Qassim I. Muaidi

Effect of Laser Therapy on Chronic Osteoarthritis of the Knee in Older Subjects

INTRODUCTION Osteoarthritis (OA) is a common degenerative joint disease particularly in older subjects. It is usually associated with pain, restricted range of motion, muscle weakness, difficulties in daily living activities and impaired quality of life. To determine the effects of adding two different intensities of low-level laser therapy (LLLT) to exercise training program on pain severity, joint stiffness, physical function, isometric muscle strength, range of motion of the knee, and quality of life in older subjects with knee OA. METHODS Patients were randomly assigned into three groups. They received 16 sessions, 2 sessions/week for 8 weeks. Group-I: 18 patients were treated with a laser dose of 6 J/cm(2) with a total dose of 48 J. Group-II: 18 patients were treated with a laser dose of 3 J/cm(2) with a total dose of 27 J. Group-III: 15 patients were treated with laser without emission as a placebo. All patients received same exercise training program including stretching and strengthening exercises. Patients were evaluated before and after intervention by visual analogue scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index for quality of life, handheld dynamometer and universal goniometer. RESULTS T test revealed that there was a significant reduction in VAS and pain intensity, an increase in isometric muscle strength and range of motion of the knee as well as increase in physical functional ability in three treatment groups. Also analysis of variance (ANOVA) proved significant differences among them and the post hoc tests (LSD) test showed the best improvements for patients of the first group. CONCLUSION It can be concluded that addition of LLLT to exercise training program is more effective than exercise training alone in the treatment of older patients with chronic knee OA and the rate of improvement may be dose dependent, as with 6 J/cm(2) or 3 J/cm(2).

Association of Postural Balance and Isometric Muscle Strength in Early- and Middle-School-Age Boys

OBJECTIVE The purpose of this study was to evaluate the isometric muscle strength (IMS) and dynamic balance in early- and middle-school-age boys and to assess the strength of association between the dynamic balance scores and 6 different IMS indexes. METHODS This is a cross-sectional study of a convenience sample of 94 boys who were 6 to 10 years of age and classified into an early school age (6-8 years) group (n = 50) and a middle school age (8-10 years) group (n = 44). Balance was tested using a Biodex Balance System. Anteroposterior Stability Index, Mediolateral Stability Index, and Overall Stability Index were recorded. IMS of 11 muscle groups was measured with a handheld dynamometer and categorized into 6 different muscle strength indices. RESULTS The mean (SD) values of anteroposterior, mediolateral, and overall stability indexes observed for all study boys were 1.9 ± 1.0, 1.2 ± 0.7, and 2.5 ± 1.2 respectively. In the middle school age group, strong positive relationships were detected between the overall stability index and trunk, lower limb, anti-gravity, pro-gravity, and total strength indexes (r = -0.86/P < .001, r = -0.91/P < .001, r = -0.88/P < .001, r = -0.83/P < .001, and r = -0.84/P < .001 respectively), while no significant relationship was detected with the upper limb strength index (r = 0.159/P = .303). In the early school age group, moderate positive relationships were detected between the overall stability index and anti-gravity, lower limb, and total strength indexes (r = -0.404/P = .004, r = -0.356/P = .011, and r = -0.350/P = .013 respectively). CONCLUSION Dynamic balance did not appear to be mature by the age of 10 years. Better balance skills were recorded in the mediolateral direction than in the anteroposterior direction. In the middle school age group, the overall stability index had positive relationships with almost all examined muscle strength indexes excepting the upper limb strength index.

Incidence and prevalence of weight lifting injuries: An update

Weightlifting is considered as a dynamic strengthen exercise and power sport in which the athletes lifts a maximum weight with one repetition. The weightlifting as other sports has common musculoskeletal injuries in different body location corresponding to the sports beneficial. However, identifying the injuries incidence and the etiology is a first two-step in the model of the injury prevention in order to introduce preventive measures for sports. Therefore, this literature review is aimed to focus on the incidence and the etiology related to injuries of the weightlifting. However, the incidence injuries studies revealed that the children have more injuries related to accident than the adults. Whereas, the adults have more injuries related to strain and sprain. The most common injured locations are shoulder, lumbar spine, knee, elbow, hand, and wrist in the weightlifters. The percentage of the injuries according to location is the shoulder (36%), lumbar spine (24%), elbow (11%), and the knee (9%). In the other hand, the rule and regulation in the weightlifting had been changed since 1972 in which the clean and press lift eliminated from the competition due to the risk of this lift. Finally, weightlifting considered as safe sport if it is compared with other sports.

Implementation of an evidence-based injury prevention program in professional and semi-professional soccer

The ideal implementation of soccer injury prevention programs is essential knowledge for soccer coaches. The objective of this study was to investigate and compare the implementation of injury prevention programs, specially the FIFA 11+ program, among Australian and Saudi Arabian soccer coaches. A Web-based survey was used to obtain information regarding the coaches’ implementation of injury prevention programs, the FIFA 11+ program, the Nordic hamstring exercise, pre- and post-training exercises. Sixty coaches—30 from both selected countries—responded to the survey (response rate = 75%). In Australia, 93% of the coaches implemented an injury prevention program; while 73% implemented the FIFA 11+ program, only 51% implemented all the FIFA 11+ exercise components as recommended. In Saudi Arabia, 70% of the coaches stated that they followed an injury prevention program, but only 40% followed the FIFA 11+ program. However, 70% reported using all the FIFA 11+ exercise components in their current practices, which they may have adapted from different exercise-based injury prevention programs. The Australian coaches were significantly more likely to implement injury prevention programs (p = 0.020) and the FIFA 11+ program (p = 0.009). Nonetheless, no significant difference in the full implementation of the FIFA 11+ exercises components was found (p = 0.114). The Australian coaches had greater awareness of injury prevention programs and more familiarity with the FIFA 11+ program than the Saudi Arabian coaches. Nevertheless, there was a gap between the coaches’ knowledge and their actual practice.

Common injuries in field hockey

Field hockey is considered as a popular sport worldwide next to soccer in popularity. According to National Collegiate Athlete Association overall injury rate is 6.3%/1000 athlete exposure. Mechanism of injury could be extrinsic injury that is, being struck by hockey stick or ball or intrinsic injury due to internal force acting on muscle or an overuse injury which includes tibial stress syndrome, shin soreness, illiotibial band pain, low back dysfunction, tendonitis, patello-femoral pain, planter fasciitis, and stress fracture of foot and leg. Initial approach to injured athlete includes airways, breathing, circulation, rest, ice, compression, elevation, referral protocol, normalize joint range of motion (ROM), restore strengthening, Improve proprioception, agility and balance, minimize chance of re injury by maintaining flexibility. Strengthening and therapeutic exercises that will vary accordingly to the injured part. Countermeasures include preparticipation screening, preseason conditioning, fitness program, adequate warm and pregame stretch, followed by cool down and postgame stretch, following rules and penalty and finally by wearing protective equipment. This article discusses the biomechanics and common injuries in field hockey. Patho-mechanics, diagnosis, and physiotherapy management of the common injures are outlined. This may help the health care practitioners who deals with different injuries related to hockey.

Comparison of Lower Extremity Muscle Flexibility in Amateur and Trained Bharatanatyam Dancers and Nondancers

OBJECTIVE This study compared lower limb muscle flexibility between amateur and trained female Bharatanatyam dancers and nondancers. METHODS Subjects consisted of 105 healthy female volunteers, with 70 female Bharatanatyam dancers (35 trained, 35 amateurs) and 35 controls, with a mean (±SD) age of 16.2±1.04 yrs, height 155.05±4.30 cm, and weight 54.54±2.77 kg. Participants were assessed for range of motion (ROM) in hip flexion, hip extension, hip abduction and adduction, hip external rotation, hip internal rotation, knee flexion, knee extension, ankle dorsiflexion (DF), and ankle plantar flexion (PF) by using a standardized goniometer. To assess for significant difference between groups, one-way ANOVA was applied, and multiple comparisons were made using Bonferroni correction. RESULTS Trained dancers had a significantly greater hip flexion, extension, abduction, and external rotation ROM than amateurs and nondancers (p<0.05). Also, internal rotation and adduction were markedly less in trained dancers (p<0.05). Knee flexion, extension, and ankle DF were higher and ankle PF ROM was lesser in trained dancers. However, not much variation was found in ankle DF and PF between amateur dancers and nondancers (p>0.05). CONCLUSION Results showed that there are significant differences in lower limb muscle flexibility between trained and amateur Bharatanatyam dancers and nondancers. These differences may be due to individual dance postures such as araimandi and muzhumandi.

Relation between peak knee flexion angle and knee ankle kinetics in single-leg jump landing from running: a pilot study on male handball players to prevent ACL injury

ABSTRACT Objectives: The relationship between knee kinematics and knee-ankle kinetics during the landing phase of single leg jumping has been widely studied to identify proper strategies for preventing non-contact ACL injury. However, there is a lack of study on knee-ankle kinetics at peak knee flexion angle during jumping from running. Hence, the purpose of this study is to establish the relationship between peak knee flexion angle, knee extension moment, ankle plantar flexion moment and ground reaction force in handball players in order to protect ACL from excessive stress during single leg jumping. In addition, the study also clarifies the role of calf muscles in relieving part of ACL stresses with different knee flexion angles during landing. Methods: Fifteen active male elite handball players of Saudi Arabia have participated in this study (Age = 22.6 ± 3.5years, Height = 182 ± 3.7 cm, Weight = 87.5 ± 10.2 kg). The players performed three successful landings of single-leg jump following running a fixed distance of about 450cm. The data were collected using a 3D motion capture and analysis system (VICON). Results: Pearson product moment correlation coefficients showed that greater peak knee flexion angle is related significantly to both lesser knee extension moment (r = -.623, P = .013) and vertical component of ground reaction force (VGRF) (r = -.688, P = .005) in landing phase. Moreover, increasing the peak knee flexion angle in landing phase tends to increase the ankle plantar flexion moment significantly (r = .832, P = .000). Conclusion: With an increase of the peak knee flexion angle during single leg jump landing from running, there would be less knee extension moment, low impact force and more plantar flexion moment. As such, the clinical implication of this study is that there may be a possible protective mechanism by increasing the knee flexion angle during landing phase, which tends to protect the ACL from vigorous strain and injuries.

Influence of increasing knee flexion angle on knee-ankle varus stress during single-leg jump landing

Objectives The primary aim of this study was to identify the relationship between the peak knee flexion angle and knee-ankle varus stress in the landing phase of the single-leg jump during running. Methods Fifteen male handball players from the first Saudi Arabian handball team were incorporated in this study. Each player performed a single-leg jump-land after running a fixed distance of 450 cm. The data were measured using a 3D motion analysis system. The maximum knee flexion angle, knee varus angle, centre of pressure pathway in the medio-lateral direction, and ankle varus moment were measured. Results The Pearson Product Moment Correlation showed that a greater knee flexion angle was related to a greater lateral displacement of the centre of pressure (r = 0.794, P = 0.000), a greater ankle varus moment (r = 0.707, P = 0.003), and a greater knee varus angle (r = 0.753, P = 0.001). In addition, the greater ankle varus moment was related to the greater lateral displacement of the centre of pressure (r = 0.734, P = 0.002). Conclusions These findings may help physical therapists and conditioning professionals to understand the impact of increasing knee flexion angle on the lower limb joints. Such findings may help to develop training protocols for enhancing the lateral body reaction during the landing phase of the single-leg jump, which may protect the knee and ankle joints from excessive varus stresses.

Effect of Acute Static Stretching on Lower Limb Movement Performance Using STABL Virtual Reality System

CONTEXT The effect of acute static stretching (ASS) on the lower limb reaction time (RT) has been recently questioned to decrease the risk of falling and injuries in situations requiring a rapid reaction, as in the cases of balance disturbance. OBJECTIVE The main purpose of this study was to detect the effect of ASS on the lower limb RT using a virtual reality device. DESIGN Two-group control group design. SETTING Research laboratory. PARTICIPANTS The control and experimental groups were formed randomly from 60 female university students. INTERVENTION Each participant in the experimental group was tested before and after ASS for the quadriceps, hamstrings, and planter flexor muscles, and compared with the control group with warming-up exercise alone. The stretching program involved warming up in the form of circular running inside the lab for 5 minutes followed by stretching of each muscle group three times, to the limit of discomfort of 45 seconds, with resting period of 15 seconds between stretches. MAIN OUTCOME MEASURES The measurements included the RT of the dominant lower-extremity using the dynamic stability program STABL Virtual Reality System (model no. DIZ 2709; Motekforce Link). RESULTS There was a statistically significant reduction (F = 162, P < .05) in posttest RT between the 2 groups and significant decrease in RT after stretching in the experimental group (7.5%; P < .05). CONCLUSION ASS of the lower limb muscles tends to decrease the lower limb RT and improve movement performance.

Relationships among peak-knee flexion angle, knee moment, ankle moment and ground reaction force of Saudi hand-ball players in landing phase of single-leg jumping

P in a pulmonary rehabilitation (PR) programme confers improvements in exercise capacity, health related quality of life (HRQoL) and breathlessness in people with chronic obstructive pulmonary disease (COPD). However, uptake to PR is poor and home-based exercise programmes may be one method of overcoming some of the barriers to participation in out-patient PR. There is, however, limited evidence regarding the effectiveness of home-based PR (HB PR). We conducted a systematic review and meta-analysis to examine the effects of HB PR on HRQoL in people with COPD compared with usual care or an education programme. Nine studies met the inclusion criteria for the meta-analysis. Meta-analyses showed significant improvements in HRQoL with a standardized mean difference of -0.64 (95% CI: -0.99, -0.30) in favour of HBPR. Sub group analysis of people with severe COPD showed a SMD of -0.62 (95% CI: -1.06, -0.18) in favour of HBPR. These results were not maintained in the long-term. Supervised or unsupervised HBPR is effective in improving HRQoL for people with COPD in the short-term. Offering HBPR may alleviate some of the barriers to accessing PR in a healthcare setting. Further research to explore the maintenance of these benefits in the long-term as well as the optimum method of delivery is required.Abstract: Background: Muscle force is affected by many factors including muscle length. The exact mechanism of the effect of muscle length is not fully understood. Objective: to determine if motoneuron discharges accommodate changes imposed by changing Medial gastrocnemius muscle length following electrically fatiguing protocol. Methods: Randomized clinical trial was conducted on 60 untrained subjects aged (20-40 years) in isokinetic & electromyography lab of Faculty of Physical Therapy in august 2014. Both fatiguing short length group (FS) and fatiguing long length group (FL) underwent low frequency electrically fatiguing protocol. Main Outcome Measures: Outcome measures obtained pre and post the fatiguing protocol were the compound muscle action potential. Results: there were no significant difference between pre outcome measures in both groups (p= 0.837) and post outcome measures in both groups (p= 0.119). Significant main effects of fatigue were observed in both groups (p= 0.0001). Significant main effects of muscle length were observed between post measurements of fatiguing short length group and post measurement of fatiguing long length group. Conclusion: Fatigue has been shown to be greater at long muscle lengths than at short muscle lengths following low frequency current fatiguing protocol.Methods: Seven older adults with osteopenia (age: 69.43±3.51 years; height: 156.51±5.76 cm; weight: 58.56±5.76 kg; T-score: -1.64±0.73; Bone mineral content: 2.24±0.46 kg) participated in this study. Data of body composition was collected using a multi-frequency bio-electrical impedance analyzer in the pre-/post-test. Participants received eight-week balance training for two sessions per week, one hour per session. A split-belt balance perturbation treadmill and the modular interactive tiles system were used in the training. The treadmill training includes unexpected anterio-posterior and side-to-side perturbation during quiet standing and treadmill walking.