Osmotic pump with potential for bone lengthening distracts continuously in vitro and in vivo.

BACKGROUND: In pediatric orthopedics, long bone lengthening procedures are routinely performed using manual, motorized or magnetically controlled implants. This study aims to prove expansion of a newly designed osmotic pump prior to long bone lengthening in living organisms and to rule out any complications related to in vivo conditions, such as congestion of the semipermeable membrane, local infection, or lack of water to drive the osmotic pump, as well as to compare in vivo and in vitro expansion data. METHODS: Osmotic pumps, which were designed to distract a plate osteosynthesis, were inserted in the dorsal paraspinal musculature of four piglets. To compare the performance of the pumps in in vivo and in vitro conditions, another set of pumps was submerged in physiologic saline solution at different temperatures. The lengthening progress was measured radiographically and sonographically in the study animals. RESULTS: Both, in vitro and in vivo tested osmotic pumps started distraction after an intended rest phase of four days and distracted evenly over the following twelve days. No complications, clogging or damages occurred. However, we observed a temperature dependency of the distraction rate ranging from 0.98 mm/day at 39°C to 1.10 mm/day at 42°C. With a second setup, we confirmed that the distraction rate differed by 72% within a measured temperature interval of 14° C. CONCLUSIONS: The data presented here confirm that the novel osmotic pump showed comparable lengthening characteristics in vivo and in vitro. No complications, such as congestion of the semipermeable membrane, local infection, or lack of water to drive the osmotic pump were observed. Thus, osmotic pumps may have great potential in future applications such as long bone lengthening procedures, where continuous distraction probably provides a better bone quality than intermittent lengthening procedures. The fact that one pump failed to elongate in each condition, highlights the importance of technical improvement, but also demonstrates that this was not due to different circumstances within the in vivo or in vitro condition.

Effects of strength training on motor performance skills in children and adolescents: a meta-analysis.

The recent literature delineates resistance training in children and adolescents to be effective and safe. However, only little is known about the transfer of achieved strength gains to athletic performance. The present meta-analysis revealed a combined mean effect size for motor skill types jumping, running, and throwing of 0.52 (95% CI: 0.33-0.71). Effect sizes for each of aforementioned skill types separately were 0.54 (95% CI: 0.34-0.74), 0.53 (95% CI: 0.23-0.83), and 0.99 (95% CI: 0.19-1.79) respectively. Furthermore, it could be shown that younger subjects and nonathletes showed higher gains in motor performance following resistance training than their counterparts and that specific resistance training regimes were not advantageous over traditional resistance training programs. Finally, a positive dose response relationship for "intensity" could be found in subgroups using traditional training regimens. These results emphasize that resistance training provides an effective way for enhancing motor performance in children and adolescents.

Effects of resistance training in children and adolescents: a meta-analysis.

CONTEXT: Although physiologic benefits of resistance training for children and adolescents have been well documented, the impact of age and maturity on trainability of muscle strength remains poorly understood. OBJECTIVE: To assess the effects of resistance training in different age groups and maturity levels. METHODS: We searched electronic bibliographic databases, key journals, and reference lists of reviews, book chapters, and articles. Two independent reviewers evaluated the effects of resistance training on muscle strength for prepubertal and postpubertal healthy children and adolescents (younger than 18 years) by using the results of randomized and nonrandomized controlled trials. Assessments of muscle endurance and motor performance tests (eg, vertical jump) were excluded. The influence of continuous and categorical moderator variables was assessed by meta-regression and subgroup analyses, respectively. RESULTS: The overall weighted effect size of 1.12 (95% confidence interval: 0.9-1.3) was significantly greater than 0 (P < .01). Subgroup analyses revealed "maturity" to be a significant categorical moderator variable (z = 2.50; P = .01) and positive correlation coefficients were found for the continuous variables "duration" (r = 0.28; P = .02) and "frequency" (r = 0.26; P = .03). CONCLUSIONS: The results of our analysis indicate that the ability to gain muscular strength seems to increase with age and maturational status, but there is no noticeable boost during puberty. Furthermore, study duration and the number of performed sets were found to have a positive impact on the outcome.