Is There a Relationship Between Tracking Ability, Joint Position Sense, and Functional Level in Patellofemoral Pain Syndrome?

Is there a relationship between tracking ability, joint position sense, and functional level in patellofemoral pain syndrome?

Filed under: Rehab Centers

Knee Surg Sports Traumatol Arthrosc. 2013 Jan 30;
Yosmaoglu HB, Kaya D, Guney H, Nyland J, Baltaci G, Yuksel I, Doral MN

PURPOSE: This prospective cohort study investigated proprioception and motor control changes in patients with patellofemoral pain syndrome (PFPS), and how these changes related to knee function, pain, muscle strength and muscle endurance. METHODS: The study included 43 women diagnosed with unilateral patellofemoral pain syndrome. Thirty-one healthy women were recruited as control group. Peak quadriceps femoris and hamstring muscle isokinetic torques were recorded at 60 and 180°/s. Joint position sense was tested by active reproduction of joint position during horizontal squat performance. Muscle coordination and motor control ability were tested by a multi-joint lower limb tracking-trajectory test. Muscle endurance was tested using a computerized functional squat system. Severity of pain in during stair ascent/descent, squatting, and prolonged sitting with knees 90° flexed were measured using a 10 category modified visual analogue scale. Functional levels of patients were determined using Kujala patellofemoral scores. RESULTS: Active reproduction of joint position did not differ between PFPS and control groups. However, tracking-trajectory error was significantly higher in PFPS group than control subjects. Hamstring and quadriceps peak isokinetic torque and muscle endurance scores were significantly lower in the PFPS group. Kujala patellofemoral score displayed significant relationships with peak isokinetic quadriceps torque, knee pain, and joint position sense scores. Pain during stair descent, sitting, and quadriceps torque at 180°/s explained 57.7 % of the variation in Kujala patellofemoral score. CONCLUSION: Although lower extremity joint position sense did not differ between groups, the PFPS group displayed a target-trajectory muscular coordination deficit, decreased muscular endurance, and decreased muscular strength compared to control group subjects. Pain level directly related to motor control performance while joint position sense scores did not. Knee pain and impaired strength related more to functional performance impairment than joint position sense scores in patients with PFPS. LEVEL OF EVIDENCE: Prospective case-control study, Level III.
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The Videoinsight(®) method: improving rehabilitation following anterior cruciate ligament reconstruction-a preliminary study.

Filed under: Rehab Centers

Knee Surg Sports Traumatol Arthrosc. 2013 Jan 30;
Zaffagnini S, Russo RL, Marcheggiani Muccioli GM, Marcacci M

PURPOSE: The purpose of this randomized double blind controlled study was to investigate if the vision of contemporary art video according to the Videoinsight(®) method could produce better short-term clinical and subjective outcomes after anterior cruciate ligament (ACL) reconstruction. METHODS: One-hundred and six patients treated with single-bundle ACL reconstruction plus extra-articular tenodesis were enrolled in this study and randomly assigned to Group A (53 patients) and Group B (53 patients). Group A received one art video that was established to produce positive and therapeutic “insight”, while Group B received one art video with an “insight” unfavourable to the psychological recovery. All patients were instructed to watch the video 3 times a week for the first 2 months during the execution of the same rehabilitative protocol. Patients were evaluated pre-operatively and 3 months after surgery with Tegner, subjective International Knee Documentation Committee (IKDC), physical and mental SF-36 scores and Tampa Scale of Kinesiophobia (TSK). Time to crutches discharge was collected at final follow-up as well. RESULTS: Five patients were lost to follow-up and 101 patients (Group A: 51 patients; Group B: 50 patients) were available at mean 3.0 ± 0.2 months follow-up. Age at surgery was 33.0 ± 17.0 years. The two groups were homogeneous regarding pre-operative demographic data, meniscal lesions and clinical outcomes. Significant improvements were observed in Group A compared to Group B at final follow-up for subjective IKDC (82.0 ± 13.8 vs. 71.0 ± 19.7, p = 0.0470), TKS (28.1 ± 6.0 vs. 32.0 ± 5.8, p = 0.0141) and time to crutches discharge (20.9 ± 5.0 vs. 26.5 ± 8.2 days, p = 0.0012). A positive significant correlation between TSK and time to crutches discharge (r = 0.35, p = 0.0121) was observed. CONCLUSIONS: The Videoinsight(®) method combined to adequate rehabilitation could be an effective tool in order to improve short-term clinical and functional outcomes in patients who underwent ACL reconstruction. LEVEL OF EVIDENCE: I.
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Critical Role for hierarchical geospatial analyses in the design of fluvial research, assessment, and management.

Filed under: Rehab Centers

Environ Monit Assess. 2013 Jan 30;
Thorp JH, Flotemersch JE, Williams BS, Gabanski LA

River science and management can be conducted at a range of spatiotemporal scales from reach to basin levels as long as the project goals and questions are matched correctly with the study design’s spatiotemporal scales and dependent variables. These project goals should also incorporate information on the hydrogeomorphically patchy nature of riverine macrosystems which is only partially predictable in type and location from a river’s headwaters to its terminus. This patchiness significantly affects a river’s habitat template, and thus community structure, ecosystem function, and responses to perturbations. Our manuscript is designed for use by senior administrators at government agencies through entry-level river scientists. It analyzes common challenges in project design and recommends solutions based partially on hierarchical analyses that combine geographic information systems and multivariate statistical analysis to enable self-emergence of a stream’s patchy structure. These approaches are useful at all spatial levels and can vary from primary reliance on geospatial techniques at the valley level to a greater dependence on field-based measurements and expert opinion at the reach level. Comparative uses of functional process zones (FPZs?=?valley-scale hydrogeomorphic patches), ecoregions, hydrologic unit codes, and reaches in project designs are discussed along with other comparative approaches for stream classification and analysis of species distributions (e.g., GAP analysis). Use of hierarchical classification of patch structure for sample stratification, reference site selection, ecosystem services, rehabilitation, and mitigation are briefly explored.
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Association of MEFV Gene Mutations With Rheumatoid Factor Levels in Patients With Rheumatoid Arthritis.

Filed under: Rehab Centers

J Investig Med. 2013 Jan 27;
Inanir A, Yigit S, Karakus N, Tekin S, Rustemoglu A

PURPOSE: Rheumatoid arthritis (RA) is a systemic autoimmune disease primarily affecting the joints. Arthritis disorders are associated with mutations of the Mediterranean fever (MEFV) gene. This gene has already been identified as being responsible for familial Mediterranean fever. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations in a cohort of Turkish patients with RA. METHODS: The study included 101 patients with RA and 110 healthy controls. Genomic DNA was isolated and genotyped using polymerase chain reaction and restriction fragment length polymorphism for the 5 MEFV gene mutations (M694V, M680I, V726A, E148Q, and P369S). RESULTS: Carrier rates of MEFV gene mutations were 31 (30.7%) of 101 and 26 (23.6%) of 110 in the RA and healthy control groups, respectively (P > 0.05; odds ratio, 1.4; 95% CI, 0.77-2.65). Whereas deformed joint count was relatively higher in the mutation carrier group than those of the noncarrier group, the rheumatoid factor levels were significantly higher in the carrier group of patients with RA (P = 0.001). CONCLUSIONS: The results of this study suggest that MEFV gene mutations are not positively associated with a predisposition to develop RA but might increase the severity of RA. Further research is needed to determine the actual pathogenic role of MEFV mutations in this disease.
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Interprofessional clinical training improves self-efficacy of health care students.

Filed under: Rehab Centers

Med Teach. 2013 Jan 29;
Nørgaard B, Draborg E, Vestergaard E, Odgaard E, Jensen DC, Sørensen J

Background: Interprofessional collaboration potentially enhances patient safety and satisfaction, and reduces tensions and conflicts among health professionals. However, health professionals often lack sufficient knowledge of other professional roles and competences to engage in interprofessional teamwork. The aim of this study was to assess the impact of an interprofessional training programme on students’ perceived self-efficacy. Methods: A quasi-experimental study with an intervention group (239 students) and a control group (405 students). The intervention was an interprofessional clinical study (ICS) unit including students from nursing, medicine, physiotherapy, occupational therapy, laboratory technology and radiography. Data on students’ perceived self-efficacy were collected through web-based questionnaires. Aspects of self-efficacy measured were: (1) collaboration with other professions in planning goals and actions for patients; (2) collaboration with other professions for rehabilitation; (3) identifying the functions of other professions and (4) assessing and describing patients’ needs and problems. Results: All scores of perceived self-efficacy for the ICS group improved over time although one score change was non-significant (p?=?0.08). After adjustment for baseline differences and the score change for the control group, the ICS group’s self-efficacy score gain remained statistically significant. Conclusion: The study showed that interprofessional training improved students’ perception of self-efficacy more than traditional clinical training.
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