PeerJ:Orthopedicshttps://peerj.com/articles/index.atom?journal=peerj&subject=5900Orthopedics articles published in PeerJReliability and validity of an app-assisted tissue compliance meter in measuring tissue stiffness on a phantom modelhttps://peerj.com/articles/171222024-03-072024-03-07Andreas BrandlEda AcikalinKatja BartschJan WilkeRobert Schleip
Background
Most methods for soft tissue stiffness assessment require high financial resources, significant technical effort, or extensive therapist training. The PACT Sense device was developed to be used in a wide range of applications and user groups. However, to date, there are no data on its validity and reliability. The aim of this study was to investigate the validity and reliability of the PACT device.
Methods
A polyurethane phantom tissue model (PTM) mimicking the mechanical properties of the fascia profunda and the erector spinae muscle was used. Stiffness measurements with PACT were conducted by two independent investigators. For construct validity, correlations were calculated between the known stiffness of the PTM and values obtained with PACT. For concurrent validity, we determined the association between the PACT values and additional measurements with the established MyotonPRO device. To estimate interrater and intrarater (two measurements with an interval of 7 days) reliability, we used the intraclass correlation coefficient (ICC).
Results
Correlation analysis (PTM/PACT) revealed very high concurrent validity (r = 0.99; p < 0.001), construct validity (PACT/MyotonPRO) was 0.87, p < 0.001. Both, interrater reliability (ICC = 0.85; p = 0.036) and intrarater reliability were good (ICC = 0.89; p < 0.001).
Conclusions
The PACT provides valid and reliable stiffness measurements in tissue phantoms. Further studies in humans are needed to confirm its physiometric properties under in vivo conditions.
Background
Most methods for soft tissue stiffness assessment require high financial resources, significant technical effort, or extensive therapist training. The PACT Sense device was developed to be used in a wide range of applications and user groups. However, to date, there are no data on its validity and reliability. The aim of this study was to investigate the validity and reliability of the PACT device.
Methods
A polyurethane phantom tissue model (PTM) mimicking the mechanical properties of the fascia profunda and the erector spinae muscle was used. Stiffness measurements with PACT were conducted by two independent investigators. For construct validity, correlations were calculated between the known stiffness of the PTM and values obtained with PACT. For concurrent validity, we determined the association between the PACT values and additional measurements with the established MyotonPRO device. To estimate interrater and intrarater (two measurements with an interval of 7 days) reliability, we used the intraclass correlation coefficient (ICC).
Results
Correlation analysis (PTM/PACT) revealed very high concurrent validity (r = 0.99; p < 0.001), construct validity (PACT/MyotonPRO) was 0.87, p < 0.001. Both, interrater reliability (ICC = 0.85; p = 0.036) and intrarater reliability were good (ICC = 0.89; p < 0.001).
Conclusions
The PACT provides valid and reliable stiffness measurements in tissue phantoms. Further studies in humans are needed to confirm its physiometric properties under in vivo conditions.Effect of lag screw on stability of first metatarsophalangeal joint arthrodesis with medial platehttps://peerj.com/articles/169012024-02-282024-02-28Karol DaszkiewiczMagdalena RuckaKrzysztof CzurajAngela AndrzejewskaPiotr Łuczkiewicz
Background
First metatarsophalangeal joint (MTP-1) arthrodesis is a commonly performed procedure in the treatment of disorders of the great toe. Since the incidence of revision after MTP-1 joint arthrodesis is not insignificant, a medial approach with a medially positioned locking plate has been proposed as a new technique. The aim of the study was to investigate the effect of the application of a lag screw on the stability and strength of first metatarsophalangeal joint arthrodesis with medial plate.
Methods
The bending tests in a testing machine were performed for models of the first metatarsal bone and the proximal phalanx printed on a 3D printer from polylactide material. The bones were joined using the locking titanium plate and six locking screws. The specimens were divided into three groups of seven each: medial plate and no lag screw, medial plate with a lag screw, dorsal plate with a lag screw. The tests were carried out quasi-static until the samples failure.
Results
The addition of the lag screw to the medial plate significantly increased flexural stiffness (41.45 N/mm vs 23.84 N/mm, p = 0.002), which was lower than that of the dorsal plate with a lag screw (81.29 N/mm, p < 0.001). The similar maximum force greater than 700 N (p > 0.50) and the relative bone displacements lower than 0.5 mm for a force of 50 N were obtained for all fixation techniques.
Conclusions
The lag screw significantly increased the shear stiffness in particular and reduced relative transverse displacements to the level that should not delay the healing process for the full load of the MTP-1 joint arthrodesis with the medial plate. It is recommended to use the locking screws with a larger cross-sectional area of the head to minimize rotation of the medial plate relative to the metatarsal bone.
Background
First metatarsophalangeal joint (MTP-1) arthrodesis is a commonly performed procedure in the treatment of disorders of the great toe. Since the incidence of revision after MTP-1 joint arthrodesis is not insignificant, a medial approach with a medially positioned locking plate has been proposed as a new technique. The aim of the study was to investigate the effect of the application of a lag screw on the stability and strength of first metatarsophalangeal joint arthrodesis with medial plate.
Methods
The bending tests in a testing machine were performed for models of the first metatarsal bone and the proximal phalanx printed on a 3D printer from polylactide material. The bones were joined using the locking titanium plate and six locking screws. The specimens were divided into three groups of seven each: medial plate and no lag screw, medial plate with a lag screw, dorsal plate with a lag screw. The tests were carried out quasi-static until the samples failure.
Results
The addition of the lag screw to the medial plate significantly increased flexural stiffness (41.45 N/mm vs 23.84 N/mm, p = 0.002), which was lower than that of the dorsal plate with a lag screw (81.29 N/mm, p < 0.001). The similar maximum force greater than 700 N (p > 0.50) and the relative bone displacements lower than 0.5 mm for a force of 50 N were obtained for all fixation techniques.
Conclusions
The lag screw significantly increased the shear stiffness in particular and reduced relative transverse displacements to the level that should not delay the healing process for the full load of the MTP-1 joint arthrodesis with the medial plate. It is recommended to use the locking screws with a larger cross-sectional area of the head to minimize rotation of the medial plate relative to the metatarsal bone.In vivo evaluation of a polyester and fiberglass composite intramedullary nail for femoral osteosynthesis in calveshttps://peerj.com/articles/166562024-02-082024-02-08Sérgio Silva Rocha JuniorMayara G. CorrêaLucas A. DiasMarcos Paulo Antunes de LimaSuzane L. BeierLeopoldo PaolucciLuiz Alberto do LagoEstevam B. Las CasasRafael R. Faleiros
The objective of this study was to test a composite of polyester resin and fiberglass in the form of an intramedullary nail for osteosynthesis of femoral fractures in calves. The methodology was established based on a previous study that used a bovine femur finite element model to simulate fractures, which were then stabilized by the same nails as proposed in this study. General anesthesia was induced in six calves followed by fracture creation via an oblique incision in the middle third of the femoral diaphysis, and osteosynthesis was immediately performed by retrograde insertion of the composite nail. Locking was achieved by drilling the bone and nail without using a jig and introducing two stainless steel screws proximal and two distal to the fracture line. Five of the six calves achieved complete fracture healing after 60 days. No signs of incompatibility or toxicity of the composite were observed. However, limitations were observed during the surgery, such as difficulty in drilling the nail and trimming the remainder portion of the nail that extended beyond the length of the bone. Small fragments produced by these maneuvers were considered irritating to soft tissues during the postoperative period. It was also found that small cracks in the nail tended to propagate in the form of longitudinal fractures. In conclusion, an intramedullary nail made of polyester resin and fiberglass (a low-cost and easy-to-acquire material) was considered biocompatible and capable of allowing bone healing of femoral fractures in young cattle. However, the development of solutions for the reported limitations is crucial prior to recommending the proposed composite for clinical use.
The objective of this study was to test a composite of polyester resin and fiberglass in the form of an intramedullary nail for osteosynthesis of femoral fractures in calves. The methodology was established based on a previous study that used a bovine femur finite element model to simulate fractures, which were then stabilized by the same nails as proposed in this study. General anesthesia was induced in six calves followed by fracture creation via an oblique incision in the middle third of the femoral diaphysis, and osteosynthesis was immediately performed by retrograde insertion of the composite nail. Locking was achieved by drilling the bone and nail without using a jig and introducing two stainless steel screws proximal and two distal to the fracture line. Five of the six calves achieved complete fracture healing after 60 days. No signs of incompatibility or toxicity of the composite were observed. However, limitations were observed during the surgery, such as difficulty in drilling the nail and trimming the remainder portion of the nail that extended beyond the length of the bone. Small fragments produced by these maneuvers were considered irritating to soft tissues during the postoperative period. It was also found that small cracks in the nail tended to propagate in the form of longitudinal fractures. In conclusion, an intramedullary nail made of polyester resin and fiberglass (a low-cost and easy-to-acquire material) was considered biocompatible and capable of allowing bone healing of femoral fractures in young cattle. However, the development of solutions for the reported limitations is crucial prior to recommending the proposed composite for clinical use.Effect of dynamic taping on neck pain, disability, and quality of life in patients with chronic non-specific neck pain: a randomized sham-control trialhttps://peerj.com/articles/167992024-01-262024-01-26Mohammad SidiqAksh ChahalBalamurugan JanakiramanFaizan KashooSharad Kumar KediaNeha KashyapRicha Hirendra RaiNeha VyasT.S. VeeragoudhamanKrishna Reddy VajralaMegha YadavShahiduz ZafarSanghamitra JenaMonika SharmaShashank BaranwalMshari AlghadierAbdullah AlhusayniAbdullah AlzahraniVijay Selvan Natarajan
Background
In 2020, 203 million people experienced neck pain, with a higher prevalence in women. By 2050, it is predicted that neck pain will affect 269 million people, representing a 32.5% increase. Physical rehabilitation is often employed for the treatment of chronic non-specific neck pain (CNSNP) and the associated functional loss. Taping is frequently used as an adjunct treatment alongside primary physical rehabilitation. Unlike kinesio tape (KT), the therapeutic benefits of dynamic tape (DT) have not been thoroughly explored and documented in non-athletic conditions. Therefore, the aim of this trial was to determine the effects of DT on pain, disability, and overall well-being in individuals experiencing CNSNP.
Methods
A prospective parallel-group active controlled trial was conducted at a single center, involving 136 patients with CNSNP, randomly allocated in a 1:1 ratio. The sham taping group (STC) received standard physiotherapy care (n = 67) alongside DT without tension, while the dynamic taping group (DTC) (n = 69) underwent standard cervical offloading technique with appropriate tension in addition to standard physiotherapy care. Demographic information and three patient-reported outcome measures (PROMs), namely the Neck Disability Index (NDI), Visual Analogue Scale (VAS), and the World Health Organization—Five Well-Being Index (WHO-5), were collected for each participant at three time points (baseline, four weeks post-taping, and four weeks follow-up).
Results
At baseline, no significant differences were observed between the STC and DTC for any outcome measure. Notably, all three PROMs exhibited a significant improvement from baseline to four weeks post-intervention, with moderate to small effect sizes (NDI ηp2 = 0.21, VAS ηp2 = 0.23, and WHO-55 ηp2 = 0.05). The WHO-5 scores for both groups demonstrated improvement from baseline through follow-up (p < 0.001). The NDI and VAS scores ameliorated from baseline to the four weeks post-taping period, with marginal improvements observed during the four weeks follow-up.
Conclusion
The incorporation of DT as an adjunct to standard physiotherapy care yielded enhancements in pain levels, functional disability, and well-being among patients with CNSNP when compared to the sham group. However, the sustainability of these improvements beyond the taping period lacks statistical significance and warrants further validation.
Background
In 2020, 203 million people experienced neck pain, with a higher prevalence in women. By 2050, it is predicted that neck pain will affect 269 million people, representing a 32.5% increase. Physical rehabilitation is often employed for the treatment of chronic non-specific neck pain (CNSNP) and the associated functional loss. Taping is frequently used as an adjunct treatment alongside primary physical rehabilitation. Unlike kinesio tape (KT), the therapeutic benefits of dynamic tape (DT) have not been thoroughly explored and documented in non-athletic conditions. Therefore, the aim of this trial was to determine the effects of DT on pain, disability, and overall well-being in individuals experiencing CNSNP.
Methods
A prospective parallel-group active controlled trial was conducted at a single center, involving 136 patients with CNSNP, randomly allocated in a 1:1 ratio. The sham taping group (STC) received standard physiotherapy care (n = 67) alongside DT without tension, while the dynamic taping group (DTC) (n = 69) underwent standard cervical offloading technique with appropriate tension in addition to standard physiotherapy care. Demographic information and three patient-reported outcome measures (PROMs), namely the Neck Disability Index (NDI), Visual Analogue Scale (VAS), and the World Health Organization—Five Well-Being Index (WHO-5), were collected for each participant at three time points (baseline, four weeks post-taping, and four weeks follow-up).
Results
At baseline, no significant differences were observed between the STC and DTC for any outcome measure. Notably, all three PROMs exhibited a significant improvement from baseline to four weeks post-intervention, with moderate to small effect sizes (NDI ηp2 = 0.21, VAS ηp2 = 0.23, and WHO-55 ηp2 = 0.05). The WHO-5 scores for both groups demonstrated improvement from baseline through follow-up (p < 0.001). The NDI and VAS scores ameliorated from baseline to the four weeks post-taping period, with marginal improvements observed during the four weeks follow-up.
Conclusion
The incorporation of DT as an adjunct to standard physiotherapy care yielded enhancements in pain levels, functional disability, and well-being among patients with CNSNP when compared to the sham group. However, the sustainability of these improvements beyond the taping period lacks statistical significance and warrants further validation.Morphometric and morphologic analysis of the foramen spinosum in the Slovenian population with clinical correlationshttps://peerj.com/articles/165592023-12-192023-12-19Žiga ŠinkNejc UmekErika Cvetko
Background
The foramen spinosum (FS) is a pivotal passage for neurovascular structures within the skull base. We performed a detailed morphometric and morphological analysis of the FS to emphasize its clinical relevance.
Materials & Methods
The study was performed on dried skull specimens obtained from the anatomical collections of the Institute of Anatomy and Institute of Forensic Medicine of the University of Ljubljana. The morphometric and morphologic features of FS in 126 whole human skulls and 15 skull halves were analyzed, including dimensions, shape, and other anatomical variations, as well as relationships to surrounding structures. Measurements were done with a digital sliding caliper.
Results
The mean length and width of the FS were 2.45 ± 0.65 mm and 2.03 ± 0.53 mm on the right side and 2.49 ± 0.61 mm and 2.08 ± 0.48 mm on the left side. The most frequently observed shape was round (56.7%), followed by oval (28.2%), irregular (8.7%) and drop shaped (6.3%). Several anatomical variations were also noted, including FS duplication, confluences with other foramina, and FS obstruction due to marginal bony outgrowths.
Conclusion
The FS exhibits notable interindividual differences in anatomical characteristics which should be considered during neurosurgical procedures and radiological interventions in the skull base.
Background
The foramen spinosum (FS) is a pivotal passage for neurovascular structures within the skull base. We performed a detailed morphometric and morphological analysis of the FS to emphasize its clinical relevance.
Materials & Methods
The study was performed on dried skull specimens obtained from the anatomical collections of the Institute of Anatomy and Institute of Forensic Medicine of the University of Ljubljana. The morphometric and morphologic features of FS in 126 whole human skulls and 15 skull halves were analyzed, including dimensions, shape, and other anatomical variations, as well as relationships to surrounding structures. Measurements were done with a digital sliding caliper.
Results
The mean length and width of the FS were 2.45 ± 0.65 mm and 2.03 ± 0.53 mm on the right side and 2.49 ± 0.61 mm and 2.08 ± 0.48 mm on the left side. The most frequently observed shape was round (56.7%), followed by oval (28.2%), irregular (8.7%) and drop shaped (6.3%). Several anatomical variations were also noted, including FS duplication, confluences with other foramina, and FS obstruction due to marginal bony outgrowths.
Conclusion
The FS exhibits notable interindividual differences in anatomical characteristics which should be considered during neurosurgical procedures and radiological interventions in the skull base.A machine learning-based model for clinical prediction of distal metastasis in chondrosarcoma: a multicenter, retrospective studyhttps://peerj.com/articles/164852023-12-182023-12-18Jihu WeiShijin LuWencai LiuHe LiuLin FengYizi TaoZhanglin PuQiang LiuZhaohui HuHaosheng WangWenle LiWei KangChengliang YinZhe Feng
Background
The occurrence of distant metastases (DM) limits the overall survival (OS) of patients with chondrosarcoma (CS). Early diagnosis and treatment of CS remains a great challenge in clinical practice. The aim of this study was to investigate metastatic factors and develop a risk stratification model for clinicians’ decision-making.
Methods
Six machine learning (ML) algorithms, including logistic regression (LR), plain Bayesian classifier (NBC), decision tree (DT), random forest (RF), gradient boosting machine (GBM) and extreme gradient boosting (XGBoost). A 10-fold cross-validation was performed for each model separately, multicenter data was used as external validation, and the best (highest AUC) model was selected to build the network calculator.
Results
A total of 1,385 patients met the inclusion criteria, including 82 (5.9%) patients with metastatic CS. Multivariate logistic regression analysis showed that the risk of DM was significantly higher in patients with higher pathologic grades, T-stage, N-stage, and non-left primary lesions, as well as those who did not receive surgery and chemotherapy. The AUC of the six ML algorithms for predicting DM ranged from 0.911–0.985, with the extreme gradient enhancement algorithm (XGBoost) having the highest AUC. Therefore, we used the XGB model and uploaded the results to an online risk calculator for estimating DM risk.
Conclusions
In this study, combined with adequate SEER case database and external validation with data from multicenter institutions in different geographic regions, we confirmed that CS, T, N, laterality, and grading of surgery and chemotherapy were independent risk factors for DM. Based on the easily available clinical risk factors, machine learning algorithms built the XGB model that predicts the best outcome for DM. An online risk calculator helps simplify the patient assessment process and provides decision guidance for precision medicine and long-term cancer surveillance, which contributes to the interpretability of the model.
Background
The occurrence of distant metastases (DM) limits the overall survival (OS) of patients with chondrosarcoma (CS). Early diagnosis and treatment of CS remains a great challenge in clinical practice. The aim of this study was to investigate metastatic factors and develop a risk stratification model for clinicians’ decision-making.
Methods
Six machine learning (ML) algorithms, including logistic regression (LR), plain Bayesian classifier (NBC), decision tree (DT), random forest (RF), gradient boosting machine (GBM) and extreme gradient boosting (XGBoost). A 10-fold cross-validation was performed for each model separately, multicenter data was used as external validation, and the best (highest AUC) model was selected to build the network calculator.
Results
A total of 1,385 patients met the inclusion criteria, including 82 (5.9%) patients with metastatic CS. Multivariate logistic regression analysis showed that the risk of DM was significantly higher in patients with higher pathologic grades, T-stage, N-stage, and non-left primary lesions, as well as those who did not receive surgery and chemotherapy. The AUC of the six ML algorithms for predicting DM ranged from 0.911–0.985, with the extreme gradient enhancement algorithm (XGBoost) having the highest AUC. Therefore, we used the XGB model and uploaded the results to an online risk calculator for estimating DM risk.
Conclusions
In this study, combined with adequate SEER case database and external validation with data from multicenter institutions in different geographic regions, we confirmed that CS, T, N, laterality, and grading of surgery and chemotherapy were independent risk factors for DM. Based on the easily available clinical risk factors, machine learning algorithms built the XGB model that predicts the best outcome for DM. An online risk calculator helps simplify the patient assessment process and provides decision guidance for precision medicine and long-term cancer surveillance, which contributes to the interpretability of the model.Diagnostic value of albumin/fibrinogen ratio and C-reactive protein/albumin/globulin ratio for periprosthetic joint infection: a retrospective studyhttps://peerj.com/articles/166622023-12-152023-12-15Wei JiZemiao LiuTao Lin
Background
The study aims to explore diagnostic value of albumin/fibrinogen ratio (AFR) and C-reactive protein (CRP)/albumin (ALB)/globulin (GLO) ratio (CAGR) for periprosthetic joint infection (PJI).
Methods
A retrospective analysis was conducted on clinical data collected from 190 patients who had joint replacement surgery in Qilu Hospital of Shandong University (Qingdao), from January 2017 to December 2022. Based on the occurrence of PJI after surgery, patients were divided as an infection group (10 cases) and non-infection group (180 cases). Diagnostic indicators were analyzed, univariate and multivariate logistic regression analyses were further performed to identify factors related to PJI. Sensitivity and specificity of AFR and CAGR, both individually and in combination, were calculated using ROC curves, and their diagnostic performance was compared based on the area under the curve (AUC).
Results
Levels of CRP, ESR, FIB, GLO, and CAGR were significantly higher in the infection group than in non-infection group (P < 0.05). Levels of ALB and AFR were significantly lower in infection group (P < 0.05). Multivariate logistic regression analysis reviewed that CRP (OR = 3.324), ESR (OR = 2.118), FIB (OR = 3.142), ALB (OR = 0.449), GLO (OR = 1.985), AFR (OR = 0.587), and CAGR (OR = 2.469) were factors influencing PJI (P < 0.05). The AUC for AFR and CAGR in diagnosing PJI were 0.739 and 0.780, while AUC for their combined detection was 0.858.
Conclusion
Abnormal levels of AFR and CAGR are associated with PJI, and their combined use has certain diagnostic value for PJI.
Background
The study aims to explore diagnostic value of albumin/fibrinogen ratio (AFR) and C-reactive protein (CRP)/albumin (ALB)/globulin (GLO) ratio (CAGR) for periprosthetic joint infection (PJI).
Methods
A retrospective analysis was conducted on clinical data collected from 190 patients who had joint replacement surgery in Qilu Hospital of Shandong University (Qingdao), from January 2017 to December 2022. Based on the occurrence of PJI after surgery, patients were divided as an infection group (10 cases) and non-infection group (180 cases). Diagnostic indicators were analyzed, univariate and multivariate logistic regression analyses were further performed to identify factors related to PJI. Sensitivity and specificity of AFR and CAGR, both individually and in combination, were calculated using ROC curves, and their diagnostic performance was compared based on the area under the curve (AUC).
Results
Levels of CRP, ESR, FIB, GLO, and CAGR were significantly higher in the infection group than in non-infection group (P < 0.05). Levels of ALB and AFR were significantly lower in infection group (P < 0.05). Multivariate logistic regression analysis reviewed that CRP (OR = 3.324), ESR (OR = 2.118), FIB (OR = 3.142), ALB (OR = 0.449), GLO (OR = 1.985), AFR (OR = 0.587), and CAGR (OR = 2.469) were factors influencing PJI (P < 0.05). The AUC for AFR and CAGR in diagnosing PJI were 0.739 and 0.780, while AUC for their combined detection was 0.858.
Conclusion
Abnormal levels of AFR and CAGR are associated with PJI, and their combined use has certain diagnostic value for PJI.Association between osteoporosis and cardiovascular disease in elderly people: evidence from a retrospective studyhttps://peerj.com/articles/165462023-12-082023-12-08Xiaoying HuShucan MaLiman ChenChunhui TianWeiwei Wang
Objective
This study aimed to investigate the associations between osteoporosis, biochemical indexes, bone mineral density (BMD), and cardiovascular disease.
Methods
A cross-sectional study design was used to examine the relationships between these parameters. Logistic regression and correlation analyses were conducted to assess the associations between elevated levels of triglyceride, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), homocysteine, and the presence of osteoporosis. Additionally, correlations between BMD and biochemical indexes were analyzed. The incidence of cardiovascular disease and its correlation with BMD were evaluated. Receiver operating characteristic (ROC) analysis was performed to determine the utility of BMD in identifying cardiovascular disease.
Results
The results revealed that elevated triglyceride, total cholesterol, and LDL levels were positively associated with osteoporosis, while higher HDL levels and homocysteine were negatively associated. Correlation analysis demonstrated negative correlations between triglyceride levels and BMD, and positive correlations between total cholesterol and HDL levels with BMD. LDL levels showed a weak negative correlation, and homocysteine levels exhibited a strong negative correlation with BMD. The osteoporosis group had lower BMD and a higher incidence of cardiovascular disease compared to the non-osteoporosis group. Logistic regression analysis confirmed the correlation between lower BMD and increased risk of cardiovascular disease.
Conclusion
This study provides evidence supporting the associations between osteoporosis, biochemical indexes, BMD, and cardiovascular disease. Aberrations in lipid profiles and homocysteine levels may contribute to osteoporosis development. Lower BMD, particularly in individuals with osteoporosis, appears to increase the risk of cardiovascular disease. BMD shows promise as a diagnostic tool for identifying individuals at risk of cardiovascular disease. Further research is needed to elucidate the underlying mechanisms and establish the clinical implications of these relationships. Future longitudinal studies are necessary to determine causality and long-term prognostic implications.
Objective
This study aimed to investigate the associations between osteoporosis, biochemical indexes, bone mineral density (BMD), and cardiovascular disease.
Methods
A cross-sectional study design was used to examine the relationships between these parameters. Logistic regression and correlation analyses were conducted to assess the associations between elevated levels of triglyceride, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), homocysteine, and the presence of osteoporosis. Additionally, correlations between BMD and biochemical indexes were analyzed. The incidence of cardiovascular disease and its correlation with BMD were evaluated. Receiver operating characteristic (ROC) analysis was performed to determine the utility of BMD in identifying cardiovascular disease.
Results
The results revealed that elevated triglyceride, total cholesterol, and LDL levels were positively associated with osteoporosis, while higher HDL levels and homocysteine were negatively associated. Correlation analysis demonstrated negative correlations between triglyceride levels and BMD, and positive correlations between total cholesterol and HDL levels with BMD. LDL levels showed a weak negative correlation, and homocysteine levels exhibited a strong negative correlation with BMD. The osteoporosis group had lower BMD and a higher incidence of cardiovascular disease compared to the non-osteoporosis group. Logistic regression analysis confirmed the correlation between lower BMD and increased risk of cardiovascular disease.
Conclusion
This study provides evidence supporting the associations between osteoporosis, biochemical indexes, BMD, and cardiovascular disease. Aberrations in lipid profiles and homocysteine levels may contribute to osteoporosis development. Lower BMD, particularly in individuals with osteoporosis, appears to increase the risk of cardiovascular disease. BMD shows promise as a diagnostic tool for identifying individuals at risk of cardiovascular disease. Further research is needed to elucidate the underlying mechanisms and establish the clinical implications of these relationships. Future longitudinal studies are necessary to determine causality and long-term prognostic implications.Relationship between isokinetic strength of the knee joint and countermovement jump performance in elite boxershttps://peerj.com/articles/165212023-12-062023-12-06Chao ChenZhalel AliMuhammad Abdul Rehman RashidMarchibayeva Ulbossyn SamethanovnaGuodong WuSagidolla MukhametkaliTussipkan Dilnur
Background
The lower limbs play a key role to develop the linear momentum for hitting power in effective boxing. The knee extensor and flexor strength guarantees the dynamic stability of boxers. The insufficient extensor strength of the lower extremities causes compensation during flexion resulting in movement errors or damage to knee joint muscles. This study was conducted to explore the isokinetic concentric strength of the knee flexor and extensor and the relationship between isokinetic knee extensors strength and countermovement jump (CMJ) performance in elite boxers.
Methods
Thirteen elite male boxers (Age: 25.15 ± 3.98 years, height 1.72 ± 0.04 m, weight 61.82 ± 10.46 kg, training years = 11.56 ± 2.67 years) performed the CMJ, and the isokinetic knee test was performed using the Biodex dynamometer.
Results
The maximal isokinetic peak torque of the knee extensor and flexor muscles was recorded at three angular velocities (60°/s, 180°/s, and 240°/s) on both sides of the legs. The relative peak value of torque in the knee extensors decreased significantly with increasing angular velocity. A difference in relative peak torque (RPT) was only seen at 60°/s in knee flexors. However, the H/Q ratio increased as the velocity increased from 60°/s to 240°/s (P < 0.05). The highest peak torque was found in the knee extensors at a velocity of 240°/s (r = 0.73, P < 0.001). The correlation between RPT and vertical jump height was the strongest at 240°/s. The strongest relationship was found between the height of the CMJ and the RPT of the deficit of knee extensors.
Conclusions
We suggest that explosive force training of the isokinetic muscles should be optimally carried out at a speed of 240°/s. The results of this study provide a reference for boxers to improve their jump height and lower-limb explosive strength through isokinetic strength training of the knee flexor and extensor.
Background
The lower limbs play a key role to develop the linear momentum for hitting power in effective boxing. The knee extensor and flexor strength guarantees the dynamic stability of boxers. The insufficient extensor strength of the lower extremities causes compensation during flexion resulting in movement errors or damage to knee joint muscles. This study was conducted to explore the isokinetic concentric strength of the knee flexor and extensor and the relationship between isokinetic knee extensors strength and countermovement jump (CMJ) performance in elite boxers.
Methods
Thirteen elite male boxers (Age: 25.15 ± 3.98 years, height 1.72 ± 0.04 m, weight 61.82 ± 10.46 kg, training years = 11.56 ± 2.67 years) performed the CMJ, and the isokinetic knee test was performed using the Biodex dynamometer.
Results
The maximal isokinetic peak torque of the knee extensor and flexor muscles was recorded at three angular velocities (60°/s, 180°/s, and 240°/s) on both sides of the legs. The relative peak value of torque in the knee extensors decreased significantly with increasing angular velocity. A difference in relative peak torque (RPT) was only seen at 60°/s in knee flexors. However, the H/Q ratio increased as the velocity increased from 60°/s to 240°/s (P < 0.05). The highest peak torque was found in the knee extensors at a velocity of 240°/s (r = 0.73, P < 0.001). The correlation between RPT and vertical jump height was the strongest at 240°/s. The strongest relationship was found between the height of the CMJ and the RPT of the deficit of knee extensors.
Conclusions
We suggest that explosive force training of the isokinetic muscles should be optimally carried out at a speed of 240°/s. The results of this study provide a reference for boxers to improve their jump height and lower-limb explosive strength through isokinetic strength training of the knee flexor and extensor.The clinical value of the Duke Anesthesia Resistance Scale in predicting postoperative delirium after hip fracture surgery: a retrospective studyhttps://peerj.com/articles/165352023-12-042023-12-04Yaya WangYan’an JiangHuajun FuYikang ZhaoZhao Xu
Aim
This study aims to investigate the clinical value of the Duke Anesthesia Resistance Scale (DARS) in predicting postoperative delirium (POD) after hip fracture surgery.
Methods
A retrospective study was conducted. Clinical data were collected from the patients who had hip fracture and underwent elective total hip arthroplasty in Shaanxi Provincial People’s Hospital, Third Affiliated Hospital of Xi’an Jiaotong University between January 2022 and June 2023. The Consciousness Fuzzy Assessment Scale was used to evaluate the occurrence of POD on postoperative day 3 (POD 3). The enrolled patients were divided into the POD group (n = 26) and the non-POD group (n = 125). Baseline characteristics, surgical data, postoperative information, and laboratory test results were collected. DARS scores were calculated using the minimum alveolar concentration, end-tidal concentration average (ETAC), and bispectral index (BIS). Multivariate logistic regression analysis was conducted to recognize the independent risk factors for POD after hip fracture surgery. Receiver operating characteristic (ROC) curve was plotted to evaluate the value of DARS in POD prediction.
Results
The average age of POD group was significantly higher, comparing to non-POD group (P < 0.05). DARS scores were statistically lower in the POD group compared to non-POD group (P < 0.05). Multivariate logistic regression analysis found that age and DARS scores were factors impacting post-operative delirium occurrence after hip fracture surgery (P < 0.05). ROC showed that the area under the curve for DARS in predicting POD after hip fracture surgery was 0.929 (95% CI [0.861–0.997]). The optimal cutoff value was 30. The sensitivity was 95.45%, while the specificity was 84.09%.
Conclusion
DARS score demonstrates good predictive value in hip fracture patients and is feasible in clinical practice, making it suitable for clinical application and promotion.
Aim
This study aims to investigate the clinical value of the Duke Anesthesia Resistance Scale (DARS) in predicting postoperative delirium (POD) after hip fracture surgery.
Methods
A retrospective study was conducted. Clinical data were collected from the patients who had hip fracture and underwent elective total hip arthroplasty in Shaanxi Provincial People’s Hospital, Third Affiliated Hospital of Xi’an Jiaotong University between January 2022 and June 2023. The Consciousness Fuzzy Assessment Scale was used to evaluate the occurrence of POD on postoperative day 3 (POD 3). The enrolled patients were divided into the POD group (n = 26) and the non-POD group (n = 125). Baseline characteristics, surgical data, postoperative information, and laboratory test results were collected. DARS scores were calculated using the minimum alveolar concentration, end-tidal concentration average (ETAC), and bispectral index (BIS). Multivariate logistic regression analysis was conducted to recognize the independent risk factors for POD after hip fracture surgery. Receiver operating characteristic (ROC) curve was plotted to evaluate the value of DARS in POD prediction.
Results
The average age of POD group was significantly higher, comparing to non-POD group (P < 0.05). DARS scores were statistically lower in the POD group compared to non-POD group (P < 0.05). Multivariate logistic regression analysis found that age and DARS scores were factors impacting post-operative delirium occurrence after hip fracture surgery (P < 0.05). ROC showed that the area under the curve for DARS in predicting POD after hip fracture surgery was 0.929 (95% CI [0.861–0.997]). The optimal cutoff value was 30. The sensitivity was 95.45%, while the specificity was 84.09%.
Conclusion
DARS score demonstrates good predictive value in hip fracture patients and is feasible in clinical practice, making it suitable for clinical application and promotion.