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Biomedical subjects

A Junge

Publications and source records attributed to A Junge.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Results of early mobilisation of acute whiplash injuries].

BACKGROUND: Diagnostic evaluation and therapeutic management of acute neck pain after whiplash is a frequent but unsolved clinical problem. Long-lasting symptoms and disability are common. Former studies proposed beneficial effects of physiotherapy in the early management of whiplash injury. The purpose of this study was to assess the effects of early active mobilization versus standard treatment with a soft cervical collar. METHODS: Between August 1997 and February 2000 a prospective randomized clinical trial with a total of 168 patients was performed. Of these patients 81 (31 male, 50 female; average age 28,78 years) were randomly assigned to the standard therapy group, which received a soft cervical collar, and 87 (31 male, 56 female; average age 29,62 years) to the early mobilization group, treated by physiotherapy. Study participants documented pain and disability twice (baseline and six week follow-up) during a one week period by diary, using numeric rating scales ranging from 0 to 10. RESULTS: The initial mean pain intensity (4,75) reported by the standard therapy group was similar to disability (4,76). There were no significant differences to initial pain (4,50) and disability (4,39) reported by the early mobilization group. The mean pain intensity reported by the standard therapy group after 6 weeks was 2,66 and disability was 2,40. The mean pain intensity indicated by physiotherapy group was 1,44 and mean disability was 1,29. The differences between the groups were both significant. CONCLUSIONS: Early mobilization is superior to the standard therapy regarding pain intensity and disability. We conclude that mobilization should be recommended as the new adequate standard-therapy in the acute management of whiplash injury.

Adult↗
PubMed2002

[Dislocation of the pisiform bone. A review of the literature].

Dislocation of the pisiform bone is extremely rare. So far, only 25 cases proved by radiographs have been reported. The sturdiness and stability of its ligamentous attachments may explain why dislocations of the pisiform are so rare. Often the dislocation is the result of direct trauma to the palmar and ulnar aspect of the wrist and less frequently due to indirect force or forceful muscular contraction. Dislocation of the pisiform bone occurs predominantly in young and active males. Usually, the pisiform is dislocated proximally or distally. The diagnosis is made by plain radiography. Operative treatment with pisiform excision and meticulous reapproximation of the attached soft-tissue structures yielded the most reliable results with preservation of wrist-flexion strength. Thus, although being very heterogenous with regard to mechanism of injury and displacement, pisiform dislocations should receive uniform treatment to obtain predictable results.

Carpal Bones↗
PubMed2001

Posterior atlanto-occipital dislocation and concomitant discoligamentous C3-C4 instability with survival.

STUDY DESIGN: A case report is presented. OBJECTIVES: To describe the diagnostic procedure, treatment, and outcome of a 56-year-old man with posterior atlanto-occipital dislocation and concomitant discoligamentous C3-C4 instability. CASE REPORT: A 56-year-old male seat-belted driver of a car was involved in an accident. After initial spontaneous breathing and weak movements of all his extremities, artificial respiration became necessary because of increasing respiratory insufficiency. Radiologic diagnostics, including computed tomography scans, showed a posterior atlanto-occipital dislocation and a Grade 2 craniocerebral trauma with occipital subarachnoidal bleeding. Further examination showed a serial rib fracture with concomitant hemopneumothorax. After stabilization of the patient, magnetic resonance imaging of the cervical spine showed a contusion of the upper cervical spinal cord. Additionally, rupture of the interspinal ligaments and the posterior longitudinal ligament could be seen, as well as a rupture of the intervertebral C3-C4 disc. Operative stabilization was performed by posterior fusion of C0-C4 using the CerviFix-System and autogenous bone grafts taken from the iliac crest. At 12 months after the operation, the patient had only slight weakness of the left arm and a 70% limitation in the range of motion of the cervical spine. CONCLUSIONS: With improvements in advanced trauma life support, the number of patients with atlanto-occipital dislocation admitted to hospital alive is increasing, so this particular lesion must be kept in mind. When the patient survives the accident, the long-term prognosis is quite good, with a high rate of recovery after initial neurologic deficits.

Accidents, Traffic↗
PubMed2001

Genetic variation and population genetic data of the short tandem repeat locus D8S320.

The locus D8S320 is an STR system first described in 1993 as a simple (AAAG) repeat. Sequencing data revealed that the D8S320 locus is a complex STR system consisting of (AAAG)- and (AAAC)-repeat units. A total of 22 different alleles were found in a population survey of 210 unrelated individuals from the Rhine area with frequencies ranging from <0.01 to 0.198. The population data revealed the existence of variant alleles differing by 1 and 2bp from the consensus allele. Due to the complex repeat structure consisting of three variable regions and one constant region, electrophoresis under denaturing conditions is strongly recommended. The statistical values were calculated to be 0.89 (observed heterozygosity rate), 0.96 (discrimination index) and 0.71 (mean exclusion chance). No deviation from Hardy-Weinberg equilibrium (HWE) was observed.

Base Sequence↗
PubMed2001

Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy.

DESIGN: Cross-sectional analysis of the factors influencing self-rated disability associated with chronic low back pain and prospective study of the relationship between changes in each of these factors and in disability following active therapy. OBJECTIVES: To examine the relative influences of pain, psychological factors, and physiological factors on self-rated disability. SUMMARY OF BACKGROUND DATA: In chronic LBP, the interrelationship between physical impairment, pain, and disability is particularly complicated, due to the influence of various psychological factors and the lack of unequivocal methods for assessing impairment. Investigations using new "belief" questionnaires and "sophisticated" performance tests, which have shown promise as discriminating measures of impairment, may assist in clarifying the situation. Previous studies have rarely investigated all these factors simultaneously. METHODS: One hundred forty-eight patients with cLBP completed questionnaires and underwent tests of mobility, strength, muscle activation, and fatigability, and (in a subgroup) erector spinae size and fiber size/type distribution. All measures were repeated after 3 months active therapy. Relationships between each factor and self-rated disability (Roland and Morris questionnaire) at baseline, and between the changes in each factor and changes in disability following therapy, were examined. RESULTS: Stepwise linear regression showed that the most significant predictors of disability at baseline were, in decreasing order of importance: pain; psychological distress; fear-avoidance beliefs; muscle activation levels; lumbar range of motion; gender. Only changes in pain, psychological distress, and fear-avoidance beliefs significantly accounted for the changes in disability following therapy. CONCLUSION: A combination of pain, psychological and physiological factors was best able to predict baseline disability, although its decrease following therapy was determined only by reductions in pain and psychological variables. The active therapy program-in addition to improving physical function-appeared capable of modifying important psychological factors, possibly as a result of the positive experience of completing the prescribed exercises without undue harm.

Adaptation, Psychological↗
PubMed2001

[Arthroscopic diagnosis of concomitant scapholunate ligament injuries in fractures of the distal radius].

To investigate the occurrence of carpal ligamentous injuries in patients with fractures of the distal radius, the results of 122 wrist arthroscopies were analysed within a retrospective study. Indications for arthroscopy included suspected carpal instability according to radiographic findings and/or the necessity for internal fixation of the radius fracture. Arthroscopy revealed acute scapholunate ligament tears in 84 patients. Scapholunate separation was found to be of prognostic value for ligament tears. There was no association between ligamentous lesions and carpal angles or fracture dislocation. Scapholunate ligament tears were most frequent in sagittal articular fractures. In these cases, wrist arthroscopy should be performed during operative treatment of the radius fracture to allow direct visualization and subsequent repair of ligamentous tears.

Adolescent↗
PubMed2001

[Primary arthroscopic treatment of TFCC tears in fractures of the distal radius].

The primary simultaneous diagnosis and therapy of TFCC tears in distal radius fractures is still the exception. We present our results of arthroscopic treatment of these injuries. From January 1998 until September 1999, we treated 21 patients with a type C fracture (AO classification) of the distal radius and one patient with a scaphoid fracture and TFCC tears. The Palmer 1A (n = 5) and 1 C (n = 4) tears have been arthroscopically shaved as well as the meniscal tear (n = 1). The Palmer 1B tears were refixed either in an outside-inside technique (n = 6) or in a new all-inside technique (n = 6). Palmer 1D tears were refixed in the Fellinger technique (n = 5). In the clinical follow-up examination six to fifteen months later, we saw symptoms of ulnar-sided wrist pain only in one case of a Palmer 1B tear treated in an outside-inside technique. Especially the patients treated by the new all-inside technique were free from symptoms of TFCC instability. We conclude, that arthroscopic treatment of TFCC tears in acute radius fractures is possible with good results. The new technique of all-inside repair is minimally invasive and shows good results.

Adolescent↗
PubMed2000

Is it possible to differentiate mtDNA by means of HVIII in samples that cannot be distinguished by sequencing the HVI and HVII regions?

The mitochondrial control region includes three so-called hypervariable (HV) regions, in which the polymorphic positions show a particularly high frequency. According to a population study of 200 unrelated individuals from Germany, HVI (positions 16,024-16,365, according to Anderson) showed 88 variable positions in a total length of 342 bp (26%) and HVII (positions 73-340) displayed 65 mutable sites in 268 bp (24%). HVIII (positions 438-574) exhibited a slightly lower variability, with 25 polymorphic sites within 137 bp (18%), but contrasted clearly with the background, which showed variability rates of only 7% (positions 16,366-16,569, 1-72) and 3% (positions 341-437), respectively. At present, the displacement (D)-loop database in Magdeburg comprises 904 sequences of the mitochondrial HVI region and HVII region from Germans, Austrians and Swiss. By means of this material, the extent to which the mtDNA sequences that do not differ in the HVI and HVII regions can be differentiated by additionally sequencing HVIII was investigated.

Austria↗
PubMed2000

The influence of psychological factors on sports injuries. Review of the literature.

The influence of psychological factors on sports injuries has been demonstrated in numerous empirical studies. Almost all investigations have been based on stress theory or a personality-profile approach. Although the majority of studies have employed different methods, the results are in general agreement that "life events" can influence the risk of injury in athletes. In this context, social support appears to have a buffering effect. According to existing results, the influence of stress-coping strategies is somewhat questionable. From the numerous psychological attributes that have been investigated in relation to sports injuries, only competitive anxiety has been shown to be associated with injury occurrence. A personality profile typical of the "injury-prone" athlete does not exist. However, several studies have shown a certain readiness to take risks (lack of caution, adventurous spirit) on the part of injured athletes. In this review, the current knowledge regarding the relationship between psychological factors and sports injuries is presented and a stress theory model is developed.

Adaptation, Psychological↗
PubMed2000

Psychological and sport-specific characteristics of football players.

It is hypothesized that players of different levels of play might differ not only in their football skills but also in their way of playing football and with respect to psychological factors such as concentration, reaction time, or competitive anxiety. The psychological characteristics of a player might influence his way of playing football (in particular with respect to fair play) and also his risk of injury. A group of 588 football players were studied by questionnaire; additionally, reaction time tests were performed. Psychological characteristics were assessed by three established self-evaluation questionnaires: the Athletic Coping Skills Inventory, the State Competitive Anxiety Test, and the State-Trait-Anger-Expression-Inventory. Football-specific characteristics that were investigated included playing experience and positions played, style of play, number of training hours and games, as well as aspects of fair play. Reaction time was tested twice: without the influence of physical exercise and immediately after a 12-minute run. A significant reduction in reaction time was observed after physical exercise. In high-level players, the reaction time immediately after the 12-minute run was significantly shorter than it was in low-level players. The questionnaire answers given regarding fair play clearly indicated that fair play is not paid sufficient respect. The relationship between psychological characteristics and attitudes toward fair play was analyzed and discussed.

Adolescent↗
PubMed2000

Assessment and evaluation of football performance.

The most important variables for measuring performance in team sports such as football are physical condition and technical and tactical performance. However, because of the complexity of the game of football it is difficult to ascertain the relative importance of each of these variables. The aim of the present study was to develop a standardized test battery to evaluate physical performance in football players. The F-MARC test battery was designed to closely relate to the football player's normal activity and comprised a functional, structured training session of approximately 2.5 hours. It included a "quality rating" of the warm-up procedure, tests of flexibility, football skills, power, speed, and endurance. The players finished with a cool-down. A total of 588 football players underwent the F-MARC test battery. Mean values for performance on each test are presented for groups of differing age and skill levels. The test battery proved to be a feasible instrument to assess both physical performance and football skills. This study supports the proposal by Balsom (1994) that analysis of an individual player's physical profile, in relation to mean values for a similar age group and skill level, might be of assistance to the coach in objectively evaluating the effects of a specific training program. It may also be of use to the physician and physical therapist responsible for monitoring progress during rehabilitation after football injuries.

Adolescent↗
PubMed2000

Football injuries and physical symptoms. A review of the literature.

Football is one of the most popular sports worldwide. The frequency of football injuries is estimated to be approximately 10 to 35 per 1000 playing hours. The majority of injuries occur in the lower extremities, mainly in the knees and ankles; the number of head injuries is probably underestimated. The average cost for medical treatment per football injury is estimated to be $150 (U.S. dollars). Considering the number of active football players worldwide, the socioeconomic and financial consequences of injury are of such a proportion that a prevention program to reduce the incidence of injuries is urgently required. For this reason, an analysis of intrinsic (person-related) and extrinsic (environment-related) risk factors was undertaken based on a review of the current literature. It was concluded that the epidemiologic information regarding the sports medicine aspects of football injuries is inconsistent and far from complete because of the employment of heterogeneous methods, various definitions of injury, and different characteristics of the assessed teams. The aim of this study was to analyze the literature on the incidence of injuries and symptoms in football players, as well as to identify risk factors for injury and to demonstrate possibilities for injury prevention.

Adolescent↗
PubMed2000

Influence of definition and data collection on the incidence of injuries in football.

Studies on the incidence of football injuries vary in the definition of injury, study design, methods of data collection, and observation periods. The aim of this study was to review the different methodologies applied in the evaluation of football injuries as well as to analyze the influence of data collection methods on the incidence of football injuries. In this study, injury data obtained weekly by a physician during 1 year of follow-up in 264 football players were compared with the results of retrospective questionnaires completed by the players at the end of the observation period. In the retrospective questionnaire, the incidence of injuries as well as of complaints was significantly lower than that found in the weekly follow-up examinations. Approximately every third moderate injury and less than 10% of the mild injuries were remembered retrospectively. The shorter the period of symptoms and the longer ago the injury occurred, the more frequently it was forgotten. However, even severe injuries, such as fractures, were not reported in the retrospective investigation. Based on the review of the literature and the data presented, recommendations in relation to study design, the definition of injury, and the calculation of incidence are proposed.

Adolescent↗
PubMed2000

Incidence of football injuries in youth players. Comparison of players from two European regions.

Several authors have investigated the frequency of football injuries in youth players. However, the results of these studies are inconsistent because of the different age groups investigated and the different methods applied. The aim of the present study was to compare the incidence and characteristics of football injuries in youth players of two European regions. A total of 444 youth players from the Czech Republic and the Alsace region of France and Germany were followed weekly for 1 year. In 311 players (70%), complete weekly follow-ups over the 1-year period were available. The comparison of injury data revealed no substantial differences between players from the Alsace region and the Czech Republic in injury incidence per 1000 hours of exposure, degree of injury severity, or the circumstances in which the injuries occurred. However, players from the Czech Republic spent more time in training and playing football than did players from the Alsace region, and in the Czech Republic a higher proportion of injuries was caused by foul play. With only a few exceptions, the statistics were similar in the amount of football played as well as in the incidence of injury between different age and skill levels in both European regions.

Adolescent↗
PubMed2000

Incidence of football injuries and complaints in different age groups and skill-level groups.

In this study, the incidence of football injuries and complaints as related to different age groups and skill levels was studied over the period of 1 year. All injuries and complaints as well as the amount of time players spent in training and games were recorded. All injured players were examined weekly by physicians, and all injuries were assessed according to the International Classification of Diseases (ICD-10), which describes them in terms of injury type and location, the treatment required, and the duration of subsequent performance limitations. A total of 264 players of different age groups and skill levels was observed for 1 year. Five hundred fifty-eight injuries were documented. Two hundred sixteen players had one or more injuries. Only 48 players (18%) had no injury. The average number of injuries per player per year was 2.1. Injuries were classified as mild (52%), moderate (33%), or severe (15%). Almost 50% of all injuries were contact injuries; half of all the contact injuries were associated with foul play. The majority of injuries were strains and sprains involving the ankle, knee, and lumbar spine. Nearly all players (91%) suffered from complaints related to football. Only 23 players reported no injuries and no complaints. Prevention programs, fair play, and continuing education in techniques and skills may reduce the incidence of injuries over time.

Adolescent↗
PubMed2000

Severe injuries in football players. Influencing factors.

The aims of this prospective study were to analyze factors related to the occurrence of severe football injuries in players of different ages (14 to 42 years) and different skill levels (local teams to first league teams). In the Czech Republic, 398 players were followed up for 1 year, during which time they sustained 686 injuries. Of these, 113 (16.5%) were severe injuries. Ninety-seven severe injuries (86%) were able to be documented in detail. Trauma was the cause of 81.5% of the injuries and overuse was the cause of 18.5%. Joint sprains predominated (30%), followed by fractures (16%), muscle strains (15%), ligament ruptures (12%), meniscal tears and contusions (8%), and other injuries. Injuries to the knee were most prevalent (29%), followed by injuries to the ankle (19%) and spine (9%). More injuries occurred during games (59%) than in practice. Twenty-four percent of the injured players had suffered a previous injury of the same body part. Forty-six percent of injuries were caused by contact and 54% involved no body contact. Thirty-one percent of severe injuries were caused by foul play. From these results and the analysis of injuries in specific body parts, the following factors were determined to influence the occurrence of severe injuries: 1) personal factors (intrinsic): age of player, previous injuries, joint instability, abnormality of the spine, poor physical condition, poor football skills, or inadequate treatment and rehabilitation of injuries; 2) environmental factors (extrinsic): subjective exercise overload during practices and games, amount and quality of training, playing field conditions, equipment (wearing of shin guards and taping) and violations of existing rules (foul play).

Adolescent↗
PubMed2000

Risk factor analysis for injuries in football players. Possibilities for a prevention program.

Review of the literature shows that information concerning risk factors for football injuries is incomplete and partly contradictory. The aim of this study was to analyze the influence of medical history, physical findings, football skills, and football performance, as well as psychosocial characteristics on the occurrence and severity of football injuries. The prospective outline of the study was as follows: after a baseline examination was performed to ascertain possible predictors of injury, all players were followed up weekly for 1 year to register subsequent injuries and complaints. Two hundred sixty-four of 398 players (67%) had complete weekly follow-ups over 1 year. A majority of the players (N = 216; 82%) were injured during the observation period. In comparing injured and uninjured players, several differences were observed. To create a multidimensional predictor score for football injuries, 17 risk factors were selected. These risk factors covered a wide spectrum, such as previous injuries, acute complaints, inadequate rehabilitation, poor health awareness, high life-event stress, playing characteristics, poor reaction time, poor endurance, and insufficient preparation for games. By summing up the individual risk factors, a predictive sum was calculated for each player. The more risk factors present at the baseline examination, the higher the probability of that player incurring an injury in the ensuing year. Using two risk factors as the cut-off score, more than 80% of the players were correctly classified as to whether they went on to incur an injury. Based on these findings, knowledge from the literature, and practical experience, possibilities for a prevention program are suggested.

Adolescent↗