Search

Eturistisidevammojen ennaltaehkäisyyn tähtäävä hermo-lihasharjoitusohjelma voidaan toteuttaa osana alkulämmittelyä ennen harjoittelua. nonPeerReviewed

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient trunk and/or knee flexion, and asymmetry as undesirable movements included on the Scale. An instruction booklet to accompany the Scale was also developed and presented in the thesis. The second study evaluated the reliability and sensitivity to change of several biomechanical parameters during a drop vertical jump measured using a motion capture system, completed by 46 patients after ACL reconstruction. Intraclass correlation coefficients ranged from 0.58-0.90 for peak knee flexion and abduction moments, 0.45-0.85 for knee flexion and abduction angles, 0.61-0.93 for forces and loading rate, and 0.42-0.61 for hip impulse. The standardized response mean for knee flexion angles were 0.38 (peak) and 0.35 (displacement), while other biomechanical measures on the drop vertical jump were ≤0.27. The present results support the interpretation of various landing biomechanics assessed during repeated assessments of patients undergoing rehabilitation after ACL reconstruction. A technical note on the determination of optimal filtering frequency of biomechanical analysis of jump landing was also completed to complement study two and is also presented in the thesis. Residual analysis resulted in a filtering frequency of 14 Hz for markers and 50 Hz for forces. The third study was a randomized clinical trial comparing biomechanics of functional outcome measures in patients undergoing staged (home-based and in-clinic) rehabilitation after ACL reconstruction versus usual care. 125 patients completed a drop vertical jump at 6 and 12 months after ACL reconstruction. Results suggested the staged rehabilitation program can be effective for patients who have the motivation and resources to complete their exercises at home, when detailed instruction by a qualified therapist is provided beforehand. Overall, the findings from this thesis provide an assessment tool to help guide rehabilitation after ACL reconstruction, describe the measurement properties of biomechanical measures in patients undergoing rehabilitation after ACL reconstruction, and supports the implementation of a novel Staged physiotherapy program.

Purpose: Few large-scale population-based studies have adequately examined the relationships between steroid hormones, health status and physical fitness. The purpose of the study was to describe the relationship of serum basal endogenous steroid hormones (testosterone, TES; empirical free testosterone, EFT; cortisol, COR) and sex hormone-binding globulin (SHBG) to body composition, cardiovascular risk factors, and physical fitness in young healthy men. Methods: Male reservists (25 ± 4 years, N = 846) participated in the study. Basal TES, EFT, COR, and SHBG were measured in morning fasted blood. Stepwise regression analyses were used to examine associations between individual hormones to four separate categories: (1) body composition; (2) cardiovascular risk factors; (3) relative, and (4) absolute physical fitness. Results: Higher TES, EFT, and SHBG were associated with lower waist circumference (TES: β = −0.239, p < 0.001; EFT: β = −0.385, p < 0.001), % body fat (TES: β = −0.163, p = 0.003), and body mass index (SHBG: β = −0.435, p < 0.001). Lower cardiovascular risk factors were associated with higher TES, EFT and SHBG concentrations, especially between SHBG and triglycerides (β = −0.277, p < 0.001) and HDL (β = 0.154, p < 0.001). Greater maximal relative aerobic capacity was concurrent with higher TES, EFT, and SHBG (β = 0.171, 0.113, 0.263, p < 0.001, =0.005