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Medicine and Science in Sports and... Apr 2015Are eccentric hamstring strength and between-limb imbalance in eccentric strength, measured during the Nordic hamstring exercise, risk factors for hamstring strain...
PURPOSE
Are eccentric hamstring strength and between-limb imbalance in eccentric strength, measured during the Nordic hamstring exercise, risk factors for hamstring strain injury (HSI)?
METHODS
Elite Australian footballers (n = 210) from five different teams participated. Eccentric hamstring strength during the Nordic exercise was obtained at the commencement and conclusion of preseason training and at the midpoint of the season. Injury history and demographic data were also collected. Reports on prospectively occurring HSI were completed by the team medical staff. Relative risk (RR) was determined for univariate data, and logistic regression was employed for multivariate data.
RESULTS
Twenty-eight new HSI were recorded. Eccentric hamstring strength below 256 N at the start of the preseason and 279 N at the end of the preseason increased the risk of future HSI 2.7-fold (RR, 2.7; 95% confidence interval, 1.3 to 5.5; P = 0.006) and 4.3-fold (RR, 4.3; 95% confidence interval, 1.7 to 11.0; P = 0.002), respectively. Between-limb imbalance in strength of greater than 10% did not increase the risk of future HSI. Univariate analysis did not reveal a significantly greater RR for future HSI in athletes who had sustained a lower limb injury of any kind within the last 12 months. Logistic regression revealed interactions between both athlete age and history of HSI with eccentric hamstring strength, whereby the likelihood of future HSI in older athletes or athletes with a history of HSI was reduced if an athlete had high levels of eccentric strength.
CONCLUSION
Low levels of eccentric hamstring strength increased the risk of future HSI. Interaction effects suggest that the additional risk of future HSI associated with advancing age or previous injury was mitigated by higher levels of eccentric hamstring strength.
Topics: Adult; Age Factors; Humans; Male; Muscle Strength; Muscle, Skeletal; Prospective Studies; Recurrence; Risk Factors; Soccer; Thigh; Young Adult
PubMed: 25137368
DOI: 10.1249/MSS.0000000000000465 -
Folia Morphologica 2022Venous anomalies of the lower extremity are a challenge when found as rare variations. Physicians should be aware of morphological variations in this region for correct...
BACKGROUND
Venous anomalies of the lower extremity are a challenge when found as rare variations. Physicians should be aware of morphological variations in this region for correct diagnosis and management of diseases such as deep vein thrombosis.
MATERIALS AND METHODS
During the routine dissection of the lower extremities of a Caucasian male cadaver, a case of persistent sciatic vein was found.
RESULTS
A persistent sciatic vein originating from the saphenopopliteal junction coursed proximally and laterally to enter into the adductor magnus muscle, at the right side. Running through the fibres of the adductor magnus anteriorly, the variant vein drained into the deep femoral vein just medial to the vastus medialis muscle.
CONCLUSIONS
As being a rare congenital vascular anomaly, the persistent sciatic vein should be correctly diagnosed and defined during the radiologic assessments, surgical interventions and blockades for better outcomes and lesser complications.
Topics: Male; Humans; Veins; Thigh; Lower Extremity; Vascular Malformations; Cadaver
PubMed: 34545558
DOI: 10.5603/FM.a2021.0091 -
Deutsches Arzteblatt International Sep 2023Pain and sensory disturbance in the distribution of the lateral femoral cutaneous nerve in the ventrolateral portion of the thigh is called meralgia paresthetica (MP).... (Review)
Review
BACKGROUND
Pain and sensory disturbance in the distribution of the lateral femoral cutaneous nerve in the ventrolateral portion of the thigh is called meralgia paresthetica (MP). The incidence of MP has risen along with the increasing prevalence of obesity and diabetes mellitus and was recently estimated at 32 new cases per 100 000 persons per year. In this review, we provide an overview of current standards and developments in the diagnosis and treatment of MP.
METHODS
This review is based on publications retrieved by a selective literature search, with special attention to meta-analyses, systematic reviews, randomized and controlled trials (RCTs), and prospective observational studies.
RESULTS
The diagnosis is mainly based on typical symptoms combined with a positive response to an infiltration procedure. In atypical cases, electrophysiological testing, neurosonography, and magnetic resonance imaging can be helpful in establishing the diagnosis. The literature search did not reveal any studies of high quality. Four prospective observational studies with small case numbers and partly inconsistent results are available. In a meta-analysis of 149 cases, pain relief was described after infiltration in 85% of cases and after surgery in 80%, with 1-38 months of follow-up. In another meta-analysis of 670 cases, there was pain relief after infiltration in 22% of cases, after surgical decompression in 63%, and after neurectomy in 85%. Hardly any data are available on more recent treatment options, such as radiofrequency therapy, spinal cord stimulation, or peripheral nerve stimulation.
CONCLUSION
The state of the evidence is limited in both quantity and quality, corresponding to evidence level 2a for surgical and non-surgical methods. Advances in imaging and neurophysiological testing have made the diagnosis easier to establish. When intervention is needed, good success rates have been achieved with surgery (decompression, neurectomy), and variable success rates with infiltration.
Topics: Humans; Decompression, Surgical; Femoral Neuropathy; Nerve Compression Syndromes; Observational Studies as Topic; Pain; Thigh
PubMed: 37534445
DOI: 10.3238/arztebl.m2023.0170 -
Ugeskrift For Laeger Sep 2022
Topics: Bicycling; Humans; Lower Extremity; Thigh; Wounds, Penetrating
PubMed: 36065872
DOI: No ID Found -
The Journals of Gerontology. Series A,... Mar 2023African Caribbeans have higher levels of myosteatosis than other populations; however, little is known about the impact of myosteatosis on physical function in African...
BACKGROUND
African Caribbeans have higher levels of myosteatosis than other populations; however, little is known about the impact of myosteatosis on physical function in African Caribbeans. Herein, we examined the association between regional myosteatosis of the calf, thigh, and abdomen versus physical function in 850 African-Ancestry men aged 64.2 ± 8.9 (range 50-95) living on the Caribbean Island of Tobago.
METHODS
Myosteatosis was measured using computed tomography and included intermuscular adipose tissue (IMAT) and muscle density levels of the thigh, calf, psoas, and paraspinous muscles. Outcomes included grip strength, time to complete 5 chair-rises, and 4-meter gait speed. Associations were quantified using separate linear models for each myosteatosis depot and were adjusted for age, height, demographics, physical activity, and chronic diseases. Beta coefficients were presented per standard deviation of each myosteatosis depot.
RESULTS
Higher thigh IMAT was the only IMAT depot significantly associated with weaker grip strength (β = -1.3 ± 0.43 kg, p = .003). However, lower muscle density of all 4 muscle groups was associated with weaker grip strength (all p < .05). Calf and thigh myosteatosis (IMAT and muscle density) were significantly associated with both worse chair rise time and gait speed (all p < .05), whereas psoas IMAT and paraspinous muscle density were associated with gait speed.
CONCLUSION
Myosteatosis of the calf and thigh-but not the abdomen-were strongly associated with grip strength and performance measures of physical function in African Caribbean men. However, posterior abdominal myosteatosis may have some utility when abdominal images are all that are available.
Topics: Male; Humans; Thigh; Lower Extremity; Leg; Muscles; Caribbean Region; Muscle, Skeletal
PubMed: 35661875
DOI: 10.1093/gerona/glac124 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Jul 2022Because of its peculiar anatomical location, most patients with hypopharyngeal and cervical esophageal cancer are at advanced stage when they visit the hospital. At...
OBJECTIVES
Because of its peculiar anatomical location, most patients with hypopharyngeal and cervical esophageal cancer are at advanced stage when they visit the hospital. At present, the treatment for hypopharyngeal and cervical esophageal cancer is primarily surgical resection and radiotherapy. However, due to the wide range of surgical resection, it can often lead to a large range of annular defects. Therefore, the upper digestive tract reconstruction after tumor resection is very important. We use the free anterolateral thigh flap (ALT) and free jejunum (FJ) transfer to reconstruct the hypopharyngeal and cervical esophagus, and to investigate the effect of both reconstruction methods on upper gastrointestinal tract defects.
METHODS
A retrospective analysis was conducted to investigate the clinical data of 42 patients with hypopharyngeal and cervical esophageal cancer (Clinical Stage IV) from Jan. 2004 to Jan. 2016 in the Second Xiangya Hospital of Central South University. All patients underwent total laryngopharyngectomy and cervical esophageal resection. The hypopharyngeal circumferential and cervical esophageal defects were reconstructed with free ALT (=22) or FJ (=20). Four patients who underwent radiotherapy and chemotherapy before surgery did not receive radiotherapy or chemotherapy after surgery. The remaining 38 patients underwent postoperative radiotherapy and chemotherapy. All patients were followed up by telephone or outpatient review, with a follow-up deadline in Jan. 2021. We compared the differences between the 2 groups in postoperative complications, radiotherapy complications, and survival rate. The differences in individual characteristics between 2 groups were analyzed using Fisher test. The differences in postoperative and radiotherapy complications between two groups were analyzed using χ² test. The 3- and 5-year overall survival rates were calculated using Kaplan-Meier survival curve method.
RESULTS
In the ALT group, the postoperative complications mainly included anastomotic fistula, chylous fistula and subcutaneous hematoma of the donor site. The radiotherapy complication was anastomotic stenosis. However, in the FJ group, the postoperative complications mainly included chylous fistula, intestinal obstruction, and intestinal fistula. The radiotherapy complications mainly contained anastomotic fistula and tissue flap necrosis. The cases of postoperative complications in the ALT group and the FJ group were 7 and 5, respectively (=0.625), and the cases of radiotherapy complications were 3 and 4, respectively (=0.563). The 3-year overall survival rates in the ALT group and the FJ group were 52.9% and 46.7%, respectively, and the 5-year total survival rates were 35.1% and 31.9%, respectively (=0.53). The cases of anastomotic stenosis after radiotherapy in the ALT group were more than those in the FJ group (=0.097). However, the cases of jejunal necrosis and anastomotic fistula after radiotherapy in the FJ group were more than those in the ALT group (=0.066).
CONCLUSIONS
There are no significant differences in postoperative and radiotherapy complications and 3-and 5-year survival rates between the ALT group and the FJ group. The reconstruction with ALT is prone to develop anastomotic stricture. The reconstruction with FJ cannot withstand high-dose radiotherapy. The ALT and FJ are effective methods in the reconstruction of hypopharynx and cervical esophagus. The treatment protocol should be carefully chosen based on its advantages and disadvantages of these 2 methods.
Topics: Constriction, Pathologic; Esophageal Neoplasms; Fistula; Free Tissue Flaps; Humans; Hypopharynx; Jejunum; Necrosis; Postoperative Complications; Plastic Surgery Procedures; Retrospective Studies; Thigh
PubMed: 36039585
DOI: 10.11817/j.issn.1672-7347.2022.210763 -
Sensors (Basel, Switzerland) Aug 2023Physical activity is increasingly being captured by accelerometers worn on different body locations. The aim of this study was to examine the associations between...
Physical activity is increasingly being captured by accelerometers worn on different body locations. The aim of this study was to examine the associations between physical activity volume (average acceleration), intensity (intensity gradient) and cardiometabolic health when assessed by a thigh-worn and wrist-worn accelerometer. A sample of 659 office workers wore an Axivity AX3 on the non-dominant wrist and an activPAL3 micro on the right thigh concurrently for 24 h a day for 8 days. An average acceleration (proxy for physical activity volume) and intensity gradient (intensity distribution) were calculated from both devices using the open-source raw accelerometer processing software GGIR. Clustered cardiometabolic risk (CMR) was calculated using markers of cardiometabolic health, including waist circumference, triglycerides, HDL-cholesterol, mean arterial pressure and fasting glucose. Linear regression analysis assessed the associations between physical activity volume and intensity gradient with cardiometabolic health. Physical activity volume derived from the thigh-worn activPAL and the wrist-worn Axivity were beneficially associated with CMR and the majority of individual health markers, but associations only remained significant after adjusting for physical activity intensity in the thigh-worn activPAL. Physical activity intensity was associated with CMR score and individual health markers when derived from the wrist-worn Axivity, and these associations were independent of volume. Associations between cardiometabolic health and physical activity volume were similarly captured by the thigh-worn activPAL and the wrist-worn Axivity. However, only the wrist-worn Axivity captured aspects of the intensity distribution associated with cardiometabolic health. This may relate to the reduced range of accelerations detected by the thigh-worn activPAL.
Topics: Humans; Wrist; Thigh; Accelerometry; Exercise; Cardiovascular Diseases
PubMed: 37687813
DOI: 10.3390/s23177353 -
Nutrition (Burbank, Los Angeles County,... 2022The aim of this study was to compare the assessment of skeletal muscle area (SMA in cm²), skeletal muscle index (SMI in cm²/m²), and skeletal muscle density (SMD in...
OBJECTIVES
The aim of this study was to compare the assessment of skeletal muscle area (SMA in cm²), skeletal muscle index (SMI in cm²/m²), and skeletal muscle density (SMD in HU) between third lumbar vertebra (L3) and thigh landmarks, and the agreement in diagnosing low muscle mass and low SMD (L3 as the reference method).
METHODS
This was a multicenter, cross-sectional study including healthy individuals (≥18 y of age) of both sexes, who had an elective computed tomography exam including abdominal and pelvic regions. Computed tomography images were analyzed to evaluate SMA, SMI, and SMD. Muscle abnormalities (low SMA, SMI, and SMD) were defined as values below the fifth percentile from a subsample of healthy young individuals (n = 111; 18-39 y of age; 55.9% women). Correlation coefficients, Bland-Altman graphs, and receiver operating characteristic (ROC) curves were calculated for the total sample and stratified by sex and age.
RESULTS
In all, 268 individuals (44.3 ± 15.2 y of age) were evaluated (53% women). Significant (P < 0.001 for all analysis) and strong correlations between SMA (r = 0.896), SMI (r= 0.853), and SMD (r= 0.864) compared with L3 and thigh landmarks were observed. For the ROC curves, similar areas under the curve values were obtained for men (0.981), women (0.895), younger (0.902), and older adults (0.894).
CONCLUSIONS
Muscle characteristics between L3and thigh landmarks have a strong correlation. This suggests that images of the thigh can be used to characterize muscle characteristics. Image acquisition and analysis of thigh region is simpler, with less radiation exposure, and consequently more appropriate for longitudinal analysis.
Topics: Aged; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Retrospective Studies; Sarcopenia; Thigh; Tomography, X-Ray Computed
PubMed: 35576877
DOI: 10.1016/j.nut.2022.111654 -
European Journal of Sport Science Jun 2022Muscle hypertrophy can occur non-uniformly in athletes who repetitively perform particular movements, presumably leading to a unique muscle size distribution along the...
Muscle hypertrophy can occur non-uniformly in athletes who repetitively perform particular movements, presumably leading to a unique muscle size distribution along the length. The present study aimed to examine if sprinters have unique size distributions within the gluteus and posterior thigh muscles. Nineteen male sprinters and 20 untrained males participated in the present study. T1-weighted magnetic resonance images of the hips and right thigh were obtained in order to determine whole and regional (proximal, middle, and distal) volumes of the gluteus maximus and individual posterior thigh muscles. The results showed that the volumes of all the examined muscles relative to body mass were significantly larger in sprinters than in untrained males (all < 0.001, = 1.40-3.29). Moreover, the magnitude of the difference in relative volume between sprinters and untrained males was different between the regions within the gluteus maximus ( = 0.048, partial = 0.187), semitendinosus ( = 0.004, partial = 0.331), and adductor magnus ( = 0.007, partial = 0.322), but not within the other posterior thigh muscles ( = 0.091-0.555, partial = 0.025-0.176). The magnitude of the difference in relative volume between the sprinters and untrained males was greatest in the distal regions within the gluteus maximus and semitendinosus, while the proximal region within the adductor magnus. These findings indicate that sprinters have unique size distributions within the gluteus maximus, semitendinosus, and adductor magnus, which may be attributed to their competitive and training activities. HighlightsSprinters showed larger gluteus maximus and individual posterior thigh muscles than untrained males.The magnitude of difference varied within the gluteus maximus, semitendinosus, and adductor magnus.The greatest difference was found in distal regions within the gluteus maximus and semitendinosus, while proximal region within the adductor magnus.
Topics: Hamstring Muscles; Hip; Humans; Lower Extremity; Male; Muscle, Skeletal; Thigh
PubMed: 33749535
DOI: 10.1080/17461391.2021.1907450 -
Scientific Reports Aug 2022Head and neck reconstruction with microvascular free flaps is frequently performed in smokers. Smoking causes various alterations in the cardiovascular system. The aim...
Head and neck reconstruction with microvascular free flaps is frequently performed in smokers. Smoking causes various alterations in the cardiovascular system. The aim of this study was to investigate the effects of smoking on flap perfusion as a critical factor for flap survival. A total of 370 patients reconstructed with a radial free forearm flap (RFFF) or anterolateral thigh flap (ALTF) in the head and neck region between 2011 and 2020 were retrospectively analyzed. Flap perfusion measurements with the O2C tissue oxygen analysis system were compared between nonsmokers, light smokers (< 20 pack-years), and heavy smokers (≥ 20 pack-years). The blood flow was intraoperatively equal in RFFFs (84.5 AU vs. 84.5 AU; p = 0.900) and increased in ALTFs (80.5 AU vs. 56.5 AU; p = 0.001) and postoperatively increased in RFFFs (114.0 AU vs. 86.0 AU; p = 0.035) and similar in ALTFs (70.5 AU vs. 71.0 AU; p = 0.856) in heavy smokers compared to nonsmokers. The flap survival rate was similar in nonsmokers, light smokers, and heavy smokers (97.3%, 98.4%, and 100.0%). Smoking partially increases rather than decreases microvascular free flap perfusion, which may contribute to similar flap survival rates in smokers and nonsmokers.
Topics: Forearm; Free Tissue Flaps; Head and Neck Neoplasms; Humans; Perfusion; Plastic Surgery Procedures; Retrospective Studies; Smoking; Thigh
PubMed: 35974131
DOI: 10.1038/s41598-022-18216-6