Nihan Kafa

Effects of kinesiologic taping on epidermal–dermal distance, pain, edema and inflammation after experimentally induced soft tissue trauma

Abstract Purpose: In sports medicine, the use of kinesiologic tape has recently gained popularity. Although widely used, there is no study examining the effects of kinesiologic tape on soft tissue after a contusion injury. The aim of this study was to examine the effects of kinesiologic taping on epidermal–dermal distance, edema, pain and inflammation after experimentally induced contusion injury. Methods: Twelve adult female Wistar albino rats were divided into two groups: (1) 30 min group: n = 6, weight range: 182.0–199.4 g; and (2) 6 h group: n = 6, weight range: 186.9–200.8 g. After soft-tissue trauma, tape was applied to the right sides of each rat. In one group, tape was applied for 30 min while 6 h in the other. To assess the epidermal–dermal distance and edematous area, tissue sections were stained with hematoxylin and eosin and examined. Tissue sections were stained with nerve growth factor (NGF) and B-cell lymphoma 2 (Bcl-2) immunohistochemically to evaluate the effect of taping on pain and inflammation respectively. Results: Epidermal–dermal distances were found to be significantly higher than controls’ in both groups (p < 0.05). Notable decreases were seen in edematous areas in both groups (p < 0.05). NGF and Bcl-2 immune reactivity were decreased in all tape applied sides. Conclusions: After soft-tissue trauma, it was histologically shown that kinesiologic taping increases epidermal–dermal distance, and may reduce the sensation of pain, edema and inflammation. For better, faster and comfortable tissue healing with protection of soft-tissue integrity, kinesiologic taping may be a valuable treatment after contusion injury. However, these results should be supported by clinical studies.

Relationship Between Functional Knee Joint Position Sense and Functional Performance Scores Following Anterior Cruciate Ligament Reconstruction (Pilot Study)

Objectives: The aim of this study was to assess the relationship between functional knee joint position sense (JPS) and functional performance following ACL reconstruction Methods: Seven male patients (mean age=32,66 ±6,47) who had undergone ACL reconstruction and 10 male healthy control subjects participated in the study. Knee joint position sense was evaluated by reproduction of 20° knee flexion angle in weight-bearing position with single and bilateral limb movement into flexion and extension. The deviations in the angle were recorded and compared to both noninjured side and healthy controls’. Functional performance was evaluated with Single Leg Hop Test in both injured and non-injured sides. The scores were also compared with healthy controls and non-injured sides. Relationship between measured values was tested with Spearman Correlation Analysis. Results: There was no significant difference in knee joint position sense in functional position between the operated and uninjured knees of patients or between patients and healthy controls (p>0,05). However, there is significant difference in Single Leg Hop test scores between operated and non-operated or between patients and healthy controls (p=0,037; p<0,05). There was no significant correlation between Single Leg Hop test scores and knee joint position sense (p>0,05). Conclusion: There was no evidence of impaired joint position sense in weight-bearing positions in subjects with ACL reconstruction but there was a decrease in functional performance. This decrease in functional performance may depend on the other parameters except proprioceptive deficits.

Assessment of function in patients with rotator cuff tears: Functional test versus self-reported questionnaire

Purpose: The rotator cuff tears (RCT) are a well-known cause of shoulder pain and loss of upper extremity function. The purpose of this study was to evaluate the upper extremity function using two different methods in patients with RCT and to determine the parameters that influence the upper extremity function. Materials and Methods: A sample of 38 patients (27-76 years; 10 men and 28 women) who were diagnosed with a chronic full-thickness RCT, confirmed by magnetic resonance imaging (MRI), was studied. Upper extremity function was determined using Western Ontario Rotator Cuff Index (WORC) and 9 Hole Peg Test (9PEG). Other assessments included active range of motion (ROM), muscle strength, shoulder pain, and scapular dyskinesis. Results: There was a weak association between WORC scores and 9PEG. A statistically significant, negative relationship was found between 9PEG and ROM in supination, as well as muscle strength of shoulder extensors, adductors, internal and external rotators. Conclusions: In addition to the weak association between WORC and 9PEG, the difference between the parameters related to each method suggests that they should not be used interchangeably to determine the upper extremity function. We recommend the utilization of 9PEG instead of WORC in assessing the upper extremity function in the setting of loss of muscle strength. Level of Evidence: Level IV, Therapeutic study.

The Relationship Between Endurance Of Periscapular Muscles, Anaerobic Performance And Agility In Professional Athletes

Objective: The purpose of this study was to identify relationships between endurance of periscapular muscle, anaerobic performance and agility in professional athletes. Methods: 70 professional basketball, volleyball, and handball players (male: 25 female: 45 age 20.41±5.72, BMI: 21.70±2.51) were included to this study. Anaerobic performance was assessed with vertical jump test. Periscapular muscles endurance was evaluated using scapular muscle endurance test and agility was measured hexagonal obstacle test. Statistical analysis was performed using the statistical software SPSS 22. Results: Spearman correlation analysis results showed that there was positive significant correlation between anaerobic performance and endurance of periscapular muscles (p<0.05 r=0.341). A negative significant relationship was demonstrated between anaerobic performance and agility (p<0.05 r=-0.332), and between agility and endurance of periscapular muscles (p<0.05 r=-0.334). Discussion: The scapula acts as an axis, transmitting the power and high energy of the lower extremities and trunk to the upper extremities. The muscles surrounding the scapula provide proximal stability for the upper extremity and act as a fix while the distal part is moving. When weakness of scapular musculature has occurred, normal scapular positioning and mechanics may be altered. Therefore, scapular stabilization failure may lead to poor anaerobic performance. These results indicate that periscapular muscle endurance affects anaerobic and agility performance in sports.

The relationship between pectoralis minor length, scapular muscle endurance and core endurance in athletes

Objective: The purpose of this study was to identify relationships between core endurance, scapular muscle endurance and pectoralis minor length in athletes. Methods: 69 professional athletes in different branches (44 men, 25 women, mean age 20.41±5.72, height 176.0±0.1, and weight 68.2±12.8) were included to this study. Pectoralis minor length was measured in supine. In this position linear distance from treatment table to posterior aspect of the acromion was measured. Core endurance was evaluated using Mcgill Core Endurance Tests. Scapular muscle endurance was assessed with scapular endurance test. Statistical analysis was performed using the statistical software SPSS. Results: Spearman correlation analysis results showed that there was correlation between pectoralis minor length and scapular muscle endurance (r=0.281, p<0.05). A positive correlation was found between pectoralis minor length and core endurance (r= 0.517, p<0.05). There was correlation between scapular muscle endurance and core endurance (r=0.524, p<0.05). Conclusions: In this study, it was shown that there were statistically significant relationship between pectoralis minor length, scapular muscle endurance and core endurance. Pectoralis minor length affects scapula biomechanics. Change in scapula biomechanics may cause reduction in scapular muscle endurance. It may affect core endurance via kinetic chain. Therefore, it can be suggested pectoralis minor stretching should be integrated to normal sports specific training programmes in professional athletes.

The Validity and Reliability of Knee Proprioception Measurement Performed With Inclinometer in Different Positions

CONTEXT Proprioception is the basic element of the spontaneous control of movement, balance and joint stability. Therefore, it is necessary for the execution of walking and daily and sport activities. Loss of proprioception of the knee, which may cause a new injury, is important to evaluate the position sense of the joint during the rehabilitation period. However, the evaluation methods that are used are very expensive, complicated and non-portable, or the measuring method is difficult to implement. OBJECTIVE We demonstrated the validity and reliability of knee proprioception measurements performed in the open kinetic chain position and closed kinetic chain position with a dual inclinometer. DESIGN We assessed the validity and intra-tester reliability of a digital inclinometer for measuring the knee joint position sense in different positions. SETTING Clinical laboratory. PARTICIPANTS We enrolled 22 participants (age = 21.8 ± 0.95 years, height = 172 ± 9.1 cm, weight = 64.9 ± 14 kg) into the study. INTERVENTION The same investigator used an inclinometer to take knee proprioception measurements in open and closed kinetic chain positions. MAIN OUTCOME MEASURES The relative angular error was calculated by taking the arithmetic average of the difference between the target angle and reproduced angle and was the main outcome measure. RESULTS We found that the dynamometer-inclinometer had a moderate ICC value (ICC = 0.594, SEM = 1.60, p = 0.005), whereas inclinometer t1 vs inclinometer t2 (ICC = 0.778, SEM = 0.62, p < 0.001) and closed kinetic chain position t1 and closed kinetic chain position t2 (ICC = 0.888, SEM = 0.63, p < 0.001) had high ICC values. CONCLUSION Knee proprioception measurements performed with a dual inclinometer were reliable in the closed kinetic chain position in healthy, sedentary individuals and were valid and reliable in the open kinetic chain position.

The presence and influence of posterior capsule tightness on different shoulder problems

BACKGROUND In the literature it has been shown that posterior capsule flexibility is a precursor to shoulder problems. However, no study thus far has shown the influence of the flexibility of posterior capsule in different shoulder pathologies. OBJECTIVE This study set about to compare the role of posterior capsule tightness in different shoulder problems. METHODS One-hundred-twenty-five patients diagnosed with shoulder subacromial impingement syndrome (n= 52), partial rotator cuff tear (n= 31) or frozen shoulder (n= 42) and 30 asymptomatic peers participated in the study. Horizontal adduction was assessed in side-lying position for posterior capsule tightness. Pain was measured via the visual analogue scale and shoulder range of motion and active total elevation was assessed with goniometer. Hand behind the back (HBB) test was assessed the active internal rotation by measuring the distance between T5 and the thumb. RESULTS It was found that the affected side of the posterior capsules of the patients with subacromial impingement syndrome (p< 0.001), partial rotator cuff tear (p< 0.001) and frozen shoulder (p< 0.001) was stiffer than their healthy side. There were significant differences among groups in the level of tightness in the posterior capsule between the affected and the healthy sides (p< 0.001). All range of motion of the shoulder including HBB test and the posterior capsule tightness of the affected side are found to be correlated (p< 0.05). CONCLUSIONS This study emphasized that the posterior capsules susceptibility to tightness is most evident in frozen shoulder among different shoulder problems.

A Comparison of Dynamic Postural Stability Between Asymptomatic Controls and Male Patients One Year After ACL Reconstruction (Pilot Study)

Objectives: The purpose of this study was to determine if dynamic postural stability gained one year after ACL reconstruction in patients who received rehabilitation. Methods: Seven male patients (mean age=32,66 ±6,47) who had previously undergone ACL reconstruction (ACL-R) and 7 sex-and general physical activity matched uninjured controls included to study. Mean time since original injury was 13±3,31 months. Dynamic postural control was assessed with 20° knee flexion with Star Excursion Balance test. Each participant performed 3 trials of the anterior, posterior-medial, and posterior-lateral directional components of the SEBT. Reach distances for each directional component were compared with non-injured leg and healthy controls’. Results: There was no significant difference in all directions of Star Excursion Balance test between neither the operated and uninjured knees of patients nor between patients and healthy controls (p>0,05). Conclusion: No deficits in dynamic postural stability were present average one year after ACL reconstruction in patients who received rehabilitation. It can be said that rehabilitation is effective in the recovery of dynamic postural stability.