Coordination of the Lower Limbs of Soccer Players after Anterior Cruciate Ligament Reconstruction with Allograft and Autograft during Landing.

Objectives: Quantitative biomechanical tests, along with physical assessment, may be useful to understand kinematics associated with graft types in anterior cruciate ligament surgery, particularly in individuals aiming for a safe return to sport. Methods: Sixty male soccer players in three groups participated in this study. Three equal groups of healthy, auto transplanted and allotransplanted participants, matched for age, gender, activity level and functional status, landed with one foot on a force plate. Their kinematic information was recorded by the motion analyzer and used to describe coordination the variability by measuring coupling angles using vector coding. Results: The coordination variability of the allograft group in the surgical limb was significantly greater than that of the healthy group at least 9 months after the reconstructive surgery of the ACL and at the stage of return to sports, (F (6, 35) = 2.79, p = 0.025; Wilk's Λ = 0.676, partial η2 = 0.32). The coordination pattern in the surgical and healthy limbs of the surgical groups also differed from that of the healthy people, which was more pronounced in the allograft group, (F (6, 35) = 2.61, p = 0.034; Wilk's Λ = 0.690, partial η2 = 0.31). Conclusion: These results show that the allograft group has a different coordination variability at return to sport than the healthy group, so they may need more time for excessive training and competition.

MR defecography: a diagnostic test for the evaluation of pelvic floor motion in patients with dyssynergic defecation after biofeedback therapy.

BACKGROUND: Dyssynergic defecation is a major cause of chronic functional constipation as a common digestive complaint. We clinically evaluated the effects of biofeedback therapy on the pelvic floor motion indices through magnetic resonance (MR) defecography, quality of life and depression in patients with dyssynergic defecation. METHODS: In this clinical trial study, among patients referring to the Colorectal Clinic of Hazrat Rasoul Hospital, 22 subjects were randomly assigned into two equal groups (n= 11) to receive either standard only or biofeedback and standard therapy. Dynamic changes of the pelvic floor were measured by MR defecography. During the simulated defecation, two MR defecography dynamic indices including abnormal anorectal angle change and perineal descent were measured before and after treatment. The effects of biofeedback therapy on patients' symptoms, quality of life and severity of depression were assessed and compared with the standard therapy. Statistical analysis was carried out using independent _t-test and Mann-Whitney test. RESULTS: Paradox index (p< 0.001), perineal descent index (p< 0.001), depression (p< 0.1), physical function (p< 0.001), vitality (p< 0.001) and role emotion (p< 0.001) significantly improved in the biofeedback therapy group in contrast to the standard therapy SDT group. CONCLUSION: Biofeedback therapy appears to be effective in improving symptoms of functional constipation and dysfunction of pelvic floor motion as well as patient's quality of life and depression state. MR defecography is able to show the changes in dynamic indices of the pelvic floor through biofeedback therapy.