating conditions favoring minimum vibration levels affected BVI noise levels, but not always adversely.

[Tobacco consumption and its relationship to the level of regular physical activity and physical fitness in adolescents from the region of Murcia (Spain)].

PubMed

García-Cantó, Eliseo; Rodríguez García, Pedro Luis; Pérez-Soto, Juan José; López Villalba, Francisco José; Rosa-Guillamón, Andrés

2015-12-01

This study looks at the relationship between tobacco consumption and the physical activity and fitness levels of adolescents. In a sample of 533 adolescents, both a questionnaire to obtain information regarding tobacco consumption and the International Physical Activity Questionnaire for information on physical activity were implemented; a battery of tests to assess physical fitness were also applied. Tobacco consumption was significantly higher in females (32.5%) than in males (25.7%). Levels of physical activity in both males and females were significantly associated with tobacco consumption (p<0.0005). Moreover, subjects who consumed tobacco showed lower overall averages in physical fitness tests than those who did not (4.26 vs. 5.77 in males and 4.54 vs. 6.71 in females). Tobacco consumption is therefore shown to be related to lower levels of physical activity and physical fitness in adolescents.

Can school income and racial/ethnic composition explain the racial/ethnic disparity in adolescent physical activity participation?

PubMed

Richmond, Tracy K; Hayward, Rodney A; Gahagan, Sheila; Field, Alison E; Heisler, Michele

2006-06-01

Our goal was to determine if racial/ethnic disparities in adolescent boys' and girls' physical activity participation exist and persist once the school attended is considered. We performed a cross-sectional analysis of 17,007 teens in the National Longitudinal Study of Adolescent Health. Using multivariate linear regression, we examined the association between adolescent self-reported physical activity and individual race/ethnicity stratified by gender, controlling for a wide range of sociodemographic, attitudinal, behavioral, and health factors. We used multilevel analyses to determine if the relationship between race/ethnicity and physical activity varied by the school attended. Participants attended racially segregated schools; approximately 80% of Hispanic and black adolescent boys and girls attended schools with student populations that were <66% white, whereas nearly 40% of the white adolescents attended schools that were >94% white. Black and Hispanic adolescent girls reported lower levels of physical activity than white adolescent girls. There were more similar levels of physical activity reported in adolescent boys, with black boys reporting slightly more activities. Although black and Hispanic adolescent girls were more likely to attend poorer schools with overall lower levels of physical activity in girls; there was no difference within schools between black, white, and Hispanic adolescent girls' physical activity levels. Within the same schools, both black and Hispanic adolescent boys had higher rates of physical activity when compared with white adolescent boys. In this nationally representative sample, lower physical activity levels in Hispanic and black adolescent girls were largely attributable to the schools they attended. In contrast, black and Hispanic males had higher activity levels than white males when attending the same schools. Future research is needed to determine the mechanisms through which school environments contribute to racial/ethnic disparities in adolescent physical activity and will need to consider gender differences in these racial/ethnic disparities.

Physical activity and associated socio-demographic factors in adolescents from the eastern region of Poland

PubMed

Wasilewska, Małgorzata; Bergier, Józef

The introduction and maintenance of healthy habits in the field of physical activity at the early stage of life is particularly important for public health. With increasing of public awareness in physical activity, researchers are increasingly questioning its determinants in different age groups. In this paper we focus on variables such as age, sex and place of residence. To determine what selected socio-demographic factors influence the level of physical activity of school youth from the eastern region of Poland in different domains of daily life. A random sample of 916 Polish school youth from Secondary Schools from Eastern Region of Poland aged 16-18 was interviewed in spring 2016 by diagnostic survey method with the use of the official Polish long version of the International Physical Activity Questionnaire (IPAQ). Analysing the relationship between gender and the level of physical activity statistically significant differences were found in all domains in favour of boys. The level of total physical activity in girls was 5345.5 MET-min./week, whereas in boys – 6556.6 MET-min./week. In the area of total physical activity, the highest values were observed in pupils from small towns and villages, with lower values in the youth living in large and medium-sized cities. When the relationship of age with the level of physical activity in particular domains was examined, only the activity in the work/ school domain (p = 0.0129) spoke in favour of the youngest pupils (2578.7 MET-min./week) when compared to the oldest ones (2226.4 MET-min./week). The level of physical activity in young people from the Eastern region of Poland is decreasing with age, both in girls and boys. It is therefore important, especially for the group emerging adulthood, to offer a wide variety of updated, involving, age and gender-oriented school physical activity classes that could be easily practised outside the school environment to improve the level of physical activity in leisure domain

Urea application promotes amino acid metabolism and membrane lipid peroxidation in Azolla.

PubMed

Chen, Jiana; Huang, Min; Cao, Fangbo; Pardha-Saradhi, P; Zou, Yingbin

2017-01-01

A pot experiment was conducted to evaluate the effect of urea on nitrogen metabolism and membrane lipid peroxidation in Azolla pinnata. Compared to controls, the application of urea to A. pinnata resulted in a 44% decrease in nitrogenase activity, no significant change in glutamine synthetase activity, 660% higher glutamic-pyruvic transaminase, 39% increase in free amino acid levels, 22% increase in malondialdehyde levels, 21% increase in Na+/K+- levels, 16% increase in Ca2+/Mg2+-ATPase levels, and 11% decrease in superoxide dismutase activity. In terms of H2O2 detoxifying enzymes, peroxidase activity did not change and catalase activity increased by 64% in urea-treated A. pinnata. These findings suggest that urea application promotes amino acid metabolism and membrane lipid peroxidation in A. pinnata.

Urea application promotes amino acid metabolism and membrane lipid peroxidation in Azolla

PubMed Central

Chen, Jiana; Cao, Fangbo; Pardha-Saradhi, P.; Zou, Yingbin

2017-01-01

A pot experiment was conducted to evaluate the effect of urea on nitrogen metabolism and membrane lipid peroxidation in Azolla pinnata. Compared to controls, the application of urea to A. pinnata resulted in a 44% decrease in nitrogenase activity, no significant change in glutamine synthetase activity, 660% higher glutamic-pyruvic transaminase, 39% increase in free amino acid levels, 22% increase in malondialdehyde levels, 21% increase in Na+/K+- levels, 16% increase in Ca2+/Mg2+-ATPase levels, and 11% decrease in superoxide dismutase activity. In terms of H2O2 detoxifying enzymes, peroxidase activity did not change and catalase activity increased by 64% in urea-treated A. pinnata. These findings suggest that urea application promotes amino acid metabolism and membrane lipid peroxidation in A. pinnata. PMID:28945775

Impact of natural gas extraction on PAH levels in ambient air.

PubMed

Paulik, L Blair; Donald, Carey E; Smith, Brian W; Tidwell, Lane G; Hobbie, Kevin A; Kincl, Laurel; Haynes, Erin N; Anderson, Kim A

2015-04-21

Natural gas extraction, often referred to as "fracking," has increased rapidly in the U.S. in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. PAH levels were highest when samplers were closest to active wells. Additionally, PAH levels closest to natural gas activity were an order of magnitude higher than levels previously reported in rural areas. Sourcing ratios indicate that PAHs were predominantly petrogenic, suggesting that elevated PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. Closest to active wells, the risk estimated for maximum residential exposure was 2.9 in 10 000, which is above the U.S. EPA's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest. This work suggests that natural gas extraction may be contributing significantly to PAHs in air, at levels that are relevant to human health.

It takes biking to learn: Physical activity improves learning a second language.

PubMed

Liu, Fengqin; Sulpizio, Simone; Kornpetpanee, Suchada; Job, Remo

2017-01-01

Recent studies have shown that concurrent physical activity enhances learning a completely unfamiliar L2 vocabulary as compared to learning it in a static condition. In this paper we report a study whose aim is twofold: to test for possible positive effects of physical activity when L2 learning has already reached some level of proficiency, and to test whether the assumed better performance when engaged in physical activity is limited to the linguistic level probed at training (i.e. L2 vocabulary tested by means of a Word-Picture Verification task), or whether it extends also to the sentence level (which was tested by means of a Sentence Semantic Judgment Task). The results show that Chinese speakers with basic knowledge of English benefited from physical activity while learning a set of new words. Furthermore, their better performance emerged also at the sentential level, as shown by their performance in a Semantic Judgment task. Finally, an interesting temporal asymmetry between the lexical and the sentential level emerges, with the difference between the experimental and control group emerging from the 1st testing session at the lexical level but after several weeks at the sentential level.

It takes biking to learn: Physical activity improves learning a second language.

PubMed Central

Liu, Fengqin; Sulpizio, Simone; Kornpetpanee, Suchada; Job, Remo

2017-01-01

Recent studies have shown that concurrent physical activity enhances learning a completely unfamiliar L2 vocabulary as compared to learning it in a static condition. In this paper we report a study whose aim is twofold: to test for possible positive effects of physical activity when L2 learning has already reached some level of proficiency, and to test whether the assumed better performance when engaged in physical activity is limited to the linguistic level probed at training (i.e. L2 vocabulary tested by means of a Word-Picture Verification task), or whether it extends also to the sentence level (which was tested by means of a Sentence Semantic Judgment Task). The results show that Chinese speakers with basic knowledge of English benefited from physical activity while learning a set of new words. Furthermore, their better performance emerged also at the sentential level, as shown by their performance in a Semantic Judgment task. Finally, an interesting temporal asymmetry between the lexical and the sentential level emerges, with the difference between the experimental and control group emerging from the 1st testing session at the lexical level but after several weeks at the sentential level. PMID:28542333

Impact of natural gas extraction on Pah levels in ambient air

PubMed Central

Paulik, L. Blair; Donald, Carey E.; Smith, Brian W.; Tidwell, Lane G.; Hobbie, Kevin A.; Kincl, Laurel; Haynes, Erin N.; Anderson, Kim A.

2015-01-01

Natural gas extraction, often referred to as “fracking,” has increased rapidly in the U.S. in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. PAH levels were highest when samplers were closest to active wells. Additionally, PAH levels closest to natural gas activity were an order of magnitude higher than levels previously reported in rural areas. Sourcing ratios indicate that PAHs were predominantly petrogenic, suggesting that elevated PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. Closest to active wells, the risk estimated for maximum residential exposure was 2.9 in 10,000, which is above the U.S. EPA's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest. This work suggests that natural gas extraction may be contributing significantly to PAHs in air, at levels that are relevant to human health. PMID:25810398

Validation of the human activity profile questionnaire as a measure of physical activity levels in older community-dwelling women.

PubMed

Bastone, Alessandra de Carvalho; Moreira, Bruno de Souza; Vieira, Renata Alvarenga; Kirkwood, Renata Noce; Dias, João Marcos Domingues; Dias, Rosângela Corrêa

2014-07-01

The purpose of this study was to assess the validity of the Human Activity Profile (HAP) by comparing scores with accelerometer data and by objectively testing its cutoff points. This study included 120 older women (age 60-90 years). Average daily time spent in sedentary, moderate, and hard activity; counts; number of steps; and energy expenditure were measured using an accelerometer. Spearman rank order correlations were used to evaluate the correlation between the HAP scores and accelerometer variables. Significant relationships were detected (rho = .47-.75, p < .001), indicating that the HAP estimates physical activity at a group level well; however, scatterplots showed individual errors. Receiver operating characteristic curves were constructed to determine HAP cutoff points on the basis of physical activity level recommendations, and the cutoff points found were similar to the original HAP cutoff points. The HAP is a useful indicator of physical activity levels in older women.

Using anthropomorphic avatars resembling sedentary older individuals as models to enhance self-efficacy and adherence to physical activity: psychophysiological correlates.

PubMed

Ruiz, Jorge G; Andrade, Allen D; Anam, Ramankumar; Aguiar, Rudxandra; Sun, Huaping; Roos, Bernard A

2012-01-01

The prevalence of obesity and associated health complications are currently at unprecedented levels. Physical activity in this population can improve patient outcomes. Virtual reality (VR) self-modeling may improve self-efficacy and adherence to physical activity. We conducted a comparative study of 30 participants randomized to 3 versions of a 3D avatar-based VR intervention about exercise: virtual representation of the self exercising condition; virtual representation of other person exercising and control condition. Participants in the virtual representation of the self group significantly increased their levels of physical activity. The improvement in physical activity for participants in the visual representation of other person exercising was marginal. The improvement for the control group was not significant. However, the effect sizes for comparing the pre and post intervention physical activity levels were quite large for all three groups. We did not find any group difference in the improvements of physical activity levels and self-efficacy among sedentary, overweight or obese individuals.

Momentary assessment of contextual influences on affective response during physical activity.

PubMed

Dunton, Genevieve Fridlund; Liao, Yue; Intille, Stephen; Huh, Jimi; Leventhal, Adam

2015-12-01

Higher positive and lower negative affective response during physical activity may reinforce motivation to engage in future activity. However, affective response during physical activity is typically examined under controlled laboratory conditions. This research used ecological momentary assessment (EMA) to examine social and physical contextual influences on momentary affective response during physical activity in naturalistic settings. Participants included 116 adults (mean age = 40.3 years, 73% female) who completed 8 randomly prompted EMA surveys per day for 4 days across 3 semiannual waves. EMA surveys measured current activity level, social context, and physical context. Participants also rated their current positive and negative affect. Multilevel models assessed whether momentary physical activity level moderated differences in affective response across contexts controlling for day of the week, time of day, and activity intensity (measured by accelerometer). The Activity Level × Alone interaction was significant for predicting positive affect (β = -0.302, SE = 0.133, p = .024). Greater positive affect during physical activity was reported when with other people (vs. alone). The Activity Level × Outdoors interaction was significant for predicting negative affect (β = -0.206, SE = 0.097, p = .034). Lower negative affect during physical activity was reported outdoors (vs. indoors). Being with other people may enhance positive affective response during physical activity, and being outdoors may dampen negative affective response during physical activity. (c) 2015 APA, all rights reserved).

Longitudinal associations between physical activity and depression scores in Swedish women followed 32 years.

PubMed

Gudmundsson, P; Lindwall, M; Gustafson, D R; Östling, S; Hällström, T; Waern, M; Skoog, I

2015-12-01

Physical activity is negatively associated with depressive symptoms. However, few studies consider dynamic associations of changes in physical activity and reciprocal relationships. This study aimed to perform comprehensive evaluations of relationships between physical activity and depression scores in women followed from mid- to late life. The Prospective Population Study of Women in Gothenburg, Sweden, provided repeated measures of self-reported physical activity and depressive symptoms between 1974 and 2005 (baseline N = 676, 84.5% response rate). Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale, and physical activity was evaluated by the Saltin-Grimby Physical Activity Level Scale. Latent growth curve analyses were used to evaluate associations of change, and cross-lagged models were used to study the reciprocal relationship between physical activity and depression scores. At baseline, lower levels of physical activity were related to higher depression scores. Individuals with decreasing physical activity over time evidenced higher depression scores at 32-year follow-up. Higher average baseline depression score was related to declining levels of physical activity at subsequent examinations. Reduced physical activity may be a long-term consequence of depression. It is important to address individual changes in physical activity and not merely absolute levels of physical activity in relationship to depression. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Health status and physical activity levels among the elderly who are participants and non-participants in social welfare groups in Florianópolis].

PubMed

Benedetti, Tânia Rosane Bertoldo; Mazo, Giovana Zarpellon; Borges, Lucélia Justino

2012-08-01

This study sought to verify the association between health status and physical activity levels among the elderly who are participants and non-participants in social welfare groups in Florianópolis in the State of Santa Catarina, Brazil. The sample included 1,062 elderly people (625 women), mean age 71.9 (± 7.6). The variables analyzed were gender, age, schooling, marital status, physical activity levels (International Physical Activity Questionnaire) and physical health status information (Brazil Elderly Schedule Questionnaire). Data were analyzed by Chi-square test. The results revealed that 60.6% were classified as physically active (total physical activity level) and 74% of the elderly reported illness. Illness status was more prevalent among social welfare group participants than non-participants. However, a better positive perception of physical health status was observed among social groups participants. For women, participation in social welfare groups was associated with a positive perception of physical health status (p<0.001) and with illness (p=0.005). The conclusion was that participation in social welfare groups contributes to a better perception of physical health status, as well as for the maintenance of adequate physical activity levels.

Population-Level Exposure to Particulate Air Pollution during Active Travel: Planning for Low-Exposure, Health-Promoting Cities

PubMed Central

Hankey, Steve; Lindsey, Greg; Marshall, Julian D.

2016-01-01

Background: Providing infrastructure and land uses to encourage active travel (i.e., bicycling and walking) are promising strategies for designing health-promoting cities. Population-level exposure to air pollution during active travel is understudied. Objectives: Our goals were a) to investigate population-level patterns in exposure during active travel, based on spatial estimates of bicycle traffic, pedestrian traffic, and particulate concentrations; and b) to assess how those exposure patterns are associated with the built environment. Methods: We employed facility–demand models (active travel) and land use regression models (particulate concentrations) to estimate block-level (n = 13,604) exposure during rush-hour (1600–1800 hours) in Minneapolis, Minnesota. We used the model-derived estimates to identify land use patterns and characteristics of the street network that are health promoting. We also assessed how exposure is correlated with indicators of health disparities (e.g., household income, proportion of nonwhite residents). Our work uses population-level rates of active travel (i.e., traffic flows) rather than the probability of walking or biking (i.e., “walkability” or “bikeability”) to assess exposure. Results: Active travel often occurs on high-traffic streets or near activity centers where particulate concentrations are highest (i.e., 20–42% of active travel occurs on blocks with high population-level exposure). Only 2–3% of blocks (3–8% of total active travel) are “sweet spots” (i.e., high active travel, low particulate concentrations); sweet spots are located a) near but slightly removed from the city-center or b) on off-street trails. We identified 1,721 blocks (~ 20% of local roads) where shifting active travel from high-traffic roads to adjacent low-traffic roads would reduce exposure by ~ 15%. Active travel is correlated with population density, land use mix, open space, and retail area; particulate concentrations were mostly unchanged with land use. Conclusions: Public health officials and urban planners may use our findings to promote healthy transportation choices. When designing health-promoting cities, benefits (physical activity) as well as hazards (air pollution) should be evaluated. Citation: Hankey S, Lindsey G, Marshall JD. 2017. Population-level exposure to particulate air pollution during active travel: planning for low-exposure, health-promoting cities. Environ Health Perspect 125:–534; http://dx.doi.org/10.1289/EHP442 PMID:27713109

Cardiovascular risk factors in young male adults: impact of physical activity and parental education.

PubMed

Çuhadar, Serap; Atay, Ayşenur; Sağlam, Gülcan; Köseoğlu, Mehmet; Cuhadar, Levent

2013-01-01

This study was conducted to assess whether choices of physical activity, smoking status, and parental education and income were correlated with the health status of young adult males which are important for preventive health policy. 491 18-29-year old males from lower socioeconomical districts in Turkey participated in this study. Information about demographic characteristics, parental education, household income, smoking status, and physical activity was obtained by means of a standardized questionnaire. BMI and metabolic parameters (serum lipid profile) were assessed. Mean total cholesterol, LDL, HDL and triglyceride levels were in the normal range. The physically active group displayed a better lipid profile. No relationship was found between parental education and serum lipids. Smoking was slightly correlated with household income (r=103, p=0.022). Young adult males who participate in relatively high levels of physical activity are at lower CHD risk than less active ones. The present study also showed that lower socioecnomic status does not always correlate with higher levels of cardiovascular risk factors. In conclusion, data supports that while family history cannot be changed, HDL levels can be modulated by lifestyle factors as in other populations and that with the determined benefits of increasing physical activity and thus, HDL levels, policy reform in schools to promote physical activity are warranted.

Heparanase level and procoagulant activity are reduced in severe sepsis.

PubMed

Matan, Moshe; King, Daniel; Peled, Eli; Ackerman, Shanny; Bar-Lavi, Yaron; Brenner, Benjamin; Nadir, Yona

2018-02-01

During severe sepsis, levels and activity of all coagulation proteins are reduced. Heparanase is implicated in angiogenesis and tumor progression. We previously demonstrated that heparanase also affected the hemostatic system. It forms a complex and increases the activity of the blood coagulation initiator tissue factor. To evaluate heparanase levels and procoagulant activity as predictors of sepsis severity. Twenty-one patients with non-trauma, non-surgical sepsis admitted to the intensive care unit and 35 controls were recruited. Plasma samples were drawn from the study participants on days 1 and 7 following admission. Heparanase levels and procoagulant activity on day 1 were significantly reduced in patients compared to controls (P < .0001, P < .0001, respectively). Day 1 heparanase procoagulant activity ≥350 ng/mL yielded a negative predictive value for severe sepsis of 89%. Additionally, heparanase procoagulant activity on day 7 correlated with the change in the APACHE score between days 1 and 7 (r = .66, P = .007). Heparanase procoagulant activity decreases during sepsis and returns to normal levels as soon as the patient recovers. Hence, it can be potentially used to predict the risk of severe sepsis. These findings need to be further explored in large-scale studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Predictors for Physical Activity in Adolescent Girls Using Statistical Shrinkage Techniques for Hierarchical Longitudinal Mixed Effects Models

PubMed Central

Grant, Edward M.; Young, Deborah Rohm; Wu, Tong Tong

2015-01-01

We examined associations among longitudinal, multilevel variables and girls’ physical activity to determine the important predictors for physical activity change at different adolescent ages. The Trial of Activity for Adolescent Girls 2 study (Maryland) contributed participants from 8th (2009) to 11th grade (2011) (n=561). Questionnaires were used to obtain demographic, and psychosocial information (individual- and social-level variables); height, weight, and triceps skinfold to assess body composition; interviews and surveys for school-level data; and self-report for neighborhood-level variables. Moderate to vigorous physical activity minutes were assessed from accelerometers. A doubly regularized linear mixed effects model was used for the longitudinal multilevel data to identify the most important covariates for physical activity. Three fixed effects at the individual level and one random effect at the school level were chosen from an initial total of 66 variables, consisting of 47 fixed effects and 19 random effects variables, in additional to the time effect. Self-management strategies, perceived barriers, and social support from friends were the three selected fixed effects, and whether intramural or interscholastic programs were offered in middle school was the selected random effect. Psychosocial factors and friend support, plus a school’s physical activity environment, affect adolescent girl’s moderate to vigorous physical activity longitudinally. PMID:25928064

Intrinsic and induced isoproturon catabolic activity in dissimilar soils and soils under dissimilar land use.

PubMed

Reid, Brian J; Papanikolaou, Niki D; Wilcox, Ronah K

2005-02-01

The catabolic activity with respect to the systemic herbicide isoproturon was determined in soil samples by (14)C-radiorespirometry. The first experiment assessed levels of intrinsic catabolic activity in soil samples that represented three dissimilar soil series under arable cultivation. Results showed average extents of isoproturon mineralisation (after 240 h assay time) in the three soil series to be low. A second experiment assessed the impact of addition of isoproturon (0.05 microg kg(-1)) into these soils on the levels of catabolic activity following 28 days of incubation. Increased catabolic activity was observed in all three soils. A third experiment assessed levels of intrinsic catabolic activity in soil samples representing a single soil series managed under either conventional agricultural practice (including the use of isoproturon) or organic farming practice (with no use of isoproturon). Results showed higher (and more consistent) levels of isoproturon mineralisation in the soil samples collected from conventional land use. The final experiment assessed the impact of isoproturon addition on the levels of inducible catabolic activity in these soils. The results showed no significant difference in the case of the conventional farm soil samples while the induction of catabolic activity in the organic farm soil samples was significant.

The effect of standard heat and filtration processing procedures on antimicrobial activity and hydrogen peroxide levels in honey.

PubMed

Chen, Cuilan; Campbell, Leona T; Blair, Shona E; Carter, Dee A

2012-01-01

There is increasing interest in the antimicrobial properties of honey. In most honey types, antimicrobial activity is due to the generation of hydrogen peroxide (H(2)O(2)), but this can vary greatly among samples. Honey is a complex product and other components may modulate activity, which can be further affected by commercial processing procedures. In this study we examined honey derived from three native Australian floral sources that had previously been associated with H(2)O(2)-dependent activity. Antibacterial activity was seen in four red stringybark samples only, and ranged from 12 to 21.1% phenol equivalence against Staphylococcus aureus. Antifungal activity ranged from MIC values of 19-38.3% (w/v) against Candida albicans, and all samples were significantly more active than an osmotically equivalent sugar solution. All honey samples were provided unprocessed and following commercial processing. Processing was usually detrimental to antimicrobial activity, but occasionally the reverse was seen and activity increased. H(2)O(2) levels varied from 0 to 1017 μM, and although samples with no H(2)O(2) had little or no antimicrobial activity, some samples had relatively high H(2)O(2) levels yet no antimicrobial activity. In samples where H(2)O(2) was detected, the correlation with antibacterial activity was greater in the processed than in the unprocessed samples, suggesting other factors present in the honey influence this activity and are sensitive to heat treatment. Antifungal activity did not correlate with the level of H(2)O(2) in honey samples, and overall it appeared that H(2)O(2) alone was not sufficient to inhibit C. albicans. We conclude that floral source and H(2)O(2) levels are not reliable predictors of the antimicrobial activity of honey, which currently can only be assessed by standardized antimicrobial testing. Heat processing should be reduced where possible, and honey destined for medicinal use should be retested post-processing to ensure that activity levels have not changed.

The effect of standard heat and filtration processing procedures on antimicrobial activity and hydrogen peroxide levels in honey

PubMed Central

Chen, Cuilan; Campbell, Leona T.; Blair, Shona E.; Carter, Dee A.

2012-01-01

There is increasing interest in the antimicrobial properties of honey. In most honey types, antimicrobial activity is due to the generation of hydrogen peroxide (H2O2), but this can vary greatly among samples. Honey is a complex product and other components may modulate activity, which can be further affected by commercial processing procedures. In this study we examined honey derived from three native Australian floral sources that had previously been associated with H2O2-dependent activity. Antibacterial activity was seen in four red stringybark samples only, and ranged from 12 to 21.1% phenol equivalence against Staphylococcus aureus. Antifungal activity ranged from MIC values of 19–38.3% (w/v) against Candida albicans, and all samples were significantly more active than an osmotically equivalent sugar solution. All honey samples were provided unprocessed and following commercial processing. Processing was usually detrimental to antimicrobial activity, but occasionally the reverse was seen and activity increased. H2O2 levels varied from 0 to 1017 μM, and although samples with no H2O2 had little or no antimicrobial activity, some samples had relatively high H2O2 levels yet no antimicrobial activity. In samples where H2O2 was detected, the correlation with antibacterial activity was greater in the processed than in the unprocessed samples, suggesting other factors present in the honey influence this activity and are sensitive to heat treatment. Antifungal activity did not correlate with the level of H2O2 in honey samples, and overall it appeared that H2O2 alone was not sufficient to inhibit C. albicans. We conclude that floral source and H2O2 levels are not reliable predictors of the antimicrobial activity of honey, which currently can only be assessed by standardized antimicrobial testing. Heat processing should be reduced where possible, and honey destined for medicinal use should be retested post-processing to ensure that activity levels have not changed. PMID:22866051

Associations between the lower esophageal sphincter function and the level of physical activity.

PubMed

Waśko-Czopnik, Dorota; Jóźków, Paweł; Dunajska, Katarzyna; Mędraś, Marek; Paradowski, Leszek

2013-01-01

Gastroesophageal reflux disease (GERD) is a very frequent and multifactorial disease. It has been found that GERD is associated with obesity, smoking, esophagitis, diet and lifestyle. Physical activity is among the factors involved in the occurrence of GERD. The aim of the study was to evaluate the associations between the different parameters of lower esophageal pressure (LES) and the level of everyday physical activity in patients with GERD. The authors examined 100 consecutive patients who underwent manometry and pH-metry because of symptoms suggesting GERD. Physical activity was assessed by means of the International Physical Activity Questionnaire (IPAQ). In accordance with IPAQ categorical scoring, the authors divided the studied subjects into 3 groups according to their level of physical activity. The investigation comprised 59 men and 41 women, with the mean age 49 ± 14 years. The authors analyzed the relationships between the LES parameters (pressure, total LES length and HPZ length) and physical activity. The authors did not find any significant correlations between the studied parameters and the amount of physical activity. The authors also did not observe any association between the LES pressure and the level of physical activity. The subgroups distinguished on the basis of LESP did not differ as to the amount of everyday physical activity as well. Although most data indicates that intense exercise exacerbates GERD symptoms, the authors did not find any associations between LES parameters and physical activity. In view of the present results maintaining the recommended level of everyday physical activity does not interfere with the mechanisms of GERD.