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- Frohm, Anna, et al.
(författare)
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Eccentric treatment for patellar tendinopathy : a prospective randomised short-term pilot study of two rehabilitation protocols.
- 2007
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 41:7, s. e7-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the efficacy and safety of two eccentric rehabilitation protocols for patients with symptomatic patellar tendinopathy. A new eccentric overload training device was compared with the present standard eccentric rehabilitation programme on a decline board. DESIGN: Prospective, randomised clinical trial. SETTING: Sports rehabilitation clinic, university sports laboratory, supplemented with home exercises. PATIENTS: 20 competitive and recreational athletes, all with clinical diagnosis of patellar tendinopathy, verified by MRI or ultrasound imaging. INTERVENTIONS: A 12-week rehabilitation period, either with bilateral eccentric overload strength training using the Bromsman device twice a week or with unilateral eccentric body load training using a decline board twice a week, supplemented with daily home exercises. OUTCOME MEASURES: The primary outcome was pain and function, assessed by the Swedish Victorian Institute of Sport Assessment for Patella (VISA-P) score. Secondary outcome measures were isokinetic muscle torque, dynamic function and muscle flexibility, as well as pain level estimations using visual analogue scale (VAS). Side effects were registered. RESULTS: Both treatment groups improved in the short term according to the VISA-P scores during the 12-week rehabilitation period. However, there were no significant differences between the groups in terms of pain and function. After a 3-month rehabilitation period, most patients could be regarded as improved enough to be able to return to training and sports. No serious side effects were detected in either group. CONCLUSION: In patients with patellar tendinopathy pain, two-legged eccentric overload training twice per week, using the new device (Bromsman), was as efficient and safe as the present standard daily eccentric one-legged rehabilitation-training regimen using a decline board.
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| 2. |
- McIntosh, Andrew Stuart, et al.
(författare)
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Sports helmets now and in the future
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 45:16, s. 1258-1265
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Forskningsöversikt (refereegranskat)abstract
- The paper reports on a symposium on sports helmets and presents a synthesis of information and opinion from a range of presenters and disciplines. A review of the literature shows that helmets play an important role in head injury prevention and control. Helmets have been shown to be very efficacious and effective in a range of sports and in preventing specific head injury risks, especially moderate to severe head injury. The symposium emphasised the importance of helmet standards and the need for further development. There are calls for helmets that address the needs of competitive (elite) athletes separate to helmets for recreational athletes. Deficiencies in the evidence base for head injury risks and helmet efficacy and effectiveness were identified in some sports. Issues in designing helmets that are suitable to prevent severe head injuries and concussion were discussed and explained from biomechanical and engineering perspectives. The need to evaluate helmet performance in oblique impacts and incorporate this into standards was covered in a number of presentations. There are emerging opportunities with in-helmet technology to improve impact performance or to measure impact exposure. In-helmet technology as it matures may provide critical information on the severity of the impact, the location of the injured athlete, for example, snowboarder, and assist in the retrieval and immediate, as well as the long-term medical management of the athlete. It was identified that athletes, families and sports organisations can benefit from access to information on helmet performance. The importance of selecting the appropriate-sized helmet and ensuring that the helmet and visor were adjusted and restrained optimally was emphasised. The translation pathway from the science to new and better helmets is the development of appropriate helmet standards and the requirement for only helmets to be used that are certified to those standards.
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| 3. |
- Patton, Declan, 1984-, et al.
(författare)
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Brain loading in concussive head impacts : implications for injury prevention
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 45:318
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Tidskriftsartikel (refereegranskat)abstract
- Background Concussion is a prominent injury risk in sport, but the mechanisms that cause concussion are unclear. An important debate centres on the roles of angular and linear head acceleration in the mechanism of concussion. Resolving this debate is a prerequisite for developing injury prevention methods. Objective To estimate the brain loading patterns in a case series of concussive and no-injury head impacts. To assess the relative affects of linear and angular acceleration on brain loading and injury. Design Biomechanical analysis of head impacts using the validated KTH human head finite element model to analyse brain loading patterns in reconstructed head impacts. Setting Professional male unhelmeted contact football. Participants Biomechanical data from a previous case series study of 40 male football players (concussed and no-injury). Main outcome measurements Maximum principle strain, a predictor of injury, was measured in discrete brain locations. Results The highest maximum principle strains were recorded in both the white and grey matter of the cerebrum. Strains in all brain regions were similar across all three grades of concussion (Cantu Revised Concussion Grading Guidelines), but lower (33–47%) for no-injury cases. Concussion was most correlated with strains in the brainstem and thalamus. Angular, rather than linear, resultant accelerations correlated higher to strains in all regions of the brain. Angular accelerations in the coronal plane and linear accelerations directed inferiorly had the greatest correlation to concussion and loss of consciousness. For linear accelerations, those directed laterally and inferiorly were most correlated with strain. Angular accelerations in the coronal plane correlated highly with strains in the brainstem, thalamus, and midbrain. Angular accelerations in the transverse plane correlated highly with strains in the cerebrum and corpus callosum. Conclusion Brain loading differences were observed between concussion and no-injury cases. Angular acceleration may play a more important role in the mechanism of concussion than linear acceleration.
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