-
Healthcare (Basel, Switzerland) Mar 2024Damage to the articular cartilage resulting in an acute tear can lead to functional changes within the joint and increase the risk of osteoarthritis developing. There is... (Review)
Review
UNLABELLED
Damage to the articular cartilage resulting in an acute tear can lead to functional changes within the joint and increase the risk of osteoarthritis developing. There is limited understanding of the association between occupational risk factors and sustaining an acute articular cartilage tear in the military and other physically demanding occupations. Therefore, the aim of this systematic review was to identify and evaluate original research reporting on occupational risk factors associated with sustaining acute articular cartilage tears.
METHODS
A systematic review following the Preferred Reporting Items for Systematic review and Meta-Analysis-Protocols was conducted and registered with the Open Science Framework. Key academic databases were searched using terms from the following concepts: risk or cause, paid occupations, and acute articular cartilage tears.
RESULTS
Of an initial 941 studies, 2 studies met the eligibility criteria, both reporting data from military contexts; only one evaluated acute articular cartilage tears in both males and females. One paper focused on articular cartilage injury within the knee and the other within the ankle joint with incidence rates being 0.2 and 0.3 per 1000 person-years, respectively. People in more physically active occupations and individuals with an above-normal body mass index were reported as being at higher risk of sustaining an acute articular cartilage tear.
CONCLUSION
Physically demanding occupations, such as the military, may increase the risk for acute tears of the articular cartilage. However, the findings of this review indicate there is a paucity of research to underpin understanding of the injury mechanisms and occupational risk factors for acute articular cartilage tears.
PubMed: 38470706
DOI: 10.3390/healthcare12050595 -
Systematic Reviews Feb 2024Chronic ankle instability (CAI) is a common yet serious problem for elder patients. This meta-analysis aimed to evaluate the effects of balance training for CAI, to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic ankle instability (CAI) is a common yet serious problem for elder patients. This meta-analysis aimed to evaluate the effects of balance training for CAI, to provide evidence for the clinical treatment, and care of CAI patients.
METHODS
Two investigators searched PubMed, EMBASE, Science Direct, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Weipu Databases up to May 20, 2023, for randomized controlled trials (RCTs) on the effects of balance training for CAI. The mean difference (MD) with 95% confidence intervals (95%CIs) was calculated for each outcome with a fixed or random effect model. Review Manager 5.3 software was used for meta-analysis.
RESULTS
Nine RCTs involving 341 patients were included. Meta-analysis results showed that compared with blank controls, balanced training treatment of CAI could significantly improve the score of CAI [MD = 3.95, 95% CI (3.26, 4.64), P < 0.00001], SEBT-PM [MD = 4.94, 95% CI (1.88, 8.00), P = 0.002], SEBT-PL [MD = 5.19, 95% CI (1.57, 8.81), P = 0.005], and FAAM Sports [MD = 17.74, 95% CI (14.36, 21.11), P < 0.00001]. Compared with strength training, balance training treatment of CAI improved the score of CAIT [MD = 2.36, 95% CI (0.29, 4.44), P = 0.03], FAAM-ADL [MD = 4.06, 95% CI (1.30, 6.83), P = 0.004].
CONCLUSION
The analysis outcomes indicate that balance training enhances daily activity capability, motor function, and dynamic balance to different extents. Additionally, when comparing the results of balance training and strength training, no significant difference was observed between the two methods in improving the dynamic stability of CAI patients. However, it is noteworthy that balance training exhibits a more pronounced impact on enhancing functional scale scores.
Topics: Humans; Aged; Ankle; Ankle Joint; Postural Balance; Exercise Therapy; Sports; Joint Instability; Chronic Disease
PubMed: 38347564
DOI: 10.1186/s13643-024-02455-x -
Diagnostics (Basel, Switzerland) Feb 2024Peripheral nerves are subjected to mechanical tension during limb movements and body postures. Nerve response to tensile stress can be assessed in vivo with shear-wave... (Review)
Review
Peripheral nerves are subjected to mechanical tension during limb movements and body postures. Nerve response to tensile stress can be assessed in vivo with shear-wave elastography (SWE). Greater tensile loads can lead to greater stiffness, which can be quantified using SWE. Therefore, this study aimed to conduct a systematic review and meta-analysis to perform an overview of the effect of joint movements on nerve mechanical properties in healthy nerves. The initial search (July 2023) yielded 501 records from six databases (PubMed, Embase, Scopus, Web of Science, Cochrane, and Science Direct). A total of 16 studies were included and assessed with a modified version of the Downs and Black checklist. Our results suggest an overall tendency for stiffness increase according to a pattern of neural tensioning. The main findings from the meta-analysis showed a significant increase in nerve stiffness for the median nerve with wrist extension (SMD [95%CI]: 3.16 [1.20, 5.12]), the ulnar nerve with elbow flexion (SMD [95%CI]: 2.91 [1.88, 3.95]), the sciatic nerve with ankle dorsiflexion (SMD [95%CI]: 1.13 [0.79, 1.47]), and the tibial nerve with both hip flexion (SMD [95%CI]: 2.14 [1.76, 2.51]) and ankle dorsiflexion (SMD [95%CI]: 1.52 [1.02, 2.02]). The effect of joint movement on nerve stiffness also depends on the nerve segment, the amount of movement of the joint mobilized, and the position of other joints comprised in the entirety of the nerve length. However, due to the limited number of studies, many aspects of nerve behavior together with the effect of using different ultrasound equipment or transducers for nerve stiffness evaluation still need to be fully investigated.
PubMed: 38337859
DOI: 10.3390/diagnostics14030343 -
BMC Sports Science, Medicine &... Feb 2024An injury can significantly harm both individual and team performance. One of the most important risk factors for sports-related injuries, especially non-collision...
INTRODUCTION
An injury can significantly harm both individual and team performance. One of the most important risk factors for sports-related injuries, especially non-collision injuries, is fatigue. It seems that poor proprioception may play an essential role to impose athletes to further injuries. This systematic review and meta-analysis aimed to examine the effectiveness of fatigue on the repositioning sense of the lower extremity joints.
METHOD
The electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar were systematically searched from inception to 11January 2024. The obtained records were exported to the EndNote Software version 8. Then, two investigators examined the records independently to find eligible studies based on the inclusion/exclusion criteria. In the case of disagreements, a consequence method was utilized. The quality of the eligible studies was evaluated using the Downs and Black checklist. Comprehensive Meta-Analysis (CMA) software ver. 3 software was used for statistical analysis. Q-test and I were employed to examine the data homogeneity. In addition, considering the risk of bias, the Funnel Plot and trim-and-fill method were used.
RESULTS
After reviewing the titles and abstracts of 3883 studies found in the selected databases, 43 articles were found to be eligible to include in meta-analyses. The results showed that fatigue led to a significant increase in the active absolute error of the knee (SDM = 0.524, 95% CI = 0.406-0.841), ankle in the horizontal plane (SDM = 0.541, 95% CI = 0.367-0.715), ankle in the sagittal plane (SDM = 0.443, 95% CI = 0.088-0.798), and hip (SDM = 0.988, 95% CI = 0.135-1.841). However, fatigue had no significant effects on the passive absolute error of the knee and ankle in horizontal plane and relative angular error of the knee.
CONCLUSION
Fatigue can diminish the active joint position sense of the lower extremities and thus may increase the risk of injury by reducing proprioception. Therefore, future research could be conducted to investigate the potential impact of integrated fatigue-mitigating exercises into athletes' training programs, with the aim of reducing the incidence of sports-related injuries.
PubMed: 38311746
DOI: 10.1186/s13102-024-00820-w -
EFORT Open Reviews Feb 2024The aim of the study was to analyze the effects of functional or biomechanical bandages, whether elastic or inelastic, in Chronic Ankle Instability (CAI).
Effectiveness of functional or biomechanical bandages with athletic taping and kinesiotaping in subjects with chronic ankle instability: a systematic review and meta-analysis.
PURPOSE
The aim of the study was to analyze the effects of functional or biomechanical bandages, whether elastic or inelastic, in Chronic Ankle Instability (CAI).
METHODS
This review used PubMed, WoS, SCOPUS, and CINAHL following PRISMA and registering in Prospero. Main PICOS: (1) CAI; (2) intervention, functional/biomechanical bandages; (3) comparison, taping effect versus placebo/no taping, or another functional taping; (4) outcomes, improvement of CAI functionality (dynamic/static balance, ankle kinematic, perception, agility and motor control, endurance and strength; (5) experimental and preexperimental studies. The meta-analyses considered mean and s.d. of the results per variable; effect size (ES) of each study and for each type of intervention. Homogeneity (Q), heterogeneity (H 2 and I 2), and 95% CI were calculated.
RESULTS
In total, 28 studies were selected. Significant differences were found for dynamic balance (66.66%) and static balance (87.5%), ankle kinematics (75.00%), perceptions (88.88%), plantar flexor strength (100%), muscle activity (66.6%), endurance (100%), functional performance (100%), and gait (66.6%). The main results of meta-analyses (eight studies) are as follows - h/M ratio soleus, ES: 0.080, 95% CI: -5.219-5.379; h/M ratio peroneus, ES: 0.070, 95% CI: -6.151-6.291; posteromedial KT, ES: 0.042 95% CI: -0.514-0.598; posteromedial-overall, ES: -0.006 95% CI: -1.071-0.819; mSEBT-KT, ES: 0.057 95% CI: -0.281-0.395; mSEBT-overall, ES: -0.035 95% CI: -0.190-0.590.
CONCLUSIONS
All biomechanical or functional bandages, whether elastic or inelastic, applied in CAI were favorable, highlighting patient perception, dynamic and static balance, kinematics and agility and motor control, for its effectiveness and evidence. Thus, bandages increase ankle functionality. The meta-analyses found no statistical significance. Clinically, soleus muscle activity, h-reflex/M-responses using fibular reposition with rigid tape, and dynamic balance with combined kinesiotaping during the modified star excursion balance test and with the posteromedial direction found improvements.
LEVEL OF EVIDENCE
Level of evidence according to Scottish Intercollegiate Guidelines Network: 1+. Level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011: 1.
PubMed: 38308953
DOI: 10.1530/EOR-23-0129 -
Cureus Nov 2023The main aim of this study was to determine the level of evidence in the literature for the main indications of osteopathy as recommended by the French osteopathy... (Review)
Review
The main aim of this study was to determine the level of evidence in the literature for the main indications of osteopathy as recommended by the French osteopathy societies. This systematic review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and evaluated articles published between January 2012 and January 2022 with one modification: when level one evidence studies were available, level two to five studies were excluded. Sources included PubMed, the Cochrane library, the French National Health Authority (HAS) and its affiliates. Inclusion criteria were level one published studies on the indications for osteopathic treatment in French and English, and level two to three studies when no level one studies were available. The level of evidence assessment was based on the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence classification. The primary outcome was the level of evidence in the literature supporting osteopathic practices. The secondary outcome was to assess French professional osteopathy recommendations and French HAS guidelines in relation to the scientific literature. A total of 51 articles and nine recommendations from the HAS and its affiliates met the inclusion criteria for the systematic review. Analysis of the studies revealed 41 osteopathic indications from French osteopathy societies for musculoskeletal, neurosensory, psychological, pediatric, gynecological, digestive, and pulmonary disorders. High-level scientific evidence supported the use of osteopathy for low back pain, sciatica, cervical radiculopathy, and ankle sprain. There was moderate evidence for tension headache, temporomandibular joint disorder, endometriosis, and low back and pelvic pain in pregnant women. HAS recommended five indications, while nine indications were supported in the scientific literature. Osteopathy has been shown to have evidence-based benefits for a range of conditions, in particular for musculoskeletal and neurosensory disorders.
PubMed: 38161897
DOI: 10.7759/cureus.49674 -
Journal of Clinical Medicine Dec 2023Periprosthetic infection (PJI) after TAR is a serious complication, often requiring further surgery, including revision arthroplasty, conversion to ankle arthrodesis, or... (Review)
Review
Periprosthetic infection (PJI) after TAR is a serious complication, often requiring further surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. This systematic review aims to summarize the current evidence on the management of TAR PJI and provide a comprehensive overview of this topic, especially from an epidemiologic point of view. Three different databases (PubMed, Scopus, and Web of Science) were searched for relevant articles, and further references were obtained by cross-referencing. Seventy-one studies met the inclusion criteria, reporting on cases of TAR PJI. A total of 298 PJIs were retrieved. The mean incidence of PJI was 3.8% (range 0.2-26.1%). Furthermore, 53 (17.8%) were acute PJIs, whereas most of them (156, 52.3%) were late PJIs. Most of the studies were heterogeneous regarding the treatment protocols used, with a two-stage approach performed in most of the cases (107, 35.9%). While the prevalence of ankle PJI remains low, it is potentially one of the most devastating complications of TAR. This review highlights the lack of strong literature regarding TAR infections, thus highlighting a need for multicentric studies with homogeneous data regarding the treatment of ankle PJI to better understand outcomes.
PubMed: 38137779
DOI: 10.3390/jcm12247711 -
Sports (Basel, Switzerland) Dec 2023Fatigue has the potential to alter how impact forces are absorbed during running, heightening the risk of injury. Conflicting findings exist regarding alterations in... (Review)
Review
Fatigue has the potential to alter how impact forces are absorbed during running, heightening the risk of injury. Conflicting findings exist regarding alterations in both kinematics and plantar pressure. Thus, this systematic review and subsequent meta-analysis were conducted to investigate the impact of general and localized muscle fatigue on kinematics and plantar pressure distribution during running. Initial searches were executed on 30 November 2021 and updated on 29 April 2023, encompassing PubMed, The Cochrane Library, SPORTDiscus, and Web of Science without imposing any restrictions on publication dates or employing additional filters. Our PECOS criteria included cross-sectional studies on healthy adults during their treadmill running to mainly evaluate local muscle fatigue, plantar pressure distribution, biomechanics of running (kinematics, kinetics, and EMG results), and temporospatial parameters. The literature search identified 6626 records, with 4626 studies removed for titles and abstract screening. Two hundred and one articles were selected for full-text screening, and 20 studies were included in qualitative data synthesis. The pooled analysis showed a non-significant decrease in maximum pressure under the right forefoot's metatarsus, which was more than the left rearfoot after local muscle fatigue at a velocity of 15 km/h (-values = 0.48 and 0.62). The results were homogeneous and showed that local muscle fatigue did not significantly affect the right forefoot's stride frequency and length (-values = 0.75 and 0.38). Strength training for the foot muscles, mainly focusing on the dorsiflexors, is recommended to prevent running-related injuries. Utilizing a standardized knee and ankle joint muscle fatigue assessment protocol is advised. Future experiments should focus on various shoes for running and varying foot strike patterns for injury prevention.
PubMed: 38133108
DOI: 10.3390/sports11120241 -
BMC Sports Science, Medicine &... Dec 2023Biofeedback may alter the biomechanics of lower extremities in patients with chronic ankle instability (CAI). We aimed to systematically review the literature on the...
BACKGROUND
Biofeedback may alter the biomechanics of lower extremities in patients with chronic ankle instability (CAI). We aimed to systematically review the literature on the effect of gait-training and biofeedback on biomechanical parameters in individuals with CAI and conduct a meta-analysis.
METHODS
We searched four databases including PubMed, Web of Science, Scopus and Embase from their inception through 30th June 2022. The Downs and Black appraisal scale was applied to assess quality of included studies. Two reviewers screened studies to identify those reporting the effect of biofeedback on biomechanical factors associated with CAI. Outcomes of interest were kinetics and kinematics. Two authors separately extracted data from included studies. Data of interest were study design, number of sessions, intervention, tools, outcomes, number, sex, age, height, and body mass of participants.
RESULTS
Thirteen studies with a total of 226 participants were included. Biofeedback was capable of shifting center of pressure (COP) and lateral plantar pressure medially and reducing foot inversion, adduction, propulsive vertical ground reaction force (vGRF), ankle joint contact force, peak pressure and pressure time integral in the lateral mid-foot and forefoot. Auditory biofeedback had agreater impact on modifying plantar pressure in individuals with CAI. The meta-analyses revealed that visual biofeedback reduces peak pressure in lateral mid-foot and pressure time integral at lateral and medial heel and pressure increases under the hallux.
CONCLUSION
Biofeedback can alter pressure, vGRF, and foot inversion associated with CAI. Auditory biofeedback had greater impact on modifying plantar pressure in individuals with CAI. Further studies are required to assess the prolonged effect and clinical consequences of biofeedback or a combination of feedback on CAI in different age groups. Moreover, developing a low-cost and user-friendly device that can be evaluated in high quality RCTs is important prior to implementing the intervention in the clinical setting to reduce symptoms of CAI.
PubMed: 38093253
DOI: 10.1186/s13102-023-00780-7 -
Frontiers in Sports and Active Living 2023Motion analysis can be used to gain information needed for disease diagnosis as well as for the design and evaluation of intervention strategies in patients with hip... (Review)
Review
INTRODUCTION
Motion analysis can be used to gain information needed for disease diagnosis as well as for the design and evaluation of intervention strategies in patients with hip osteoarthritis (HOA). Thereby, joint kinematics might be of great interest due to their discriminative capacity and accessibility, especially with regard to the growing usage of wearable sensors for motion analysis. So far, no comprehensive literature review on lower limb joint kinematics of patients with HOA exists. Thus, the aim of this systematic review and meta-analysis was to synthesise existing literature on lower body joint kinematics of persons with HOA compared to those of healthy controls during locomotion tasks.
METHODS
Three databases were searched for studies on pelvis, hip, knee and ankle kinematics in subjects with HOA compared to healthy controls during locomotion tasks. Standardised mean differences were calculated and pooled using a random-effects model. Where possible, subgroup analyses were conducted. Risk of bias was assessed with the Downs and Black checklist.
RESULTS AND DISCUSSION
A total of 47 reports from 35 individual studies were included in this review. Most studies analysed walking and only a few studies analysed stair walking or turning while walking. Most group differences were found in ipsi- and contralateral three-dimensional hip and sagittal knee angles with reduced ranges of motion in HOA subjects. Differences between subjects with mild to moderate and severe HOA were found, with larger effects in severe HOA subjects. Additionally, stair walking and turning while walking might be promising extensions in clinical gait analysis due to their elevated requirements for joint mobility. Large between-study heterogeneity was observed, and future studies have to clarify the effects of OA severity, laterality, age, gender, study design and movement execution on lower limb joint kinematics.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42021238237).
PubMed: 38046934
DOI: 10.3389/fspor.2023.1197883