Laimonas Šiupšinskas

Dynamics of pelvic floor muscle functional parameters and their correlations with urinary incontinence in men after radical prostatectomy.

To evaluate the dynamics of pelvic floor muscle strength, endurance, and urinary incontinence in a 6‐month period in men after radical prostatectomy and to determine correlations between pelvic floor muscle strength, endurance, and urinary incontinence.

IS THAT POSSIBLE TO RESTORE PRE-INJURY PHYSICAL ACTIVITY LEVEL AFTER ONE-STAGE ARTICULAR CARTILAGE AND ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION PROCEDURE

Purpose to compare the concomitant treatment of the articular cartilage damage (ACD) in the knee with three different articular cartilage procedures at the time of anterior cruciate ligament (ACL) reconstruction. Methods between the 2006 and 2009, 102 patients with a mean age of 34.1 years and with an ACL rupture and the articular cartilage damage in the knee were randomized to undergo osteochondral autologous transplantation (OAT), microfractures (MF) or debridement (D) at the time of ACL reconstruction. Matched control group was included with 34 patients having intact articular cartilage (IAC) at the time of ACL reconstruction. There were 34 patients in OAT-ACL group, 34 patients in MF-ACL group, 34-D-ACL group and 34-control IAC-ACL group. The mean ACL injury-operation time was 19.32±3.43 months and the mean follow-up was 36.1 months (range from 34 to 37 months). Patients were evaluated using International Knee Documentation Committee (IKDC) score, Tegner activity score and clinical assessment. Results 97 of 102 (95 %) were available for the final follow-up. According to subjective IKDC score, all 4 groups did significantly better at the 3-year follow up than preoperatively (P<0.0000001). OAT–ACL group IKDC Subjective Knee evaluation was significantly better than MF-ACL (p=0.024) and D-ACL (p=0.018). However, IKDC subjective score of IAC-ACL group was significantly better, than OAT-ACL group IKDC evaluation (p=0.043). There was no significant difference between the MF-ACL and D-ACL IKDC subjective scores (p=0.058). Evaluation of manual pivot-shift knee laxity according to IKDC Knee Examination Form revealed similar evaluations for the four groups immediate postoperative and at 3 year follow-up and was normal or nearly normal (IKDC grade A and B) for 29 of 33 patients (88%) with OAT-ACL, 28 of 32 patients (88%) with MF-ACL, 27 of 32 patients (84%) with D-ACL and 31 of 34 patients (91%) with intact IAC-ACL. Conclusions Our study shows that intact articular cartilage during ACL reconstruction gives more favourable IKDC subjective scores compared to any other articular cartilage surgery types. However, if you have an articular defect, there are significantly better subjective IKDC scores for OAT versus microfracture or debridement after a mean period of 3 years. Anterior knee stability results were not significantly affected by the different articular cartilage treatment methods.

The effect of integrated training program on functional movements patterns, dynamic stability, biomechanics, and muscle strength of lower limbs in elite young basketball players

PurposeThe aim of study was to evaluate the effect of integrated exercise training programs on functional movement’s patterns, dynamic stability, jump-landing biomechanics, and muscle strength in elite young basketball players.MethodsA study involved 31 youth most talented Lithuanian basketball players (15 male, 16 female) selected by the coaches of Lithuanian basketball federation. Functional movement patterns were evaluated with Functional Movement Screen (FMS) tests. The Y Balance test was used to assess athlete’s dynamic stability of lower extremities. Landing error scoring system (LESS) was used to assess athlete’s body and lower extremity biomechanical properties during the jump-landing task. Isokinetic dynamometry was used to measure thigh muscle’s strength. The integrated training program that incorporates multiple types of exercise, such as stability, flexibility, and strength exercises. Data analysis was performed using the dependent nonparametric Wilcoxon signed-rank test. In all statistical procedures, pxa0≤xa00.05 was regarded as significant. Correlation coefficients of tests results and efficiency were analyzed using Spearman correlation coefficient.ResultsThe total score of FMS had increased from 15.89xa0±xa02.0 to 17xa0±xa01.23 (pxa0=xa00.04) in female basketball players. Jump-landing biomechanics measured by LESS had improved from 6.85xa0±xa02.34 to 4.62xa0±xa02.87 (pxa0=xa00.01) points in male basketball players. All the parameters of dynamic stability of lower limbs had improved after exercise training sessions. The knee flexion/extension ratio peak torque to body weight measured by isokinetic dynamometer increased in males and females except right leg at speed of 60°/s in males.ConclusionsThese results indicate that integrated exercise training program incorporated into regular basketball training sessions might have influence on performance and risk factors of sports injuries in youth basketball players.

The Patello-Femoral Joint Degeneration and the Shape of the Patella in the Population Needing an Arthroscopic Procedure

Background: the main goal of the study was to investigate the prevalence of the articular cartilage defects (ACD) in the patellofemoral (PF) region of the knee joint based on the anatomical shapes of patella and its impact on the level of physical activity in the population needing arthroscopic procedures for all types of pathologies in the knee. Methods: The articular cartilage status of the PF region was obtained from 1098 arthroscopic procedures of the knee joint. The ACD were correlated to Wiberg’s shape of the patella and classified according to the degree, size and depth of the ACD in the PF region using the ICRS (International Cartilage Repair Society) system: group I consisting of patients with Wiberg type I shape (W1), group II—patients with Wiberg type II shape (W2) and group III—patients with Wiberg type III shape (W3). The Tegner physical activity scale was used to evaluate the physical activity of the patients. Results: The mean of ACD size (PF region) in the W3 group was 3.10 ± 0.99 cm2, which was a statistically significantly larger area in comparison with the W1 (1.90 ± 0.63 cm2; p < 0.0000) and W2 (1.95 ± 0.71 cm2; p < 0.0000). The patients from the W3 group (mean 3.10 ± 0.99) were less physically active (<4 Tegner) compared to the W2 group (mean of 4.48 ± 0.88; p = 0.004) and W1 group (mean of 4.55 ± 0.72; p = 0.002). Conclusions: The patients with the Wiberg type III patella shape had a higher incidence and larger size of ACD in the PF of the knee compared to the groups of Wiberg type I and II. Wiberg III patients with a lower level of physical activity had a larger size of ACD in the PF joint.

ARTHROSCOPIC FINDINGS AND FUNCTIONAL OUTCOME OF SHOULDER INJURY IN THE YOUNG OVERHEAD ATHLETES

Research background and hypothesis Overhead athletes are having higher risk to suffer from acute and chronic shoulder injuries. Research aim to evaluate shoulder complex functional characteristics of the overhead and non-overhead young athletes before and 2 years after the concomitant arthroscopic type II superior labrum anterior posterior (SLAP) and partial–thickness rotator cuff (PTRC) repair and to present specific rehabilitation guidelines needed for successful return to sports. Methods The sample of the research included 38 male athletes: overhead (n=19) and non-overhead (n=19) athletes. All participants underwent concomitant arthroscopic type II SLAP and PTRC repair and were available for review at a minimum of 2 year after surgery. Shoulder range of motion was measured with goniometer. Constant score was used for evaluation of the shoulder functions quality. Results Function of the shoulder complex had higher increase in non-overhead group (p<0.05). Constant score 2 years after surgery hadnt returned to optimal level. Shoulder flexion and internal rotation ROM in both groups and external rotation ROM of non-overhead athletes were the same as before surgery. Discussion and conclusion Functional characteristics of shoulder complex measured with Constant score of overhead and non-overhead athletes statistically significant increased 2 years after the arthroscopic surgery. Significant change of external rotation was established in overhead athletes: 2 years after surgery it was significantly smaller. Sports specific and diagnose-based rehabilitation is needed to decrease deficit in function of the shoulder complex after concomitant arthroscopic type II SLAP and PTRC repair.