A Biomechanical Foot-Worn Device Improves Total Knee Arthroplasty Outcomes

Background

Biomechanics after total knee arthroplasty (TKA) often remain abnormal and may lead to prolonged postoperative recovery. The purpose of this study is to assess a biomechanical therapy after TKA.

Shall we use cryotherapy in the treatment in surgical procedures,in acute pain or injury,or in long term pain or dysfunction? - A systematic review

PurposeThis review aimed to evaluate the certainty of evidence for the use of cryotherapy in patients with musculoskeletal disorders.MethodsPubMed, Embase, Cochrane Library and AMED were searched from January 2000 to January 2018 (update June 2019) for systematic reviews (SRs) and randomized controlled trials (RCTs) reporting outcomes on pain, swelling, range of motion (ROM), function, blood loss, analgesic use, patient satisfaction and adverse advents. The papers were categorised into: surgical procedures, acute pain or injury and long-term pain or dysfunction. Methodological quality and risk of bias were assessed using the AMSTAR and the Swedish Health Technology Assessment instruments. Level of certainty of evidence was synthesized using GRADE.Study selectionEight SRs and 50 RCTs from a total of 6027 (+839) were included. In total 34 studies evaluated cryotherapy in surgical procedures, twelve evaluated cryotherapy use in acute pain or injury and twelve studies evaluated cryotherapy in long-term pain and dysfunction.ResultsThe certainty of evidence is moderate (GRADE III) after surgical procedures to reduce pain, improve ROM, for patient satisfaction and few adverse events are reported. Cryotherapy in acute pain and injury or long-term pain and dysfunction show positive effects but have a higher number of outcomes with low certainty of evidence (GRADE II).ConclusionCryotherapy may safely be used in musculoskeletal injuries and dysfunctions. It is well tolerated by patients. More advanced forms of cryotherapy may accentuate the effect. Future research is needed where timing, temperature for cooling, dose (time) and frequency are evaluated.     

StepWatch accuracy during walking,running, and intermittent activities

IntroductionThe purpose of this study was two-fold: 1) to investigate effects of cadence and sensitivity settings for the StepWatch (SW3) on step count accuracy over a wide range of ambulatory speeds, and 2) to compare the preprogrammed “quick start” settings to modified settings during intermittent lifestyle activities.MethodsPart 1: Fifteen participants (18–57 years of age) performed two trials of treadmill walking and running at ten speeds ranging from 26.8 to 268 m min⁻¹ while wearing four SW3 devices. During the first trial, the cadence setting was maintained while sensitivity was varied; in the second trial sensitivity was maintained while the cadence setting was varied. Part 2: Fifteen participants performed four intermittent activities and drove an automobile while wearing two SW3 devices, one with preprogrammed settings and the other with the modified settings determined in Part 1.ResultsPart 1: The modified settings (cadence setting of 70% of default and sensitivity of 16) provided the greatest step counting accuracy across a wide range of speeds reporting 96.0–104% of actual steps between 53.6 and 268 m min⁻¹. Part 2: The preprogrammed settings tended to have higher accuracy for light household tasks (recording 88% to 94% of actual steps) than the modified settings (recording 82% to 86% of actual steps) which showed a trend towards higher accuracy for tennis (recording 93% vs. 89% of actual steps) (p < 0.05).ConclusionThe preprogrammed “quick start” StepWatch settings should be used with individuals who do not engage in running and vigorous sports. However, for individuals who engage in running and tennis, use of modified settings may result in improved step counting accuracy.     

Effect of dynamic tape on postural sway in individuals with chronic ankle instability

ObjectiveTo examine the effects of dynamic tape on balance control in subjects with chronic ankle instability (CAI).MethodsThis two group experimental pre- and post-treatment design included 18 individuals with CAI and 18 controls. The single-limb stance test with eyes open and closed, standing on a force plate (Accusway Plus; AMTI) for 30 s, was conducted before, 10 min (T1) and 24 h (T24) after a dynamic tape application over the gastrocnemius muscle. Outcome measurements were: mean sway velocity, sway area (circular area), and standard deviation of the body center of pressure path length in both mediolateral and anteroposterior directions. Individuals with poor (unable to perform a single leg test for at least 30 s, eyes closed) vs. good postural stability, were also compared.ResultsIn both groups, a repeated analysis of variance demonstrated a significant time main effect on sway velocity (F = 14.95; p < 0.001) and path length (F = 14.95; p < 0.001) during eyes closed. Post-hoc analysis revealed a significant decrease in T1 values compared to baseline. When comparing individuals with poor vs good stability amongst the CAI group, a statistically significant interaction was observed between group, time on sway velocity and path length (F = 3.92; p < 0.05) during eyes closed. In the poor postural group, most T1 values were significantly lower than baseline.ConclusionsDynamic tape when applied to posterior calf muscles, enhanced balance control with no difference between CAI individuals and controls. The contribution of the tape was greater in those with poor postural stability.     

Recovery profiles of eccentric hamstring strength in response to cooling and compression

IntroductionThe effectiveness of different forms of cryotherapy and combined compression (cryo-compression) commonly used in sport to enhance recovery following exercise are not fully understood. Therefore, the exploration of protocols that use contemporary cryo-compression is warranted. The purpose of the study was to investigate the effectiveness of using a cryo-compression device to recover hamstrings eccentric strength following a fatiguing exercise.MethodsEighteen healthy male adult footballers were randomly allocated to receive cryo-compression or rest following a lower limb fatiguing protocol. Cryo-compression was applied for 15-min, target temperature of 10 °C, and high intermittent pressure (5–75 mm Hg) using the Game Ready® device. Rest consisted of 15-min in a prone position on a plinth. To induce hamstring fatigue, participants performed the Yo-Yo intermittent fatigue test (IFT). Skin surface temperature (T_sk) and hamstring eccentric strength measures were taken at three time points; pre-IFT, immediately post-fatigue test (IPFT), and immediately post-intervention (IPI) (rest or Game Ready®). Participants returned one week later and performed the Yo-Yo IFT again and were exposed to the opposite intervention and data collection.ResultsSignificant decreases in T_sk over the posterior thigh were reported for all timepoints compared to pre cryo-compression temperatures (p=<0.05). Overall data displayed no significant main effects for timepoint or condition for PT or AvT (p=<0.05). There was no timepoint × condition interaction for PT or AvT (p=<0.05). Collapse of the data by condition (CC/R) demonstrated no significant effect for time for PT or AvT (p=>0.05).ConclusionsNo significant changes in HES occurred after exposure to cryo-compression or rest applied immediately following the Yo-Yo IFT. Further investigations to maximise beneficial application of contemporary cryo-compression applications in sport are required. Multiple measures of performance over rewarming periods, within competitive training schedules after sport-specific training are required to develop optimal cooling protocols for recovery.