It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, "ossified" knowledge or modalities really prove themselves in the literature? Could questions such as "is postoperative brace use really necessary?", "what are the benefits of early restoration of the range of motion (ROM)?", "to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?", "how early can proprioception training and open chain exercises begin?", "should strengthening training start in the immediate postoperative period?" be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper.
The increased PWV demonstrated in migraine patients in this study stands out as an additional parameter elucidating endothelial dysfunction in these patients. Decreasing the number of migraine attacks with prophylactic treatment may reduce PWV and decrease cardiovascular risk in long-term follow-up.
Background: Rheumatic mitral stenosis (MS) is still a common disease in developing countries with high morbidity and mortality rates. The purpose of the study was to evaluate arterial stiffness in severe MS before and after percutaneous mitral balloon valvuloplasty (PMBV). Methods: Thirty patients with MS in sinus rhythm requiring PMBV and 20 age-gender matched healthy volunteers. The analyze of pulse wave velocities (PWV) were performed using of the carotid artery at the femoral by PWV technique on patients at baseline and a week after PMBV. Results: The values of PWV were significantly decreased after successful PMBW in MS patients. Mitral mean gradients and systolic pulmonary artery pressures (sPAP) both on echocardiography and catheterization also had a significant decrease after PMBW. The mitral valve areas were significantly increased after PMBW. There was a highly significant negative correlation between mitral valve areas and PWV values. A highly significant positive correlation was seen between mitral mean gradient on catheterization and PWV (r = 0.830, p < 0.001). There was also a significant correlation between sPAP on catheterization and PWV values (r = 0.639, p < 0.001). Echocardiographic mitral mean gradients and PWV were highly positive correlated with each other (r = 0.841, p < 0.001). The sPAP on echocardiography had also a highly positive correlation with PWV (r = 0.681, p < 0.001). Conclusions: Mitral stenosis is a cause of impaired arterial stiffness and after the enlargened mitral valve area arterial stiffness improved in patients with MS.
Aim:In contrast to the one-sided evaluation methods used in the past, combining multiple tests allows one to obtain a global assessment of the ankle joint.
Materials and Methods:Twenty healthy male volunteers participated in this study. One component of the test battery included five different functional ability tests, which included: single limb hopping course, onelegged and triple-legged hop for distance, and six-meter (6-m) and cross 6-m hop for time. Ankle joint position sense and one leg standing test were used for proprioceptive evaluation. Isokinetic strength of the ankle invertor and evertor muscles were evaluated at a velocity of 120°/sec. Reliability of the test battery was assessed by calculating the intraclass correlation coefficient (ICC).
Results:The ICCs for ankle functional and proprioceptive ability showed good to high reliability (ICC ranging from 0.89 to 0.98). Furthermore, isokinetic ankle joint inversion and eversion strength measurements represented good reliability (ICCs between 0.86-0.89).
Conclusions:The functional test battery investigated in this study proved to be a reliable tool in the assessment of the ankle joints of healthy recreational athletes. Clinicians may use the information of the functional test battery to detect changes in ankle joint performance as a component of a screening evaluation.Key Words: Reliability, clinical functional test battery, functional ability, proprioception, strength, ankle joint
Ayak Bileği Ekleminin Fonksiyonelliğini, Propriosepsiyonunu ve Kuvvetini Değerlendiren Fonksiyonel Test Bataryasının GüvenirliğiAmaç: Geçmişte kullanılan tek yönlü değerlendirme yöntemlerinin aksine birden fazla testin birleştirilmesi ayak bileği eklemi için daha geniş çaplı bir değerlendirme yapılmasına olanak sağlayacaktır.
Yöntem ve Gereç:Çalışmaya 20 sağlıklı erkek denek katıldı. Kullanılan test bataryasının bir bölümü beş farklı fonksiyonel testi kapsadı. Bunlar arasında parkur testi, tek adım ve üç adım sıçrama mesafesinin ve altı metreyi düz ve çapraz sıçrama zamanının ölçümü vardı. Ayak bileği propriosepsiyonu eklem pozisyon hissi ve tek bacak durma testi ile değerlendirildi. Ayak bileği invertör ve evertör kaslarının izokinetik kuvveti 120°/sn'lik açısal hız ile ölçüldü. Test bataryasının güvenirliği sınıf içi korelasyon katsayısının (ICC) hesaplanması ile değerlendirildi.Bulgular: Ayak bileğinin fonksiyonel ve proprioseptif becerisi için elde edilen ICC değerleri iyi ve yüksek bir güvenirliğe işaret etti (0.89-0.98 arasında değişim göstermiştir). Bunun yanısıra, ayak bileği izokinetik invertör ve evertör kuvvet ölçümleri de iyi düzeyde bir güvenirliği yansıttı (0.86-0.89 arasında değişim göstermiştir).
Sonuç:Bu çalışmada incelenen fonksiyonel test bataryası sağlıklı rekreasyonel sporcuların ayak bileği eklemlerinin değerlendirilmesinde güvenilir bir yöntem olduğunu kanıtlamıştır. Klinisyenler fonksiyonel test bataryasından elde edecekleri bilgileri tarama muayeneleri kapsamında ayak bileği performansındaki değişiklikleri tespit etmek için kullanabilirler.
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