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Relationship between individual forces of each quadriceps head during low-load knee extension and cartilage thickness and knee pain in women with knee osteoarthritis / 変形性膝関節症患者における低負荷膝関節伸展中の大腿四頭筋各筋の筋張力と軟骨厚・膝関節症状との関連Yagi, Masahide 23 May 2022 (has links)
京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第24097号 / 人健博第104号 / 新制||人健||7(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 黒木 裕士, 教授 青山 朋樹, 教授 松田 秀一 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM
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Impact of Passive Range of Motion Exercises and Stretching in Knee Osteoarthritis Pain during WalkingOttonello, Dominique Marchelle 05 August 2020 (has links)
No description available.
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Kneeling function following total knee arthroplastyBenfayed, Rida A. January 2018 (has links)
The ability to kneel is an important function of the knee joint, as it is required for many daily activities, including religious practices, professional occupations and recreational pursuits. The inability to kneel following total knee arthroplasty (TKA) is frequently a source of disappointment. This work investigates patients' understanding of the term 'kneeling' and what proportion of patients can kneel before and after TKA, as well as identifying the factors that can affect the ability to kneel following TKA. The underlying hypothesis tested was: 'There are no differences between kneeling ability before and after TKA'. Kneeling ability after TKA may be affected by many factors, including patient-specific factors, the extent of wear on RPC (Retro patellar Cartilage), postoperative AKP (Anterior Knee Pain) and post-operative ROM (Range of Motion). Thus a consecutive series of TKA patients were assessed to test the afore-mentioned hypothesis. In particular, the thesis has examined: • Interpretation of kneeling and perceptions of kneeling ability after TKA. • The extent of wear on Retro Patellar Cartilage (RPC) and its correlation to kneeling ability. • Sensory changes in the knee after TKA. • Preoperative and Postoperative Anterior Knee Pain (AKP) assessment. • The reality of kneeling ability before and after TKA. • Postoperative ROM of the knee and its correlation to kneeling function. The advice offered by healthcare professionals may contribute to a low postoperative rate of kneeling. The patellofemoral joint plays an essential role in knee function and a person's kneeling ability, may be greatly affected by the performance of this joint. Firstly, this study analysed the responses of two samples of participants drawn from diverse cultural backgrounds (Christian and Muslim), it examined their primary interpretation of what kneeling constitutes, along with a subjective assessment of the importance of kneeling in their everyday lives. Secondly, it explored patients' perceptions of their kneeling ability after TKA, with a comparative analysis of their responses to the kneeling questionnaire specifically constructed by the author and also the question in relation to kneeling in the Oxford Knee Score (OKS). The third component investigated retro-patellar cartilage (RPC) morphology using intraoperative examination and standardised photography. Fourthly, a cohort of patients listed for TKAs was followed prospectively, in order to assess their kneeling ability prior to and following treatment, along with identifying the factors that could affect this function, i.e. knee pain, range of motion, sensory changes and sensitivity to pain on the anterior aspect of the knee as assessed with dolorimetry. Differences were detected in the subjective interpretation of the kneeling function, as well as its importance, for the two diverse cultures involved in this study. Pain, as opposed to poor range of movement, was identified as the main reason which led to kneeling difficulties. The majority of respondents reported that it was either extremely difficult or impossible to kneel on the operated knee. The high flexed position (required for prayer in certain cultures) was the most difficult position to achieve for most of the patients. Prior to surgery, 30 patients were seen during this period, 15 (50%) out of 30 consecutive patients were unable to kneel in any position whatsoever. Of those who could kneel to some degree, the most common posture that they could achieve was the upright kneeling position. Considerable variations were found to occur in patients' understanding of the term 'kneeling'. Consequently, this has significant implications for the design and interpretation of questions in relation to kneeling for diverse cultures, which are characterised by distinct lifestyles. The current patient-based selfV administered questionnaires, such as the OKS, although useful as a simple measure of overall knee function, were found to have limitations as an effective assessment tool in the measurement of kneeling function either before or after TKA and indicate that there is a need for a culturally appropriate questionnaire to assess kneeling function. Retro-patellar cartilage lesions were very prevalent in patients undergoing TKA. However, no significant correlation existed between the total amount of retro-patellar cartilage wear and the ability to kneel. Patients were more likely to be able to kneel if the cartilage of the superior facets of the patella were disease free (P=0.02). At the six months post-surgery stage, of the 14 consecutive patients, who could kneel pre-operatively 6 were able to kneel post-operatively. Of the 13 consecutive patients who were unable to kneel pre-operatively, all were unable to kneel post-operatively. Knee pain was the main reason attributed to this difficulty. However, no link was found to occur between sensory changes and kneeling function in the patients who participated in the study, after TKA performed via an anterior midline incision.
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Exercise, physical activity, and physical performance in Thai elders after knee replacement surgery a behavioral change intervention study /Harnirattisai, Teeranut, January 2003 (has links)
Thesis (Ph. D.)--University of Missouri--Columbia, 2003. / Typescript. Vita. Includes bibliographical references (leaves 162-175). Also available on the Internet.
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Neuromuscular-biomechanical outcomes of different types of resistance training on people with knee osteoarthritisHeiden, Tamika Louise January 2009 (has links)
[Truncated abstract] Knee osteoarthritis (OA) patients have high levels of pain, functional and strength deficits of the quadriceps, decreased proprioceptive acuity, and increased co-contraction and knee joint loading in gait, compared to age matched controls. The increased knee joint loading in this population occurs most commonly in the medial tibio-femoral compartment, due to increased external adduction moments, and with increasing disease severity there is a concomitant increase in the knee adduction moments. A key finding within the knee OA literature is that dynamic loading in gait, due to increased external adduction moments, strongly predicts pain and radiographic disease progression. Current research has shown that exercise interventions reduce pain and time to complete functional activities; however, the effect of these interventions on knee joint loading and muscular activation in gait is still unclear. In addition, the need for specific knee joint strengthening to cause these alterations has not been investigated and it remains unknown if improvements occur due to specific muscle strengthening or due to some general effect of exercise. Therefore, the primary aim of this research study was to examine the effects of general (upper body) and specific (lower body) resistance training interventions on self-perceived outcomes, neuromuscular function and kinematic, kinetic and muscle activation during gait of OA patients compared with asymptomatic controls. ... The examination of gait data following exercise (Study 4) showed trends for changes in the muscle co-contraction ratios. Specifically, the medial/lateral co-contraction ratio (MLCCR) displayed a trend in early stance where the upper body exercise group increased their lateral muscle activity and the lower body group reduced their lateral muscle activity, and the medial/lateral hamstring co-contraction ratio (HAMCCR) displayed this same trend during loading. The trend toward reduced lateral muscle activation, following lower body resistance training, suggests that specific muscle strengthening may have the ability to alter the load distribution. The kinematic and kinetic variables of gait were unchanged by the exercise interventions, highlighting the sensitivity of muscle activation pattern changes due to muscle strengthening. This thesis provides new insights into the co-contraction strategies utilised by knee OA patients. The directed co-contraction strategy employed by knee OA patients and its relationship to the external adduction moment in gait suggest an attempt to redistribute the loading within the knee joint, most likely in response to pain. Further, we have separated the effects of exercise and found differences in self-perceived outcomes based on exercise specificity. This first examination into muscle co-contraction following resistance training of knee OA patients has highlighted the possibility of alterations to the co-contraction patterns following lower body exercise. However, the implications of altering this muscle activation strategy and the consequent effect on distribution of load within the knee joint requires further consideration.
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Varus-Valgus Knee Laxity and Biomechanical Function in Patients with Severe Osteoarthritis and after Total Knee ArthroplastyFreisinger, Gregory Martin 29 May 2015 (has links)
No description available.
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The state of current knowledge regarding evidence-based conservative management of iliotibial band syndrome : a systematic reviewHarris, Kelly Jayne 23 July 2014 (has links)
Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background : It has become practically impossible for practitioners to remain current with clinical developments. Additionally the demand from patients and third party payors for quality evidence is increasing. A systematic review is one manner in which information can be graded, summarised and presented in a succinct format for use by practitioners, patients and third party payors.
Objectives : To identify the current knowledge available on the conservative management of iliotibial band syndrome (ITBS) and to evaluate the scientific and methodological rigor of that knowledge. The systematic review of these studies identified the level and type of evidence that currently exists in the support of conservative management of ITBS and the specific interventions and combinations of interventions currently employed.
Method : A systematic review of ITBS studies was conducted. ITBS studies were identified using key indexing terms (iliotibial band syndrome, treatment, conservative and intervention) on several databases (EBSCOhost, Google Scholar, Metalib, Pubmed, Science Direct and Springerlink), all studies were included up until the date of ethics approval (21st May 2012) . The gathered studies were screened for compliance with the inclusion criteria, and then reviewed by blinded independent reviewers (reviewer criteria included qualification, clinical experience, academic experience, research experience and discipline).
Data collection and analysis : The reviewers rated the methodological rigour of the ITBS studies utilising an appropriate scale (e.g. PEDro Scale). Feedback was collated and analysed for discordance. Studies were then analysed, ranked and followed by a discussion in the context of their clinical outcomes, thus formulating a structured summary of the known clinical data with regards to the clinical management of ITBS.
Results:
The identified citations (4130) were screened and sorted by study type. This resulted in 167 citations that were reviewed by abstract for compliance with the inclusion criteria. A final total of 23 studies meet eligibility criteria. Eight articles reported on a combination of interventions, four discussed biomechanical and causative factors, and the remaining eleven articles investigated individual interventions in the treatment of ITBS. After review and analysis, combination interventions were supported by the strongest level of evidence, thus advocating the use of a combination of interventions in the management of ITBS in providing better clinical outcomes. Moderate evidence favoured the use of customised orthoses, injectable corticosteroids, phonophoresis and addressing biomechanical and causative factors. However, there was moderate evidence against the use of deep tissue frictions, as no improvement was found. This outcome suggests a need for further evidence to advocate the appropriateness of these interventions in clinical care of ITBS. Hip abductor strengthening and stretch therapy were found to have limited evidence. However, no evidence was found to support the application of active release technique, corrective neuromuscular approach, custom dry floatation cushions and talar joint manipulation in the management of ITBS. This latter outcome indicated a need for studies to investigate their appropriateness or inappropriateness in clinical care.
Conclusion : The systematic review of ITBS studies revealed that use of a combination of conservative therapies was found to have the strongest level of evidence, which may indicate its appropriateness in the management of patients suffering from ITBS. Specific combinations of conservative therapies and the use of individual therapies require future research in order to better delineate their contribution to the management of ITBS. Randomised controlled trials are the gold standard for research, as they have the greatest level of methodological quality, and should be used where possible when investigating the efficiency of interventions in the treatment of ITBS. Studies, which were not randomised controlled trials, but adopted the principles of a randomised controlled trial structure, contributed positively towards the methodological rigor of these studies.
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The presence and extent of quadriceps femoris weakness in individuals with patellofemoral pain syndromeClifton, Stuart Ronald January 2003 (has links)
Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003
xvi, 121 leaves / The purpose of the investigation was to evaluate the presence and extent of Quadriceps Femoris weakness in subjects with patellofemoral pain syndrome by the use of an isokinetic dynamometer.
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The effectiveness of three treatment protocols in the treatment of iliotibial band friction syndromeTurnbull, Grant S. D. January 2010 (has links)
Mini-dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Iliotibial Band Friction Syndrome (ITBFS) is an overuse injury induced by friction of the iliotibial
band (ITB) over the lateral epicondyle of the femur (LFE) with secondary inflammation. ITBFS is
a prevalent condition and is the most common cause of lateral knee pain in long distance
runners and cyclists.
There are a significant number of aetiological factors related to ITBFS. As a result of this the
general chiropractic approach to the treatment of ITBFS is multimodal and include interventions
such as joint manipulation, cryotherapy, orthotics, massage, electrical stimulation, acupuncture
type procedures and therapeutic exercise. Dry-needling is an effective therapy in the treatment
of active Myofascial Trigger Points (MFTP’s) that are associated with ITBFS. However, the
available literature suggests that to determine its efficacy, it should be performed in isolation.
The association of sacroiliac joint dysfunction in ITBFS has also been addressed and are
thought to co-exist and perpetuate one another. It is recommended that chiropractors include
pelvic manipulation in their treatment protocol for ITBFS however there is a paucity of literature
showing its effectiveness in the treatment of this condition.
There appears to be a need for further research in the form of randomized controlled clinical
trials with regard to chiropractic specific procedures, performed in isolation, in the treatment of
ITBFS. Therefore this study aimed to add to the literature by assessing the effect of the
sacroiliac joint manipulation and dry needling in the treatment of ITBFS.
Objectives
The study aimed to determine the comparative effectiveness of dry needling alone versus
manipulation alone, as well as a combination of the two interventions in the treatment of ITBFS.
Methods
This study was a randomised, open label trial. 47 participants with ITBFS were divided into
three groups, each group receiving a different intervention i.e.: group one received dry needling
of the active MFTP’s in the Tensor Fascia Lata (TFL) and ITB, group two received sacroiliac
joint manipulation, group three received a combination of the two interventions. Subjective
measurements, in the form of the Numerical Pain Rating Scale-101 (NRS-101), and objective
measurements, in the form of algometer readings in the TFL, ITB and Nobles Compression test
as well as digital inclinometer readings of Modified Obers test, were utilised to determine the
effects of the respective interventions. These measurements were recorded twice, once prior to
commencing the treatment programme. These values were then evaluated to compare the
efficacy of the different treatment interventions. Each participant received four treatments over a
two week period.
Results
There were no statistically significant differences between the three treatment groups as they all
seemed to parallel one another with regards to overall improvement in subjective and objective
measurements (P<0.5). However on closer examination subtle differences between the groups
were noted. An interesting endpoint is that the combination group did not fair the best
throughout the study, which was contrary to the original hypothesis. The groups receiving only
the single intervention appeared to fair marginally better over the combination group. A
secondary endpoint that became evident during the study and on analysis of the data, was that
hip joint instability must also be considered when treating ITBFS when there is concomitant
sacroiliac joint dysfunction.
Conclusion
A decision needs to be made with regard to which intervention best suits the individual at the
time. A combination therapy, which originally was thought to be the best treatment option,
should possibly be reconsidered. Perhaps a single intervention of manipulation or dry needling
should be decided upon. In totality, all intervention proved to be effective in the treatment of
ITBFS.
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Knee kinematics during a novel hop test with an unanticipated change of direction for female floorball athletes and controls : Evaluation of within-session and test-retest reliability and assessment of knee functionÅström, William January 2016 (has links)
Introduction: The incidence of anterior cruciate ligament (ACL) injuries in female floorball is relativley high, and the risk for sustaining a second ACL injury is greater compared to previously uninjured. Existing evaluation tests in rehabilition may not be discriminative enough to guide decisions on return to sport Aim: To evaluate the withinAsession and testAretest reliability of knee kinematics in floorball athletes and controls during a hop encompassing a sudden unanticipated change of direction. A second aim was to investigate the discriminative validity by comparing the test outcomes between the athletes and a control group of nonAathletes. Method: 11 elite floorball athletes and 8 controls were tested on two occassions separated by one to three weeks. Knee kinematics, ground contact time and number of succesfull hops were analyzed. Relative reliability was quantifyed by Intraclass correlation coefficient (ICC) and absolute reliability by standard error of measurement (SEM). Results: ICCs for knee kinematics withinAsession reliability were excellent (0.83A0.96) for athletes and poor to excellent (0.40A0.94) for the controls. For the testAretest reliability, the athletes had good to excellent (0.56A0.96) reliability and the controls had poor to excellent (0.26A0.93) reliability. Only two measured kinematic variables were significantly different between the groups. Conclusion: This pilot study indictate good to excellent reliability for the majority of the kinematic variables tested and, therefore, it could be assumed to be adequatley reliable. Discriminative validity needs to be further evaluated in a larger material.
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