Pseudo-tendinopathy on MRI of the navicular and tarsometatarsal parts of the tibialis posterior tendon: A study in normal individuals.

PURPOSE: To determine the normal thickness and MRI appearance of the Tibialis Posterior Tendon near the navicular insertion in normal volunteers. MATERIALS AND METHODS: By using a 3T MRI system 41 ankles were imaged, and PD weighted images with fat saturation were acquired in the three orthogonal planes. Symptoms of tendon pathology and history of trauma or surgery of the tendon were used as volunteer exclusion criteria. Two different measurement points were determined to evaluate hyperintensity and thickness. Two radiologists assessed the internal signal of the Tibialis Posterior Tendon independently by using axial and coronal images. Tendon hyperintensity was classified from homogenously dark to different degrees of hyperintense signal, where 0 means no internal hyperintensity, 1 - minimal hyperintensity, 2 - moderate and 3 - marked. Correlations between the two observers were obtained by Cohen's kappa. Descriptive statistics were also obtained. RESULTS: Eight men and 13 women (total 21) volunteers, age range 19-43(average 24.7)years were included in the study. At measurement point-1 on the coronal images, observer-1 and observer-2 evaluated hyperintensity (mostly minimal) respectively in 90.5% and 95.3% of tendons with a Cohen's kappa coefficient of 0.701 (moderate agreement) for the right foot and in 60% and 70% of tendons with a Cohen's kappa coefficient of 0.624 (moderate agreement) for the left foot. On axial images both observers assessed hyperintensity (mostly marked) in 100% of the tendons with a coefficient of 0.763 (moderate agreement) for the right foot, and in 95% of tendons with a coefficient of 0.839 (strong agreement) for the left foot. At measurement point-2 on coronal images, both observers rated any degree of hyperintensity in 33.3% of tendons with a coefficient of 1.00 (perfect agreement) for the right foot, in 38.9% of tendons with a coefficient of 0.766 (moderate agreement) for the left foot. On axial images both observers evaluated hyperintensity (mostly minimal) in 100% of tendons with a kappa coefficient of 0.702 (moderate agreement) for the right foot, in 95% of tendons with a coefficient of 0.790 (moderate- to strong agreement) for the left foot. CONCLUSION: The Tibialis Posterior Tendon, near the navicular insertion (navicular tendon and tarsometatarsal tendon), exhibits an apparent thickening and most importantly hyperintensity which should be regarded as a normal finding, and not lead to an erroneous diagnosis of tendinopathy. This observation was almost always the case for the navicular insertion and less so for the tarsometatarsal tendon.

Immediate Effects of Local Vibration and Whole-body Vibration on Postural Control in Patients with Ataxia: an Assessor-Blind, Cross-over randomized trial.

Vibration interventions are used in neurorehabilitation to improve postural control in recent years. Little is known about the immediate effects of vibration interventions on postural control in patients with ataxia. The aim of this study is to investigate and compare the immediate effects of local vibration (LV) and whole-body vibration (WBV) on postural control in patients with ataxia. This study was designed as cross-over, single blind randomized clinical trial. Twenty-one patients with ataxia met the inclusion criteria. LV (frequency, 80 Hz; amplitude, 1 mm) and WBV (30 Hz, 2 mm) were applied to all patients. There was a 1-week washout time between interventions. Each patient was assessed 3 times: pre-intervention and 1 and 60 min post-intervention. The assessor was blinded to the interventions. Outcome measures were limits of stability (LoS), and postural sways (Bertec Balance Check Screener), gait parameters (GAITRite), and static balance (one-leg stance test). Twenty patients completed both interventions. The mean patient age was 39.43 ± 9.67 years. LV increased the left-LoS post-vibration (1 and 60 min post) more than WBV did (p ˂ 0.05). LV increased the LoS stability score and the base of support at 1 min post-vibration, while WBV decreased them (p ˂ 0.05). This study demonstrated different immediate effects of a single session of LV versus WBV and showed that LV has better effects on postural control in patients with ataxia. ClinicalTrials.gov. nr NCT04183647.

Plant Species Recovery on a Compacted Skid Road.

This study was executed to determine the plant species of herbaceous cover in a skid road subjected to soil compaction due to timber skidding in a beech (Fagus orientalis Lipsky.) stand. Our previous studies have shown that ground based timber skidding destroys the soils extremely, and degradations on ecosystem because of the timber skidding limit recovery and growth of plant cover on skid roads. However, some plant species show healthy habitat, recovery and they can survive after the extreme degradation in study area. We evaluated composition of these plant species and their cover-abundance scales in 100 m x 3 m transect. 15 plant species were determined belongs to 12 plant families and Liliaceae was the highest representative plant family. Smilax aspera L., Epimedium pubigerum (DC.) Moren et Decaisne, Carex distachya Desf. var. distachya Desf., Pteridium aquilinum (L.) Kuhn., Trachystemon orientalis (L.) G. Don, Hedera helix L. have the highest coverabundance scale overall of determined species on compacted skid road.