A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal, 2000. / The purpose of this study was to determine the relative effectiveness of combined Action Potential Therapy (APT) and patella mobilization versus combined patella mobilization and placebo Action Potential Therapy in the treatment of Patellofemoral Pain Syndrome. The study was a prospective, randomized, placebo controlled study. The study involved 60 subjects, 30 in each group which were selected from the general population. Group one received patella mobilization and APT while group two received patella mobilization and placebo APT. Patients received four treatments over a period of two weeks. The first treatment consisted of patella mobilization and APT (group one) or patella mobilization and placebo APT (group two), treatment 2,3 and 4 consisted of APT (group one) or placebo A,PT (group two). Subjective assessment was by means of the short form Me Gill pain Questionnaire, Numerical Pain Rating Scale - 101 Questionnaire and the Patient Specific Functional Scale. Objective assessment of tenderness was by means of an algometer. Assessments were taken on the first, second and fifth consultations for all subjective and objective measures. Statistical analysis was completed under the supervision of Dr Myburgh at Technikon Natal, at a 95% confidence interval. The parametric two-sample paired t-test and the non-parametric Wilcoxon signed rank tests were used to analyze data within each group, while the parametric / M

Die Arthrose des Kniegelenkes stellt heutzutage die häufigste Gelenkerkrankung des Menschen dar. Nachdem die konservativen Therapiemöglichkeiten ausgeschöpft sind, wird dem Patienten meist die Implantation einer Knietotalendoprothese empfohlen. Aufgrund von Schmerzen, einer Infektion, oder einer Lockerung der Prothese kann jedoch ein Wechsel des Gelenkersatzes notwendig werden. Das Femoropatellargelenk stellt bei solchen Revisionsoperationen das häufigste und bedeutendste Problem dar. Diese Studie vergleicht 5 operative Verfahren der Patella-rückflächenbearbeitung bei Revisionsoperationen. Hierzu wurden 118 Patienten anhand von 6 etablierten Scores sowie klinisch und radiologisch nach durchschnittlich ca. 2 Jahren nachuntersucht. Die Gruppe der Patienten, welche vor der Revisionsoperation eine ersetzte Patellarückfläche aufwiesen und bei welchen dieser Ersatz entnommen und somit ein knöcherner Rest hinterlassen wurde, zeigte in fast allen Scores deutliche, wenn auch nicht signifikant schlechtere Ergebnisse. Diese gliedern sich gut in die Arbeiten anderer Autoren zu diesem Thema ein. Weiterhin zeigte sich, dass der Kniescore nach Turba et al. für die Evaluation des Femoropatellargelenkes bei Knieprothesenrevisionen ungeeignet ist. Bei der Patellarückflächenbearbeitung während Revisionsoperationen sollte beim Hinweis auf eine Beschädigung der Patellakomponente diese gewechselt werden, ansonsten kann der bestehende Ersatz belassen werden. Das Entfernen eines bestehenden Ersatzes mit Hinterlassen eines knöchernen Restes sollte vermieden werden. Bei weiteren Studien zu diesem Thema wäre es wünschenswert, zusätzlich zur postoperativen Untersuchung eine präoperative Untersuchung durchzuführen. Die Ergebnisse dieser Arbeit wurden auf dem SICOT-Weltkongress der Orthopäden 2013 vorgestellt. / Comparison of different treatments of the Patella at the time of Knee Revision Arthroplasty

No description available.

Diss. (sammanfattning) Umeå : Umeå universitet, 2007. / Härtill 7 uppsatser.

Orientador: Gil Lucio Almeida / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-05T17:19:49Z (GMT). No. of bitstreams: 1 Dionisio_ValdeciCarlos_D.pdf: 5165065 bytes, checksum: 671e611cd8ab8c54d1ba86b902bcb5e6 (MD5) Previous issue date: 2005 / Resumo: A síndrome da dor fêmoro-patelar (SDFP) acomete uma em cada quatro pessoas da população em geral, e é composta por várias lesões que acometem a articulação fêmoro-patelar. O tratamento fisioterapêutico é fundamental na reabilitação dos portadores dessa síndrome, e que tem como uma de suas principais ferramentas o treinamento em cadeia cinética fechada. Dentre as várias formas de realizar esse treinamento, o agachamento é uma das mais utilizadas. Contudo, quando realizado o agachamento, a pessoa nem sempre tem o controle adequado da posição do tronco e dos membros, o que pode favorecer diferentes padrões cinemáticos, cinéticos e eletromiográficos. Portanto o presente estudo teve por objetivo identificar e descrever a estratégia cinética e eletromiográfica usada para realizar o agachamento nas fases ascendente e descendente em sujeitos saudáveis e portadores da SDFP, quando os movimentos são restritos no plano sagital, com padrão cinemático similar na maioria das articulações envolvidas. Oito sujeitos saudáveis e oito portadores da SDFP participaram deste estudo e realizaram o agachamento mantendo os braços flexionados à frente do corpo em duas distâncias, semi-agachamento (de 30º a 50º) e meio-agachamento (de 60º a 80º) na fase descendente. Para a fase ascendente eles realizaram a subida a partir do meio-agachamento. A atividade eletromiográfica dos músculos vasto medial oblíquo, vasto medial longo, reto femoral, vasto lateral, bíceps femoral, semitendinoso, gastrocnêmio lateral e tibial anterior foi registrada. A cinemática das articulações do membro inferior foi reconstruída utilizando-se um sistema óptico de análise de movimento. O centro de pressão (COP) foi obtido utilizando-se dados de uma plataforma de força, e os torques no tornozelo e joelho foram calculados por meio da dinâmica inversa. As tarefas foram eficazes em restringir o movimento no sentido céfalo-caudal em ambos os grupos. Também foi possível identificar e descrever uma estratégia clara para ambas as fases ascendente e descendente do agachamento. O músculo tibial anterior foi o responsável por iniciar o agachamento na fase descendente e se manteve coativado com o gastrocnêmio durante todo o movimento. O quadríceps foi o principal responsável em desacelerar o movimento e não houve grande atividade dos isquiotibiais. Comparado com o grupo controle, o grupo SDFP apresentou menor torque no joelho e menor atividade eletromiográfica do quadríceps, mas o torque no tornozelo e o deslocamento anterior do COP foram maiores durante as duas distâncias, na fase descendente do agachamento. Para a fase ascendente do agachamento, o grupo SDFP apresentou diferença na posição inicial, revelando uma estratégia protetora da articulação fêmoro-patelar. Antes de iniciar o movimento, houve forte ativação do quadríceps, isquiotibiais e gastrocnêmio para vencer a ação gravitacional em ambos os grupos. Comparado com o grupo controle, o grupo SDFP apresentou menor torque no joelho e menor atividade eletromiográfica do quadríceps, mas o torque no tornozelo e o deslocamento anterior do COP foram maiores. As fases de cada tarefa foram descritas e as implicações clínicas discutidas. Palavras chave: torque, centro de pressão, eletromiografia, patela, agachamento / Abstract: The patellofemoral pain syndrome (PFPS) affects one in four people in the general population, and is composed of several lesions of the patellofemoral joint. The physical therapy is essential for the rehabilitation of the population with this syndrome, and one of its main tools is the training in closed kinetic chain. Among the several ways of performing that training, the squat is one of the most used. However, when performing it, a person does not always have a proper control of the position of the trunk and of the limbs, what can produce different kinematic, kinetic and electromyographic patterns. Therefore, the present study had as an objective identifying and describing the kinetic and electromyographic strategy used to perform the squat in the ascending and descending phases by people with and without PFPS, when the movements are restricted in the sagittal plane, with a similar kinematic pattern in most of the involved joints. Eight healthy subjects and eight with PFPS participated in this study and they performed the squat keeping the upper arm elevated at 90º at the shoulder joint, just in front of the body in two distances, semisquatting (30º to 50º) and half squatting (60º to 80º) in the descending phase. For the ascending phase they performed the ascent from the half squatting. The electromyographic activity of the vastus medialis oblique, vastus medialis longus, rectus femoris, vastus lateralis, biceps femoris, semitendineous, gastrocnemius lateralis and tibialis anterior muscles was registered. The joint kinematics of the inferior limbs was reconstructed using an optical system for movement analysis. The center of the pressure (COP) was obtained using data from a force plate and the joint torques in the ankle and knee were calculated using inverse dynamics. The tasks were effective in restricting the movement in the cefalo-caudal direction for both groups. Moreover, it was possible to identify and to describe a clear strategy for both the ascending and the descending phases of the squat. The anterior tibialis muscle was the responsible for beginning the squatting in the descending phase, and kept co-activated with the gastrocnemius during the whole movement. The quadriceps was mainly responsible for decelerating the movement and there was not great activity of the hamstrings. Compared to the control group, the PFPS group presented smaller knee torque and smaller quadriceps electromyographic activity, but the ankle torque and the COP displacement to the anterior direction were larger in the two distances, in the descending phase of the squatting. For the ascending phase of the squatting the PFPS group presented difference in the initial position, revealing a protecting strategy for the patellofemoral joint. Before beginning the movement, there was a strong activation of the quadriceps, hamstrings and gastrocnemius. This was necessary for the motor control system to generate the forces that overcome the inertia of the limb and resist the flexion force acting on the knee due to gravity in both groups. Compared to the control group, the PFPS group presented smaller torque in the knee and smaller electromyographic activity of the quadriceps, but the ankle torque and the COP displacement to the anterior direction were larger. The phases of each task were described and clinical implications were discussed. Key words: torque, center of the pressure, electromyographic activity, patella, squat / Doutorado / Fisiologia / Doutor em Biologia Funcional e Molecular

Study Design: Cross-sectional. Background: Although decreased hip abduction and lateral rotation strength has been found in females with patellofemoral pain syndrome (PFPS), few studies have included males. Aim: To determine if hip abduction and lateral rotation strength is decreased in males with PFPS. Methods: Eight males participated. Isometric hip abduction and external rotation strength was measured with a hand-held dynamometer. Four subjects had unilateral patellofemoral pain (mean age = 26.5 ± 7.5 years) and 4 asymptomatic subjects were controls (mean age = 23 ± 6.4 years). The recorded measurements from the symptomatic legs were compared with the asymptomatic legs, and also with the controls. Results: No significant differences in hip abduction or lateral rotation strength were found between the symptomatic and asymptomatic legs of male subjects with PFPS. The PFPS subjects did not have generally weaker hip strength compared with the asymptomatic controls. Conclusion: Males with PFPS do not appear to have decreased hip abduction and lateral rotation strength. However, the sample size was too small for conclusions to be drawn. This study can be used as a preliminary step in gathering evidence about factors affecting PFPS in males, which may in turn shed light on appropriate clinical treatments.

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1994

Thesis (Ph.D.) -- University of Adelaide, Dept. of Anatomical Sciences, 2003. / "June 2003" Includes bibliographical references (leaves 408-457).

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.