Popliteal Artery Entrapment Syndrome-Return to Sport Considerations: A Case Report.

This is a case of a 19-year-old female collegiate field hockey player with left leg pain, numbness, and tingling. A comprehensive workup including dynamic ultrasound, magnetic resonance imaging (MRI), and magnetic resonance angiogram (MRA) revealed a type VI functional popliteal artery entrapment syndrome (PAES). There are many options for treatment of functional PAES including activity modification, botulinum toxin injection, and surgery. To the authors' knowledge there is no published return to sport recommendation for postsurgical functional PAES. This report highlights alternative treatment options and proposes a postsurgical return to play rehabilitation protocol in functional PAES. LEVEL OF EVIDENCE: V.

Soleus Muscle Herniation With Magnetic Resonance Imaging and Ultrasound Correlation in a Female Long-Distance Runner: A Case Report.

This is a case of a 40-year-old female endurance athlete with right leg pain while running. A comprehensive workup revealed a fascial defect with soleus muscle herniation. Although historically in many practice settings magnetic resonance imaging is the diagnostic imaging modality of choice for suspected muscle herniation through the fascia, the use of ultrasound is increasing because of lower cost, ease of access, and dynamic evaluation. To the authors' knowledge, there has not been a direct comparison between the accuracy of magnetic resonance imaging versus ultrasound in determining the size or location of a soleus muscle herniation. LEVEL OF EVIDENCE: Not applicable.

Physiatrist referral preferences for postacute stroke rehabilitation.

This study was intended to determine if there is variation among physiatrists in referral preferences for postacute rehabilitation for stroke patients based on physician demographic characteristics or geography.A cross-sectional survey study was developed with 5 fictional case vignettes that included information about medical, social, and functional domains. Eighty-six physiatrist residents, fellows, and attendings were asked to select the most appropriate postacute rehabilitation setting and also to rank, by importance, 15 factors influencing the referral decision. Chi-square bivariate analysis was used to analyze the data.Eighty-six surveys were collected over a 3-day period. Bivariate analysis (using chi-square) showed no statistically significant relationship between any of the demographic variables and poststroke rehabilitation preference for any of the cases. The prognosis for functional outcome and quality of postacute facility had the highest mean influence ratings (8.63 and 8.31, respectively), whereas location of postacute facility and insurance had the lowest mean influence ratings (5.74 and 5.76, respectively).Physiatrists' referral preferences did not vary with any identified practitioner variables or geographic region; referral preferences only varied significantly by case.

Impaired mastication modifies the dynamics of bolus formation.

Mastication is a complex sensory-motor activity whereby a food product is transformed into a bolus. Consumers mainly perceive the sensory properties of the food during the intra-oral manipulation of the product. Consequently, the quality of the chewing process could have consequences on the perception of sensory properties and food choice. By focusing on meat products, this study aimed to analyze the influence of dental status on (i) dynamic adaptation of the chewing behavior (evaluated by electromyography) to the changes in texture during bolus formation and (ii) bolus properties (mechanical resistance and saliva incorporation) obtained from meat of different initial textures. Two groups of subjects (dentate subjects and denture wearers), known to present highly different chewing efficiency, were compared. For both groups, salivary flow rates were evaluated at rest and after stimulation by chewing (paraffin and meat). The salivary flow rates, assessed during chewing of a nonedible matrix (paraffin), were a good predictor of salivary flow rates induced by meat chewing for both groups of subjects. Salivary flow rates were not affected by the dental status. In contrast, the chewing behavior varied between groups. For denture wearers, the chewing pattern was strongly impaired and not adapted to the changes in meat structure during bolus formation. Denture wearers swallowed less fragmented boli than dentate subjects, but boli had a similar level of moisture for both groups of subjects.

Changes in jaw muscles activity with age: effects on food bolus properties.

Bolus formation depends on chewing process that evolves with age. This study aims to analyze the effect of age on chewing behavior (recorded by EMG) and the consequences on bolus formation for meat products. Twenty-five young adults (age range: 25-30) and 20 healthy elderly (age range: 68-73) having at least six pairs of natural postcanine teeth participated. From two different textures of bovine meat, boli were characterized by shear force measurements. Saliva incorporated into the bolus was quantified. Chewing duration was significantly longer in the elderly group for both textures, but muscle activity was significantly lower for the toughest texture only. Moreover, muscle activity was less accurately adapted to food texture in elderly than in young. In order to control that changes in EMG reflect changes in bite force, EMG was recorded during static bite forces. Slopes were fairly similar for both groups suggesting that EMG/bite force relationships do not vary with age. Elderly subjects could partly compensate for a weaker chewing efficiency by increasing the number of chewing cycles before swallowing. It is hypothesized that lengthening of chewing duration results from a decrease in muscle activity during healthy aging. After chewing, the mechanical resistance of the bolus was always higher for the elderly than for the young subjects. No significant age effect was found on the amount of saliva incorporated in the bolus. Elderly subjects, despite the lengthening of the chewing sequence, were less efficient to comminute a meat bolus than young subjects and swallowed less comminuted boli.