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Motowidło J, Stronska-Garbien K, Bichowska-Pawęska M, Kostrzewa M, Zając A, Ficek K, Drozd M. Effect of Step Load Based on Time under Tension in Hypoxia on the ACL Pre-Operative Rehabilitation and Hormone Levels: A Case Study. J Clin Med 2024; 13:2792. [PMID: 38792333 PMCID: PMC11122198 DOI: 10.3390/jcm13102792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
The aim of the study was to determine the effect of step load in hypoxia on the effectiveness of preoperative rehabilitation (PR) and hormone levels based on a case study. Introduction: We assessed the impact of variables such as rate of movement and time under tension (TUT) in normobaric hypoxia on the levels of growth hormone (GH), insulin-like growth factor 1 (IGF-1), and erythropoietin (EPO). Additionally, the impact of step load on the hypertrophy and strength of knee extensors and flexors was assessed. Methods: The work uses a case study, the research subject of which was a 23-year-old female professional handball player. The tests included an isokinetic assessment of the peak torque of knee extensors and flexors as well as body composition analysis. Results: The results showed a more than (10.81-fold) increase in GH after the microcycle with time under tension (TUT). The deficit between the lower limbs was also reduced. Conclusions: Using a hypoxic environment based on an appropriate altitude, combined with changes such as a short rest break between sets and a controlled tempo of movement with an eccentric phase, TUT may offer an alternative to the PR process, especially among athletes who care about fast RTS.
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Affiliation(s)
- Joanna Motowidło
- Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (K.S.-G.); (M.K.); (A.Z.); (K.F.)
| | - Katarzyna Stronska-Garbien
- Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (K.S.-G.); (M.K.); (A.Z.); (K.F.)
| | - Marta Bichowska-Pawęska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Maciej Kostrzewa
- Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (K.S.-G.); (M.K.); (A.Z.); (K.F.)
| | - Adam Zając
- Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (K.S.-G.); (M.K.); (A.Z.); (K.F.)
| | - Krzysztof Ficek
- Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (K.S.-G.); (M.K.); (A.Z.); (K.F.)
| | - Miłosz Drozd
- Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (K.S.-G.); (M.K.); (A.Z.); (K.F.)
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Qiu J, Ong MTY, Choi CY, He X, Lau LCM, Fu SC, Fong DTP, Yung PSH. Associations of patient characteristics, rate of torque development, voluntary activation of quadriceps with quadriceps strength, and knee function before anterior cruciate ligament reconstruction. Res Sports Med 2024; 32:491-503. [PMID: 36254570 DOI: 10.1080/15438627.2022.2132860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/28/2022] [Indexed: 10/24/2022]
Abstract
Good preoperative knee function (KF) and quadriceps strength (QS) relate to good prognoses after anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate the associations between patient characteristics, rate of torque development (RTD), voluntary activation (VA) of the quadriceps against preoperative KF and QS. A cross-sectional study was conducted. Forty patients with a primary, unilateral ACL injury who had finished the preoperative rehabilitation and scheduled for an ACLR were included. KF was evaluated using the International Knee Documentation Committee score. QS was measured by maximal voluntary isometric contractions. RTD was divided into the early (RTD0-50) and the late (RTD100-200) phases. Quadriceps VA was measured using the superimposed burst technique. Our results showed that patients with poor preoperative KF had more deficits in RTD0-50 (P = 0.025), higher BMI(P = 0.043), and more meniscus injuries (MI) (P = 0.001) than those with good KF. Patients with asymmetrical QS showed lower BMI (P = 0.020) and shorter time from injury (TFI) (P = 0.027) than those with symmetrical QS. Additionally, a higher pre-injury Tegner score combined with greater RTD100-200 contributed to greater QS on the injured limb (R2 = 0.357, P = 0.001). To conclude, BMI, TFI, concomitant MI, pre-injury physical activity level, and quadriceps RTD are related to QS and KF before ACLR.
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Affiliation(s)
- Jihong Qiu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael Tim-Yun Ong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi-Yin Choi
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xin He
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lawrence Chun-Man Lau
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sai-Chuen Fu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Sengoku T, Nakase J, Mizuno Y, Kanayama T, Ishida Y, Yanatori Y, Arima Y. Limited preoperative knee extension in anterior cruciate ligament reconstruction using a hamstring tendon affects improvement of postoperative knee extensor strength. Knee Surg Sports Traumatol Arthrosc 2023; 31:5621-5628. [PMID: 37857706 DOI: 10.1007/s00167-023-07620-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE This study aimed to determine the factors affecting knee extensor strength 6 months after anterior cruciate ligament (ACL) reconstruction using autograft hamstring tendon. METHODS 144 patients who could undergo regular follow-up after ACL reconstruction were divided into 2 groups: those with greater than 90% (Group A: n = 95) and less than 85% (Group B: n = 49) isokinetic knee contraction at 60°/s 6 months post-ACL reconstruction. Basic information, injury status, limited preoperative knee extension, and knee extensor strength at 3 and 6 months postoperatively were compared between the groups. Multivariate logistic analysis was performed and included variables that showed statistically significant differences between the groups in the univariate analysis. In addition, the cut-off value for the limb symmetry index (LSI) at 3 months postoperatively needed to exceed an LSI of 90% at 6 months postoperatively was calculated using the receiver operating characteristics curve. RESULTS Age, preoperative waiting period, limited preoperative knee extension, and knee extensor strength at 3 months postoperatively were significantly different between the two groups. The multivariate logistic analysis showed that all the variables affected the improvement in knee extensor strength at 6 months postoperatively. Limited preoperative knee extension was the most significant factor (odds ratio: 15.1, 95% confidence interval: 2.57-118.56, p < 0.01). The LSI cut-off value at 3 months postoperatively was 72.0%. CONCLUSION Key factors in achieving the necessary knee extensor strength criteria for return to sports at 6 months post-ACL reconstruction include addressing limited preoperative knee extension and achieving an LSI ≥ 72% in knee extensor strength at 3 months postoperatively. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Takuya Sengoku
- Section of Rehabilitation, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
| | - Junsuke Nakase
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
| | - Yushin Mizuno
- Section of Rehabilitation, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
| | - Tomoyuki Kanayama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
| | - Yoshihiro Ishida
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
| | - Yusuke Yanatori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
| | - Yu Arima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
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Ueda Y, Matsushita T, Shibata Y, Takiguchi K, Ono K, Kida A, Nishida K, Nagai K, Hoshino Y, Matsumoto T, Sakai Y, Kuroda R. Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2023; 31:4390-4398. [PMID: 37354214 PMCID: PMC10471663 DOI: 10.1007/s00167-023-07492-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/12/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE This study compared the predictive ability of each independent predictor with that of a combination of predictors for quadriceps strength recovery one year after anterior cruciate ligament (ACL) reconstruction. METHODS Patients who underwent primary ACL reconstruction using hamstring autografts were enrolled. Quadriceps strength, hamstring strength, and anterior tibial translation were measured, and the limb symmetry index (LSI) of the quadriceps and the hamstrings was calculated preoperatively and one year after surgery. Patients were classified into two groups according to the LSI of the quadriceps strength at one year postoperatively (≥ 80% or < 80%). Multivariate logistic regression analysis identified the independent predictors of quadriceps strength recovery, and the cut-off value was calculated using the receiver operating characteristic curve. A model assessing predictive ability of the combination of independent predictors was created, and the area under the curve (AUC) for each independent predictor was calculated by using the receiver-operating characteristic curves and the DeLong method. RESULTS Of the 646 patients, 414 (64.1%) had an LSI of at least 80% for quadriceps strength one year after surgery, and 232 patients (35.9%) had an LSI of < 80%. Age, sex, body mass index (BMI), preinjury sport level, and LSI of preoperative quadriceps strength were independently associated with quadriceps strength recovery one year after ACL reconstruction. The cut-off values were age: 22.5 years; sex: female; BMI: 24.3 kg/m2; preinjury sport level: no sport; and LSI of preoperative quadriceps strength: 63.3%. The AUC of the model assessing the predictive ability of the combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength was significantly higher (0.73) than that of similar factors of preoperative quadriceps strength (AUC: 0.63, 0.53, 0.56, 0.61, and 0.68, p < 0.01, respectively). CONCLUSION The combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength had a superior predictive ability for quadriceps strength recovery at one year after ACL reconstruction than these predictors alone. Multiple factors, including patient characteristics and preoperative quadriceps strength, should be considered when planning rehabilitation programs to improve quadriceps strength recovery after ACL reconstruction. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Yuya Ueda
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo, 650‑0017, Japan.
| | - Yohei Shibata
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Kohei Takiguchi
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Kumiko Ono
- Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Akihiro Kida
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Kyohei Nishida
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo, 650‑0017, Japan
| | - Kanto Nagai
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo, 650‑0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo, 650‑0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo, 650‑0017, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo, 650‑0017, Japan
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Kim DK, Park G, Wang JH, Kuo LT, Park WH. Preoperative quadriceps muscle strength deficit severity predicts knee function one year after anterior cruciate ligament reconstruction. Sci Rep 2022; 12:5830. [PMID: 35388112 PMCID: PMC8986796 DOI: 10.1038/s41598-022-09816-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/28/2022] [Indexed: 11/09/2022] Open
Abstract
Quadriceps strength is critical for patients with anterior cruciate ligament (ACL) reconstruction; however, little is known about the relationship between preoperative quadriceps strength deficit and postoperative subjective knee functions. The study aimed to investigate the relationship between preoperative quadriceps strength and postoperative knee function in patients after ACL reconstruction. Seventy-five male patients with primary ACL reconstruction surgery with hamstring autografts between 2014 and 2017 were included. An isokinetic dynamometer assessed quadriceps strength while self-reported knee functions were measured by the International Knee Documentation Committee (IKDC) and Lysholm scores at baseline and 1 year after surgery. The three identified groups (Q1-Q3) were classified according to the preoperative quadriceps muscle strength deficit. Q1 were patients with < 25% quadriceps muscle strength deficit, Q2 showed a 25-45% deficit, and Q3 included those with a deficit > 45%. We compared knee functions between the three groups and examined the associations between preoperative variables and functional knee outcomes. The preoperative quadriceps muscle strength deficit had a negative association with the knee functional scores at 1 year follow-up including the IKDC score (rs = - 0.397, p = 0.005) and the Lysholm score (rs = - 0.454, p < 0.001), but not other factors. Furthermore, only the Q1 group, with < 25% deficit in preoperative quadriceps muscle strength, showed a significant correlation in postoperative IKDC score (r = - 0.462, p = 0.030), and Lysholm score (r = - 0.446, p = 0.038). Preoperative quadriceps muscle strength deficit had a significant negative relationship with postoperative function at 1 year following ACL reconstruction.
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Affiliation(s)
- Do Kyung Kim
- Department of Sports Medicine Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - Geon Park
- Department of Sports Medicine Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - Joon Ho Wang
- Department of Orthopaedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Liang-Tseng Kuo
- Department of Orthopaedic Surgery, Sports Medicine Center, Chang Gung Memorial Hospital, No. 6 West Sec, Chia-Pu Road, Putz City, Chiayi, 613, Taiwan. .,Department of Medicine, Chang Gung University, Taoyüan, Taiwan.
| | - Won Hah Park
- Department of Sports Medicine Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
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Alves AFF, de Arruda Miranda JR, de Souza SAS, Pereira RV, de Almeida Silvares PR, Yamashita S, Deffune E, de Pina DR. Texture analysis to differentiate anterior cruciate ligament in patients after surgery with platelet-rich plasma. J Orthop Surg Res 2021; 16:283. [PMID: 33910605 PMCID: PMC8080342 DOI: 10.1186/s13018-021-02437-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/20/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) has been used to favor anterior cruciate ligament (ACL) healing after reconstruction surgeries. However, clinical data are still inconclusive and subjective about PRP. Thus, we propose a quantitative method to demonstrate that PRP produced morphological structure changes. METHODS Thirty-four patients undergoing ACL reconstruction surgery were evaluated and divided into control group (sixteen patients) without PRP application and experiment group (eighteen patients) with intraoperative application of PRP. Magnetic resonance imaging (MRI) scans were performed 3 months after surgery. We used Matlab® and machine learning (ML) in Orange Canvas® to texture analysis (TA) features extraction. Experienced radiologists delimited the regions of interest (RoIs) in the T2-weighted images. Sixty-two texture parameters were extracted, including gray-level co-occurrence matrix and gray level run length. We used the algorithms logistic regression (LR), naive Bayes (NB), and stochastic gradient descent (SGD). RESULTS The accuracy of the classification with NB, LR, and SGD was 83.3%, 75%, 75%, respectively. For the area under the curve, NB, LR, and SGD presented values of 91.7%, 94.4%, 75%, respectively. In clinical evaluations, the groups show similar responses in terms of improvement in pain and increase in the IKDC index (International Knee Documentation Committee) and Lysholm score indices differing only in the assessment of flexion, which presents a significant difference for the group treated with PRP. CONCLUSIONS Here, we demonstrated quantitatively that patients who received PRP presented texture changes when compared to the control group. Thus, our findings suggest that PRP interferes with morphological parameters of the ACL. TRIAL REGISTRATION Protocol no. CAAE 56164316.6.0000.5411.
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Affiliation(s)
- Allan Felipe Fattori Alves
- grid.410543.70000 0001 2188 478XMedical School, Sao Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP - Campus de Botucatu, Botucatu, SP CEP 18618687 Brazil
| | - José Ricardo de Arruda Miranda
- grid.410543.70000 0001 2188 478XInstitute of Bioscience, Sao Paulo State University Julio de Mesquita Filho, R. Prof. Dr. Antônio Celso Wagner Zanin, 250 - Distrito de Rubião Junior, Botucatu, SP CEP 18618687 Brazil
| | - Sérgio Augusto Santana de Souza
- grid.410543.70000 0001 2188 478XInstitute of Bioscience, Sao Paulo State University Julio de Mesquita Filho, R. Prof. Dr. Antônio Celso Wagner Zanin, 250 - Distrito de Rubião Junior, Botucatu, SP CEP 18618687 Brazil
| | - Ricardo Violante Pereira
- grid.410543.70000 0001 2188 478XMedical School, Sao Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP - Campus de Botucatu, Botucatu, SP CEP 18618687 Brazil
| | - Paulo Roberto de Almeida Silvares
- grid.410543.70000 0001 2188 478XMedical School, Sao Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP - Campus de Botucatu, Botucatu, SP CEP 18618687 Brazil
| | - Seizo Yamashita
- grid.410543.70000 0001 2188 478XMedical School, Sao Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP - Campus de Botucatu, Botucatu, SP CEP 18618687 Brazil
| | - Elenice Deffune
- grid.410543.70000 0001 2188 478XMedical School, Sao Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP - Campus de Botucatu, Botucatu, SP CEP 18618687 Brazil
| | - Diana Rodrigues de Pina
- grid.410543.70000 0001 2188 478XMedical School, Sao Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP - Campus de Botucatu, Botucatu, SP CEP 18618687 Brazil
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Alves AFF, Souza SA, Ruiz RL, Reis TA, Ximenes AMG, Hasimoto EN, Lima RPS, Miranda JRA, Pina DR. Combining machine learning and texture analysis to differentiate mediastinal lymph nodes in lung cancer patients. Phys Eng Sci Med 2021; 44:387-394. [PMID: 33730292 PMCID: PMC7967117 DOI: 10.1007/s13246-021-00988-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 03/03/2021] [Indexed: 11/30/2022]
Abstract
Evaluate whether texture analysis associated with machine learning approaches could differentiate between malignant and benign lymph nodes. A total 18 patients with lung cancer were selected, with 39 lymph nodes, being 15 malignant and 24 benign. Retrospective computed tomography scans were utilized both with and without contrast medium. The great differential of this work was the use of 15 textures from mediastinal lymph nodes, with five different physicians as operators. First and second order statistical textures such as gray level run length and co-occurrence matrix were extracted and applied to three different machine learning classifiers. The best machine learning classifier demonstrated a variability of less than 5% among operators. The support vector machine (SVM) classifier presented 95% of the area under the ROC curve (AUC) and 89% of sensitivity for sequences without contrast medium. SVM classifier presented 93% of AUC and 86% of sensitivity for sequences with contrast medium. Texture analysis and machine learning may be helpful in the differentiation between malign and benign lymph nodes. This study can aid the physician in diagnosis and staging of lymph nodes and potentially reduce the number of invasive analysis to histopathological confirmation.
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Affiliation(s)
- Allan F F Alves
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Sérgio A Souza
- Institute of Bioscience, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Raul L Ruiz
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Tarcísio A Reis
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Agláia M G Ximenes
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Erica N Hasimoto
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Rodrigo P S Lima
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - José Ricardo A Miranda
- Institute of Bioscience, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil
| | - Diana R Pina
- Medical School, Sao Paulo State University Julio de Mesquita Filho, Botucatu, Brazil.
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Qiu J, He X, Fu SC, Ong MTY, Teng Leong H, Shu-Hang Yung P. Is Pre-operative Quadriceps Strength a Predictive Factor for the Outcomes of Anterior Cruciate Ligament Reconstructions. Int J Sports Med 2020; 41:912-920. [PMID: 32590844 DOI: 10.1055/a-1144-3111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Persistent quadriceps weakness prevents patients from returning to sports after ACL reconstruction. Pre-operative quadriceps strength was indicated as an important factor for the outcomes of ACL reconstruction. However, the existing evidence is controversial. Therefore, this systematic review was conducted to summarize and evaluate the relationship between pre-operative quadriceps strength and the outcomes following ACL reconstruction, and to summarize the predictive value of pre-operative quadriceps strength for satisfactory post-operative outcomes. Pubmed, WOS, Embase, CINAHL and SportDiscus were searched to identify eligible studies according to PRISMA guidelines. Relevant data was extracted regarding quadriceps strength assessment methods, pre-operative quadriceps strength, participants treatment protocols, post-operative outcomes, follow-up time points and the relevant results of each individual study. Twelve cohort studies (Coleman methodology score: 62±10.4; from 44-78) with 1773 participants included. Follow-up period ranged from 3 months to 2 years. Moderate evidence supports the positive association between pre-operative quadriceps strength and post-operative quadriceps strength; weak evidence supports the positive association between pre-operative quadriceps strength and post-operative functional outcomes. By now, there is no consensus on the predictive value of pre-operative quadriceps strength for achieving satisfactory quadriceps strength after ACLR. To conclude, pre-operative quadriceps strength should be taken into consideration when predict patient recovery of ACLR.
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Affiliation(s)
- Jihong Qiu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xin He
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sai-Chuen Fu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Luis Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael Tim-Yun Ong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hio Teng Leong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Luis Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kitaguchi T, Tanaka Y, Takeshita S, Akizaki K, Takao R, Kinugasa K, Tachibana Y, Natsuume T, Horibe S. Preoperative quadriceps strength as a predictor of return to sports after anterior cruciate ligament reconstruction in competitive athletes. Phys Ther Sport 2020; 45:7-13. [PMID: 32563035 DOI: 10.1016/j.ptsp.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine whether preoperative quadriceps strength predicts the likelihood of return to sports (RTS) following anterior cruciate ligament reconstruction (ACLR) in competitive athletes. DESIGN Case-control study. SETTING Single-center. PARTICIPANTS A total of 221 competitive athletes who underwent primary ACLR were followed and divided into RTS (n = 177) and non-RTS (n = 44) groups based on self-reported sports activities at one year postoperatively. MAIN OUTCOME MEASURES Isokinetic quadriceps strength tests were performed preoperatively and at six months and one year postoperatively, and the quadriceps index (QI) was calculated. Functional performance was evaluated by the single-leg hop (SLH) test at six months postoperatively. RESULTS Preoperative QI significantly predicted the likelihood of RTS (odds ratio, 1.68 per 10-unit increase; P < 0.001), with a preoperative QI cut-off of 66% (AUC: 0.74; sensitivity: 68.9%; specificity: 77.3%). Subjects with a preoperative QI < 66% had a significantly lower postoperative QI, SLH, and rates of RTS compared to those with a higher preoperative QI (P < 0.01). CONCLUSIONS Preoperative quadriceps strength could predict the likelihood of RTS following ACLR, and a preoperative QI < 66% was associated with a greater risk of unsuccessful RTS at one year postoperatively. Preoperative QI should be evaluated as a predictor of RTS.
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Affiliation(s)
- Takuya Kitaguchi
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan.
| | - Yoshinari Tanaka
- Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Shinya Takeshita
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Koji Akizaki
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Rikio Takao
- Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino, Osaka, 583-8555, Japan
| | - Kazutaka Kinugasa
- Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Yuta Tachibana
- Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Takashi Natsuume
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Shuji Horibe
- Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino, Osaka, 583-8555, Japan
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