Effects of Viscosupplementation on Quality of Knee Joint Arthrokinematic Motion Analyzed by Vibroarthrography.

OBJECTIVE: To evaluate the influence of viscosupplementation on osteoarthritic knee arthrokinematics analyzed by VAG. It is considered that intra-articular hyaluronic acid injection may improve the function of synovial joints by recovery of friction-reducing properties of articular environment. DESIGN: Thirty-five patients with knee osteoarthritis (grade II according to the Kellgren-Lawrence system) and 50 asymptomatic subjects were enrolled in the study. Patients were analyzed at 3 time points: 1 day before and 2 weeks and 4 weeks after single injection of 1.5% cross-linked hyaluronate. Control subjects were tested once. The vibroarthrographic signals were collected during knee flexion/extension motion using an accelerator and described by variation of mean square (VMS), mean range (R5), and power spectral density for frequency of 50 to 250 Hz (P1), and 250 to 450 Hz (P2). RESULTS: Patients before viscosupplementation were characterized by about 2-fold higher values of vibroarthrographic parameters than controls. Two weeks after the procedure, the values of R5, P1, and P2 significantly decreased, in comparison to pre-injection. At 4 weeks post-injection, we noted a significant increase in R5, P1, and P2 values, when compared to 2 weeks post-injection. Finally, at 4 weeks post-injection, the level of VMS, R5, and P2 parameters did not differ from values obtained at pre-injection. CONCLUSIONS: We showed that viscosupplementation may be effective in providing arthrokinematics improvement, but with a relatively short period of duration. This phenomenon is observed as decreased vibroacoustic emission, which reflects a more smooth movement in the joint.

Kinematic Chains in Ski Jumping In-run Posture.

The concept of kinematic chains has been systematically applied to biological systems since the 1950s. The course of a ski jump can be characterized as a change between closed and open kinematic chains. The purpose of this study was to determine a relationship between adjacent segments within the ski jumper's body's kinematic chain during the in-run phase of the ski jump. The in-run positions of 267 elite male ski jumpers who participated in the FIS World Cup events in Innsbruck, Austria, between 1992 and 2001 were analyzed (656 jumps). Two-dimensional (2-D) kinematic data were collected from the bodies of the subjects. Relationships between adjacent segments of the kinematic chain in the ski jumper's body at the in-run position are greater nearer the chain's ground contact. The coefficient of determination between the ankle and knee joint angles is 0.67. Changes in the segments' positions in the kinematic chain of the ski jumper's body are stable during longitudinal assessment. Changes in shank and thigh positions, in the sense of increase or decrease, are the same.

Evaluation of postural asymmetry and gross joint mobility in elite female volleyball athletes.

The purpose of the study was to evaluate marked postural asymmetry and gross joint mobility in elite female volleyball athletes. Sixty-two Czech and Slovak elite female volleyball athletes (age 20.7±2.03 years, body mass 71.1±6.18 kg, body height 1.804±.0618 m, BMI 21.8±1.78) were examined by an experienced rehabilitation physician. The set of tests included the frontal posture gross examination, the forward bending test from the standing position and the deep squat test. The spiking hand and the presence of any lower extremity injury were estimated by interview. The proportion test, Mann-Whitney test and t-test were used to evaluate statistical significance (p<0.05). Fifty subjects (80.6%) exhibited "typical" frontal plane posture in which the acromion, scapula and the iliac crest were in a higher position on the left side than on the right, significantly more frequently than all the other patterns (proportion test, p<0.0001). Ninety-eight percent of the subjects with the "LLL pattern" preferred the right arm for spiking (proportion test, p<0.0001). Forty-one subjects (66%) exhibited hypermobility in the forward bending test, significantly more frequently than twenty-one subjects (34%) with normal results (proportion test, p=0.0003). Thirty-four subjects (55%) did not succeed in the deep squat test and hypermobility in the forward bending test paradoxically prevailed in them significantly (proportion test, p=0.004). Restriction in the deep squat test was not linked to obesity, age (t-test, p=0.081) nor knee (proportion test, p=0.85) and ankle injury (Mann-Whitney test, p=0.36) in the past. Significant prevalence of hypermobility in the forward bending test was not surprising because of general body composition and the performance of regular stretching exercises in elite female volleyball athletes. On the other hand, surprisingly, more than half of the subjects did not succeed in the deep squat test. The cause of poor results in the deep squat test could be due to the tightness of the soleus muscle suffering from chronic overloading and/or an inappropriate stretching methods. An inappropriate and/or insufficient compensatory exercise and stretching method or system could be the cause of their marked postural asymmetry as well. A detailed examination of posture and muscle imbalance performed by an experienced physician or physiotherapist as well as individually tailored compensatory exercises and a stretching system can be strongly recommended to all elite athletes, not only to volleyball players.

Changes in clusterin serum concentration levels in oncologic patients during the course of spa therapy--a pilot study.

BACKGROUND: Clusterin (70-80 kDa; synonym ApoJ) is a stress-associated cytoprotective glycoprotein involved in many physiological and pathophysiological processes and it is up-regulated by various apoptotic triggers in many cancers and neurodegenerative diseases. AIM: Measurement of serum clusterin values in individuals with a history of cancer before and after spa therapy. METHODS: Serum clusterin concentration (ELISA) was determined in a group of 26 oncologic patients (4 men and 22 women) at the beginning and at the end (the 18th or 19th day) of spa treatment. The spa treatment lasted 3 weeks. The patients with various types of cancer had undergone basic therapy (surgery, chemotherapy, actinotherapy) prior to spa treatment. They were divided according to the interval between the end of basic treatment and the start of spa therapy. Patients coming within 12 months comprised group A (n=15) while patients coming later comprised group B (n=11). RESULTS: clusterin concentrations increased in 11 patients (73%) and decreased in 4 (27%) in group A and increased in 5 (45%) and decreased in 6 (55%) in group B. The non-parametric sign test was non-significant. There were positive value of average change between the second and the first sample in group A and negative value in group B. In group A the parametric test showed significant increased clusterin concentration at the end of spa treatment but the data had non-parametric distribution in fact. CONCLUSION: It is concluded that early spa therapy increases clusterin serum concentration. This is probably due to to the positive effects of balneotherapy. However the sample was very small and further research is required.