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Knee osteoarthritis is a prevalent joint disease affecting millions of individuals globally. While total knee arthroplasty is an effective treatment for advanced stages of KOA, it may not be suitable for earlier stages or younger patients. Supervised exercise therapy has proven to be the first-line treatment of preference in tackling pain and disability caused by KOA. However, the high intensities required to induce positive muscle adaptations are not indicated in this population, as this is often accompanied by pain, discomfort, and frustration, leaving low-load resistance training as the only feasible method of treatment. Recently, the use of blood flow restriction training has begun to emerge as a substitute for high-load resistance training. With BFRT, a cuff is applied around the proximal aspect of the affected limb, causing partial arterial and full venous occlusion, thereby inducing localized hypoxia and the accumulation of metabolites, mimicking the effects of high-load resistance training, albeit with low loads. Consequently, BFRT might offer a suitable and more effective alternative for KOA patients who are not (yet) eligible for TKA compared to traditional exercise therapy. This review aims to summarize the current evidence as regards the application of Blood Flow Restriction in exercise therapy for knee osteoarthritis patients, with particular consideration of the underlying mechanisms and its safety, as well as general guidelines for practical implementation in clinical practice. In doing so, this narrative review aims to create a framework for translating from theory into practice. [ABSTRACT FROM AUTHOR]

Context: Although training with an aquabag (AB) has gained popularity, there is a lack of evidence of its effect. This study wanted to evaluate the effect of AB implementation on muscle activity of core and lower limb muscles during 3 functional exercises. Design: Cross-sectional observational study. Methods: Twenty healthy subjects performed a squat, lunge, and step-up, while using a stick and an AB. Surface electromyography signals were recorded from the trunk, pelvis, and thigh muscles in the dominant leg. Linear-mixed models were used to analyze the normalized surface electromyography signals. Results: Results demonstrated a significant increase in muscle activity of the back muscles during all 3 exercises (P<.00l to P=.003), abdominals during squat (P = .034) and step-up (P = .046), hamstrings during lunge (P = .008) and step-up (P = .008), and gluteal muscles during lunge (P < .001 and P = .010, respectively). Conclusions: These results indicate that an AB promotes functional strength training by demanding compensatory/additional activity of both stabilizing muscles (specifically in the core and pelvis regions) and prime movers of the lower limb. The authors recommend the use of an AB to enhance training and rehabilitation effects. [ABSTRACT FROM AUTHOR]

Hamstring strain injuries (HSI) are still the most common injuries in soccer. Recent research has been focusing on the role of hamstring muscle morphology and architecture. The hamstring's fibre type composition might play a role as well, but this has never been investigated in the light of HSI risk in an athletic population. The purpose of this study was to investigate the association between hamstring muscle fibre type, hamstring strain injury history (HSIH), performance and isokinetic strength in a population of amateur male soccer players. In this cross-sectional observational study, 44 male soccer players (22 with and 22 without HSIH) participated. The research consisted of a non-invasive fibre composition evaluation using proton magnetic resonance spectroscopy (1H-MRS), functional performance (evaluated by means of maximal jumping height, maximal sprinting speed and hamstring muscle strength endurance (single leg hamstring bridge testing)), and isokinetic strength testing. The results revealed that hamstring carnosine concentration demonstrated a high inter-individual variability within this soccer population and was not significantly associated with either HSIH or with any of the functional performance parameters. The only secondary outcome measure presenting a significant association with the intramuscular carnosine content was the hamstrings' explosive strength production capacity, objectified by means of the time to peak torque (TPT), measured concentrically at an angular velocity of 240 degrees/second (°/s) during isokinetic strength testing. This TPT was significantly shorter in players presenting higher carnosine concentrations (p = 0.044). The findings indicate that in male amateur soccer players (1) the hamstrings have no distinct fibre type dominance and (2) fibre typology in this population does not relate to HSIH or performance. [ABSTRACT FROM AUTHOR]

Although isokinetic strength testing is commonly used in hamstring strain injury (HSI) rehabilitation and prevention, research findings concerning its predictive value remain inconclusive. Existing research focuses on peak torque (PT) and angle of PT, not analysing the torque behaviour throughout the testing range of motion (ROM). This study intended to assess the value of isokinetic curve evaluation in association with HSI. A sample of 116 male football players with and without a recent HSI history was submitted to bilateral isokinetic assessment of the knee and hip muscles. Raw isokinetic data were filtered and normalized prior to curve analysis submission in MATLAB. Torque development of each muscle group throughout the entire testing ROM was assessed using HSI history as an independent variable. Curve analysis revealed significant differences in torque behaviour in function of injury history. Players with an HSI history demonstrated significantly stronger concentric knee flexion and extension, eccentric knee extension and concentric hip extension patterns compared to the controls and their uninjured limb. HSI history was also associated with lower concentric hip flexion torques and lower mixed H:Q ratios compared to the control group and their contralateral limb. HSI history was associated with altered knee and hip muscle strength profiles, potentially due to isolated focus on local strength training in rehabilitation or mechanisms of neuromuscular inhibition. Because the differences in torque amplitude were range-dependent and did not systematically concur with the point of PT achievement, isokinetic strength evaluation should most probably be conducted using curve analysis. [ABSTRACT FROM AUTHOR]

Background: Rates of reinjury, return to play (RTP) at the preinjury level, and hamstring strain injuries in male soccer players after anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, due to multifactorial causes. Recent insights on intramuscular hamstring coordination revealed the semitendinosus (ST) to be of crucial importance for hamstring functioning, especially during heavy eccentric hamstring loading. Scientific evidence on the consequences of ST tendon harvest for ACLR is scarce and inconsistent. This study intended to investigate the repercussions of ST harvest for ACLR on hamstring muscle function. Hypothesis: Harvest of the ST tendon for ACLR was expected to have a significant influence on hamstring muscle activation patterns during eccentric exercises, evaluated at RTP in a population of male soccer athletes. Study Design: Controlled laboratory study. Methods: A total of 30 male soccer players with a history of ACLR who were cleared for RTP and 30 healthy controls were allocated to this study during the 2018-2019 soccer season. The influence of ACLR on hamstring muscle activation patterns was assessed by comparing the change in T2 relaxation times [ΔT2 (%) = post − exercise − T 2 pre − exercise T 2 pre − exercise ] of the hamstring muscle tissue before and after an eccentric hamstring loading task between athletes with and without a recent history of ACLR through use of muscle functional magnetic resonance imaging, induced by an eccentric hamstring loading task between scans. Results: Significantly higher exercise-related activity was observed in the biceps femoris (BF) of athletes after ACLR compared with uninjured control athletes (13.92% vs 8.48%; P =.003), whereas the ST had significantly lower activity (19.97% vs 25.32%; P =.049). Significant differences were also established in a within-group comparison of the operated versus the contralateral leg in the ACLR group (operated vs nonoperated leg: 14.54% vs 11.63% for BF [ P =.000], 17.31% vs 22.37% for ST [ P =.000], and 15.64% vs 13.54% for semimembranosus [SM] [ P =.014]). Neither the muscle activity of SM and gracilis muscles nor total posterior thigh muscle activity (sum of exercise-related ΔT2 of the BF, ST, and SM muscles) presented any differences in individuals who had undergone ACLR with an ST tendon autograft compared with healthy controls. Conclusion: These findings indicate that ACLR with a ST tendon autograft might notably influence the function of the hamstring muscles and, in particular, their hierarchic dimensions under fatiguing loading circumstances, with increases in relative BF activity contribution and decreases in relative ST activity after ACLR. This between-group difference in hamstring muscle activation pattern suggests that the BF partly compensates for deficient ST function in eccentric loading. These alterations might have implications for athletic performance and injury risk and should probably be considered in rehabilitation and hamstring injury prevention after ACLR with a ST tendon autograft. [ABSTRACT FROM AUTHOR]

Abstract Introduction Auto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars. However, little is known about the precise role of the periodontal membrane during this procedure. Therefore, we investigated if the epithelial rests of Malassez persist in the periodontal ligament of auto-transplanted teeth and, if so, whether these may show signs of a neuro-epithelial relationship. Case presentation We report a case of a 21-year-old Caucasian woman who underwent an auto-transplantation of two third molars. After two years, renewed progressive caries of the auto-transplanted teeth led to the removal of the auto-transplanted elements. The periodontal ligament was removed and studied with a light and transmission electron microscope. Conclusion In this report we examined the ultrastructure of the periodontal ligament after auto-transplantation in order to see if the periodontal ligament recovers completely from this intervention. We observed fully developed blood vessels and a re-innervation of the epithelial rests of Malassez which were proliferating following auto-transplantation. This proliferation might be critical in the remodelling of the alveolar socket in order to provide a perfect fit for the transplanted tooth. In order to minimalise the damage to the epithelial rests of Malassez, the extraction of the tooth should be as atraumatic as possible in order to provide an optimal conservation of the periodontal ligament which will be beneficial to the healing-process.

Hamstring injury prevention puts emphasis on optimizing the muscle's strength–length relationship. To assure appropriate muscle length, flexibility training is imperative. As neurodynamics play an important role herein, the goal of this study was to explore the intervention effect of home-based neurodynamic slider program on hamstring flexibility. Fifty physically active male subjects were randomly assigned to either performing a neurodynamic sliding technique (3 × 20 reps) or a static stretching protocol (3 × 30″) on a daily basis for a 6-week period. Hamstring flexibility was assessed by means of the Straight Leg Raise at baseline, immediately after the intervention and after 4 weeks follow up. There was no between group baseline difference in hamstring flexibility. The repeated measure ANOVA showed a significant interaction effect for group × time (p < 0.001). Independent sample t-test showed a significantly higher increase in flexibility gain in the neurodynamic group immediately after the intervention (p < 0.001), as well as at 4 weeks retention analysis (p = 0.001) compared to the static stretch group. In conclusion, neurodynamic sliders might be more efficient than regular static stretching in affecting hamstring flexibility in the long run. [ABSTRACT FROM AUTHOR]

Introduction: Stretching and strengthening exercises are commonly used to improve muscle tightness. The objective of this trial was to compare the electromyography (EMG) activities of the shortened hamstring in chronic non-specific LBP patients after 12 sessions of static stretching or strengthening exercise. Methods: Forty-five patients were randomly allocated to either of three groups. All patients received the heat and transcutaneous electrical stimulation to the low back area. Also, specific interventions for (1) Static stretching group (n = 15), (2) Strengthening of hamstring muscle in its lengthened position group (n = 15) and no extra intervention for (3) Control group (n = 15) were applied. Blinded assessments of EMG of hamstring, disability and pain were undertaken at baseline and 12 sessions of interventions. Results: No significant difference in change in EMG records due to intervention was found between the three groups (p >.05). Comparing the post-intervention with the baseline results, change in hamstring EMG activity in the three groups was not different significantly (p >.05). Moreover, the result of comparison between groups did not show any significant differences in the mean of secondary outcome measures (pain and disability) either (p >.05). Conclusions: Neither static stretching nor strengthening exercise in the lengthened position for hamstring muscle tightness significantly affected EMG activity of this muscle. [ABSTRACT FROM AUTHOR]