Injury prevalence in dancers is high, and misaligned turnout (TO) is claimed to bear injury risk. This systematic review aimed to investigate if compensating or forcing TO leads to musculoskeletal... Show moreInjury prevalence in dancers is high, and misaligned turnout (TO) is claimed to bear injury risk. This systematic review aimed to investigate if compensating or forcing TO leads to musculoskeletal injuries.A systematic literature review was conducted according to the PRISMA Guidelines using the databases of PubMed, Embase, Emcare, Web of Science, Cochrane Library, Academic Search Premier, and ScienceDirect. Studies investigating the relationship between compensated or forced TO and injuries in all genders, all ages, and levels of dancers were included. Details on misaligned TO measurements and injuries had to be provided. Screening was performed by two researchers, data extraction and methodological quality assessment executed by one researcher and checked by another.7 studies with 1293 dancers were included. Methodological quality was low due to study designs and a general lack of standardised definition of pathology and methods of assessment of misaligned TO. The studies investigating the lower extremities showed a hip-focus only. Non-hip contributors as well as their natural anatomical variations were not accounted for, limiting the understanding of injury mechanisms underlying misaligned TO. As such no definite conclusions on the effect of compensating or forcing TO on musculoskeletal injuries could be made.Total TO is dependent on complex motion cycles rather than generalised (hip) joint dominance only. Objective dual assessment of maximum passive joint range of motion through 3D kinematic analysis in combination with physical examination is needed to account for anatomical variations, locate sites prone to (overuse)injury, and investigate underlying injury mechanisms. (C) 2020 Elsevier Ltd. All rights reserved. Show less
Interpretation: Non-invasive quantitative analysis, including estimation of optimal muscle lengths, enables to identify neural and non-neural changes in chronic stroke patients. Monitoring these... Show moreInterpretation: Non-invasive quantitative analysis, including estimation of optimal muscle lengths, enables to identify neural and non-neural changes in chronic stroke patients. Monitoring these changes in time is important to understand the recovery process and to optimize treatment. (C) 2016 Elsevier Ltd. All rights reserved. Show less
Oomen, P.J.A.; Loerakker, S.; Geemen, D. van; Neggers, J.; Goumans, M.J.T.H.; Bogaerdt, A.J. van den; ... ; Baaijens, F.P.T. 2016
Clavicular fractures are among the most common fractures of the shoulder. Displacement or comminution of the fracture fragments may lead to shortening of the clavicle, but could also cause mal... Show moreClavicular fractures are among the most common fractures of the shoulder. Displacement or comminution of the fracture fragments may lead to shortening of the clavicle, but could also cause mal-union or non-union of the clavicle and might lead to poor functional outcome. These fracture characteristics are therefore important in clinical decision making. The diagnostic aspects of clavicular fractures are evaluated in the first part of this thesis, whereas the second part describes studies on treatment and clinical outcomes. The third part of these thesis focuses on the complex biomechanics of the shoulder after a displaced midshaft clavicular fracture. The findings on diagnostic aspects underline the importance of fracture characteristics for classification and of two-view radiography for treatment decisions for clavicular fractures. Clavicular shortening after a midshaft clavicular fracture is deemed the most important factor in deciding whether or not to operate, but no clinically relevant changes after clavicular shortening in the scapular kinematics and functional outcome were demonstrated. Clavicular shortening should therefore not be used as the only reason to justify operative treatment. Show less
The Subacromial Impingement Syndrome (SIS) is the most prevalent disorder of the shoulder in primary health care. Acromionplasty, as the main surgical treatment of SIS, is one of the most performed... Show moreThe Subacromial Impingement Syndrome (SIS) is the most prevalent disorder of the shoulder in primary health care. Acromionplasty, as the main surgical treatment of SIS, is one of the most performed orthopedic surgeries. However, its results are highly variable. Possibly, there are different etiologic subgroups of patients, that might need specific treatment approaches. Several etiologic mechanisms have been described for subacromial narrowing or __impingement__: i.e. 1) structural causes, including acromion shape, subacromial bony spurs, osteophytes; 2) narrowing of the subacromial space due to humerus cranialisation in patients with (micro)instability, or scapular dyskinesia; 3) intrinsic mechanisms such as primary degenerative tendinopathy of the rotator cuff. The aim of this thesis is to unravel the clinical entity __Subacromial Impingement Syndrome__ and to develop methods for identifying distinct etiological patient subgroups that need specific diagnostics and treatment strategies. To this end, we explore the terminological problems and opinions on the main characteristics of SIS amongst international health practitioners, study the prevalence of previously reported etiologic mechanisms in patients with SIS symptoms, develop clinical and biomechanical methods to evaluate and categorize patients with SIS symptoms in diagnostic subgroups, and compare treatment outcomes in trials and follow-up studies. Show less
Wall shear stress (WSS) exerted by flowing blood at the vessel wall, is defined as the velocity gradient at the vessel wall times the blood viscosity. Low WSS is related to atherosclerotic risk... Show moreWall shear stress (WSS) exerted by flowing blood at the vessel wall, is defined as the velocity gradient at the vessel wall times the blood viscosity. Low WSS is related to atherosclerotic risk profiles and WSS is low or oscillating at locations where plaque development is observed. In vivo cross-sectional images of blood flow suffer from limited resolution and lack of info on local viscosity. However, WSS can be assessed by modeling of velocity profiles and blood viscosity. Already with a first approximation of velocity profiles by an imprecise model, such as a paraboloid, and under the assumption of a constant (average) human blood viscosity, correlations between various cardiovascular risk factors and WSS were found. Also the effect of treatment with pravastatin on WSS has been demonstrated with this model. The more detailed the model, the more accurate WSS can be assessed. An accurate 4D WSS assessment can be obtained by application of a so-called Finite Element Method (FEM) calculation. Blood velocity was simulated for a certain vessel segment. A model of the vessel geometry composed of bricks (a so called mesh) was created in order to simulate the blood flow. Show less
