Prospective assessment of functional and clinical results of surgical patellar stabilization in rural and urban populations. Equal chance to success?

INTRODUCTION AND OBJECTIVE: Patella dislocation represents 3.3% of all knee injuries often leading to persistent instability. Medial patello-femoral ligament(MPFL) reconstruction is the standard method of treatment in the patellar instability. Rehabilitation after MPFL-R is a long and demanding procedure. The hypothesis presented reflects the idea that despite relatively good access to hospital care and surgical options, the post-operative rehabilitation care system is still inferior in rural areas versus the one offered in major cities and towns. MATERIAL AND METHODS: Between January 2015 - January 2018, 47 patients met the study inclusion criteria, diagnosed and operated on due to patellar instability. 8 patients were lost for full follow-up. Finally, 39 patients were included, divided into two groups - group A (19 from cities), group B (20 from rural area). Prospective KOOS and Kujala scales assessments were conducted: preoperative, 6 and 12 months after surgery. Knee isokinetic muscle strength was measured at 3 stages; prior to surgery, 6 and 12 months after reconstruction. RESULTS: All patients showed significant improvement measured in the KOOS and Kujala scales after the procedure, compared to the pre-operational results. Despite equal clinical improvement, patients from Group A(city) achieved better functional outcomes as presented in the results of knee extensor functional tests using a Biodex dynamometer. CONCLUSIONS: Rehabilitation after MPFL reconstruction improves muscle strength and clinical outcome. Patients from rural areas had inferior functional results in comparison to the patients from major cities, even 12 months after surgical patella stabilization. Despite the development of roads and transport according to the EU cohesion policy, there are still differences in rehabilitation results between rural and city areas.

The efficacy of intermittent pneumatic compression and negative pressure therapy on muscle function, soreness and serum indices of muscle damage: a randomized controlled trial.

BACKGROUND: The study aimed to assess whether intermittent pneumatic compression (IPC) and intermittent negative pressure (INP) would attenuate the muscle damaging effects of eccentric exercise. METHODS: Forty-five healthy males were recruited. Immediately post, 24 and 48 h post eccentric exercise consisting of 100 drop jumps, volunteers randomly received 30-min sessions of intermittent pneumatic compression (IPC, n = 15) or intermittent negative pressure (INP, n = 15), or sham microcurrent (PT, n = 15). Creatine kinase (CK), lactate dehydrogenase (LDH), isokinetic muscle strength, soreness and active flexion of the knee joint were measured after every therapy session. RESULTS: No significant intergroup differences were observed in biochemical or functional measurements. However, there was an increase in muscle soreness (P < 0.05), CK and LDH activity (P < 0.05), and a reduction in muscle strength (P < 0.05) and range of active knee flexion (P < 0.05). CONCLUSIONS: The prescription of IPC and INP did not attenuate the reduction of markers to muscle function or pain perception up to 48 h after muscle damaging exercise. Future research should focus on the potential impact of treatment frequency and duration on muscle recovery. Trial registration The study was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR); The trial registration number: ACTRN12621001294842; date of registration: 24/09/2021.

Influence of Running Phases on the Postural Balance of Modern Pentathlon Athletes in a Laser Run Event.

Background: The Laser Run combined event is part of the modern pentathlon, consisting of successive shooting and running phases. The main factor hindering accurate and fast shooting is the increasing fatigue caused by running effort. The aim of this study was to assess the impact of the running phases on the postural balance in the shooting position of pentathletes in a Laser Run event. Methods: 25 modern pentathletes (18.6 ± 1.7 years), members of the Polish Association of Modern Pentathlon, completed a Laser Run event. During each shooting series, a Zebris dynamometric platform recorded the displacement of the centre of pressure (COP). Results: Significant changes in the average velocity of the COP (F = 3.43; p = 0.0223) and the width of the ellipse of the COP shifts area WoE (F = 3.30; p = 0.0259) between the first and the second shooting series were observed. The average velocity of the COP in series I was 72.6 m/s and increased to 84.3 m/s in series II. In turn, the average width of the ellipse of the COP in series I reached 29.1 mm and in series II, 34.1 mm. Conclusions: The fatigue caused by the running phases in the Laser Run affects the stability of the shooting position of pentathletes. Disturbances that occur after the first running phase are maintained at the same level during the subsequent shooting series. The fatigue level does not affect the magnitude of the disturbances of the postural balance in the shooting position.

Static Postural Balance in Modern Pentathletes: A Pilot Study.

Postural balance is a key element of shooting effectiveness, which determines the outcome of modern pentathlon competitions. The aim of the study is to examine the postural balance of 27 pentathletes (12 females and 15 males; mean age: 18.0 ± 1.8 years), and 26 physically active, untrained subjects (12 females and 14 males; mean age: 22.5 ± 1.4 years), and to investigate the impact of footwear on the stability of the shooting position in pentathletes. Methods: Static postural balance was examined during quiet stance in four test conditions (standing in footwear with eyes opened, standing in footwear with eyes closed, standing barefoot with eyes opened, and standing barefoot with eyes closed). During each postural balance measurement, the participant remained still on the platform, with their arms in front of their body. Postural balance in the shooting position was only evaluated in the group of pentathletes. The athlete was asked to assume a comfortable shooting position on the platform and to aim at the target. Standard pentathlon targets and pistols were used in the study. Measurements were carried out twice (barefoot and in footwear). Results: In all conditions, pentathletes achieved lower values of posturographic measures than in the control group. In non-visual conditions, measures describing the surface area of the centre of pressure decreased in pentathletes and increased in the control group. Both pentathletes and non-athletes were equally stable barefoot as in footwear. Footwear did not affect postural sway in the shooting position in pentathletes. Conclusions: Pentathletes were found to have significantly better stance stability and were less vision-dependent in postural balance than untrained subjects. Bearing in mind that the shooting position of pentathletes was as stable barefoot as in footwear, the main factors which were most likely responsible for minimising body oscillations in the pentathletes were their high level of concentration and conscious control of body alignment.

The effect of low level laser irradiation on oxidative stress, muscle damage and function following neuromuscular electrical stimulation. A double blind, randomised, crossover trial.

BACKGROUND: Low level laser therapy (LLLT) is among novel methods for preventing and treating muscle damage and soreness induced by volitional exercise, but little is known about using LLLT before neuromuscular electrical stimulation. The aim of this first randomised, double blind, crossover trial addressing this issue was to evaluate effects of LLLT on muscle damage and oxidative stress, as well as recovery of muscle function after a single session of isometric neuromuscular electrical stimulation(NMES). METHODS: Twenty four moderately active, healthy men aged 21-22 years received 45 electrically evoked tetanic, isometric contractions of the quadriceps femoris, preceded by LLLT or sham-LLLT. Maximal isometric voluntary muscle torques, perceived soreness, and blood samples were analysed from baseline to 96 h post intervention. We measured plasma markers of muscle damage (the activity of creatine kinase), and inflammation (C-reactive protein), and evaluated redox state parameters. RESULTS: NMES-evoked contractions induced oxidative stress, demonstrated by an increase in lipid peroxidation and impairments in enzymatic antioxidant system. LLLT irradiations had a protective effect on NMES-induced decrease in enzymatic antioxidant defence and shortened the duration of inflammation. This effect of irradiations on redox state and inflammation did not affect lipid peroxidation, muscle damage, and muscle torque. CONCLUSIONS: LLLT may protect from impairments in enzymatic antioxidant system and may shorten inflammation induced by a single NMES session in moderately active, healthy men. However, the effects of LLLT on redox state and inflammatory processes do not seem to affect muscle damage and recovery of muscle function after NMES. TRIAL REGISTRATION: The study was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR); The trial registration number: ACTRN12619000678190; date of registration: 6 May 2019.

Effects of unilateral and bilateral plyometric training on power and jumping ability in women.

Makaruk, H, Winchester, JB, Sadowski, J, Czaplicki, A, and Sacewicz, T. Effects of unilateral and bilateral plyometric training on power and jumping ability in women. J Strength Cond Res 25(12): 3311-3318, 2011-The purpose of this study was to examine the effects of unilateral and bilateral plyometric exercise on peak power and jumping performance during different stages of a 12-week training and detraining in women. Forty-nine untrained but physically active female college students were randomly assigned to 1 of 3 groups: unilateral plyometric group (n = 16), bilateral plyometric group (BLE; n = 18), and a control group (n = 15). Peak power and jumping ability were assessed by means of the alternate leg tests (10-second Wingate test and 5 alternate leg bounds), bilateral leg test (countermovement jump [CMJ]) and unilateral leg test (unilateral CMJ). Performance indicators were measured pretraining, midtraining, posttraining, and detraining. Differences between dependent variables were assessed with a 3 × 4 (group × time) repeated analysis of variance with Tukey's post hoc test applied where appropriate. Effect size was calculated to determine the magnitude of significant differences between the researched parameters. Only the unilateral plyometric training produced significant (p < 0.05) improvement in all tests from pretraining to midtraining, but there was no significant (p < 0.05) increase in performance indicators from midtraining to posttraining. The BLE group significantly (p < 0.05) improved in all tests from pretraining to posttraining and did not significantly (p > 0.05) decrease power and jumping ability in all tests during detraining. These results suggest that unilateral plyometric exercises produce power and jumping performance during a shorter period when compared to bilateral plyometric exercises but achieved performance gains last longer after bilateral plyometric training. Practitioners should consider the inclusion of both unilateral and bilateral modes of plyometric exercise to elicit rapid improvements and guard against detraining.