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Biomedical subjects

K M Khan

Publications and source records attributed to K M Khan.

At least 37 records · Page 2Linked to original sources
PubMed2004

The role of balance and agility training in fall reduction. A comprehensive review.

AIM: In the elderly, falls and fall-related injuries are a major problem worldwide and the number of injuries are continuing to increase. It is well established that stability requires a well-functioning muscular-skeletal system as well as an intact balance system. The purpose of this comprehensive review of controlled trials is to examine the evidence for the value of balance and agility training in preventing falls and injuries resulting from falls in older people. METHODS: Thirteen studies meeting our inclusion criteria have been reviewed. RESULTS: Of these 13 studies, 6 demonstrated a significant reduction in the rate of falls. CONCLUSIONS: The conclusion is drawn that an exercise program with a balance component in healthy community dwelling older people is likely to prevent future falls.

Journal Article↗
PubMed2003

The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee: a randomized clinical trial.

OBJECTIVES: The purpose of this study was to determine the effects of a proprioceptive training program (PT) vs. a strength training (ST) program on neuromuscular function after anterior cruciate ligament (ACL) reconstruction. The second purpose was to establish the determinants of functional ability for the operated limb. METHODS: Ten participants with unilateral ACL reconstructions were randomly assigned to one of the following 12-week training protocols: (1) isotonic ST, and (2) PT. The outcome measures were: (1) peak torque time of the hamstring muscles (PeakTT), (2) average concentric and eccentric torques of the quadriceps and hamstring muscles, (3) one-legged single hop for distance (SLHD), (4) one-legged time hop (TH), and (5) subjective scores. RESULTS: : There was a significant group by time interaction effect for PeakTT (P = 0.017). The PT group demonstrated greater percent change in isokinetic torques than the ST group at the end of the 12 weeks (P < or = 0.05). Participants in both groups demonstrated similar significant gains in functional ability and subjective scores (P < or = 0.014). Quadriceps strength is a determinant of functional ability for the operated limb (R2 = 0.72). CONCLUSIONS: : Both training protocols influenced PeakTT. The beneficial effects of ST on PeakTT appear to be load-dependent, while sufficient practice may be crucial in maintaining PeakTT improvements induced by PT. Proprioceptive training alone can induce isokinetic strength gains. Restoring and increasing quadriceps strength is essential to maximize functional ability of the operated knee joint.

Adult↗
PubMed2003

Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study.

OBJECTIVES: To (a) compare ultrasound (US; including grey scale and colour and power Doppler) and magnetic resonance imaging (MRI; with high resolution and fat saturation sequences) with a clinical yardstick in the evaluation of chronic Achilles tendinopathy, and (b) examine whether either imaging method predicted 12 and 24 month clinical outcome. METHODS: Forty five patients with symptoms in 57 Achilles tendons were diagnosed with tendinopathy by an experienced sports medicine doctor. All patients underwent US examination (12 MHz probe) with colour and power Doppler, and 25 consecutive patients also underwent MRI with high resolution T1 weighted and STIR sequences. RESULTS: US identified abnormal morphology in 37 of the 57 symptomatic tendons (65%) and normal morphology in 19 of 28 asymptomatic tendons (68%). Baseline US findings did not predict 12 month clinical outcome. The addition of colour and power Doppler did not improve the diagnostic performance of US. MRI identified abnormal morphology in 19 of 34 symptomatic tendons (56%) and normal morphology in 15 of 16 asymptomatic tendons (94%). Lesser grades of MR signal abnormality at baseline were associated with better clinical status at 12 month follow up. CONCLUSIONS: US and MRI show only moderate correlation with clinical assessment of chronic Achilles tendinopathy. Graded MRI appearance was associated with clinical outcome but US was not.

Achilles Tendon↗
PubMed2003

Body position affects performance in untrained cyclists.

OBJECTIVE: To compare cardiovascular and ventilatory variables in upright versus aero cycle ergometry at submaximal and maximal exercise intensities in untrained cyclists. METHOD: Ten physically active men (mean (SD) age 19.1 (1.10) years) who were unfamiliar with aerobars underwent maximal exercise testing and steady state cycling at 50, 100, and 150 W. RESULTS: Participants had significantly greater maxima for oxygen uptake (VO2), ventilation, heart rate, and workload maximum in the upright position. During steady state cycling at the three workloads, VO2 (ml/kg/min) and gross mechanical efficiency were significantly greater in the upright position. CONCLUSIONS: In untrained subjects performing with maximal effort, the upright position permits greater VO2, ventilation, heart rate, and workload maxima. Further, in the steady state, exercise cycling may be less costly in the upright position. For this reason, untrained cyclists need to weigh body position effects against the well known aerodynamic advantages of the aero position.

Adolescent↗
PubMed2002

The influence of back pain on balance and functional mobility in 65- to 75-year-old women with osteoporosis.

To determine whether the presence of back pain and its related disabilities are determinants of balance and functional mobility in a group of women with osteoporosis, we carried out a cross-sectional analysis of 93 community-dwelling women with osteoporosis between the ages of 65 and 75 years old. We assessed health history, anthropometrics, self-report of current physical activity level and self-report of back pain (intensity and pain-related disabilities). Balance was measured by computerized dynamic posturography and functional mobility was assessed by timed figure-of-eight test. The prevalence of back pain was high (75%) in this cohort of older women with osteoporosis. Age was the major determinant of both balance and functional mobility and accounted for 9% and 14% of the variance, respectively. After accounting for age, back pain explained an additional 9% of the variance in balance and 13% of the variance in functional mobility. The high prevalence of back pain demonstrates the importance of pain management in the treatment of osteoporosis. Furthermore, the finding of self-reported back pain as a determinant of both balance and functional mobility suggests that this measure may deserve attention when screening women with osteoporosis for fracture risk. Prospective studies are needed to determine whether pain management will improve balance and functional mobility.

Aged↗
PubMed2002

Muscarinic receptor subtypes are differentially distributed in the rat cochlea.

Five different genes encode the muscarinic acetylcholine receptors. The muscarinic receptor subtypes M1, M3, and M5 are typically coupled to activation of the Galpha(q/11)-phosphatidyl inositol pathway, whereas the M2 and M4 subtypes are typically linked to Galpha(i) and adenylyl cyclase inhibition. In order to localize muscarinic receptors in the rat cochlea, we applied polyclonal antibodies for subtypes M1, M2, M3, and M5, and monoclonal antibody for subtype M4 to paraffin sections. In the organ of Corti, outer hair cells exhibited strong immunoreactivity for M3 and weak immunoreactivity for M1. Deiters' cells were strongly immunoreactive to antibodies for the M1 and M2 subtypes, with weak staining observed for M3, and weaker yet for M5. Inner hair cells showed moderate immunoreactivity for the M1 subtype, weaker staining for the M5 subtype, and slight staining for the M3 subtype. Among the spiral ganglion neurons, weak to moderate immunoreactivity was detected for M3 and M5 subtypes and weak staining was observed for the M1 subtype. The efferent fibers of the intraganglionic spiral bundle were positive for M2 and M5. In the lateral wall, weak to moderate staining was detected for M5 in the stria vascularis corresponding in position to the basolateral extensions of marginal cells. Staining for M3 was observed associated with capillaries. Fibrocytes of the spiral ligament exhibited limited but selective subtype immunoreactivity. No immunoreactivity was detected in the cochlea for the M4 subtype. From the present findings we suggest that M3 is the primary muscarinic receptor subtype in outer hair cells mediating a postsynaptic response to the medial olivocochlear cholinergic efferent input. The muscarinic receptor subtypes M1, M3, and M5 appear to subserve the action of cholinergic lateral olivocochlear efferent stimulation on postsynaptic responses in type I afferents. Whether M1, M3, and M5 protein in inner hair cells indicates constitutive or vestigial expression remaining from development is unknown. M2 and M5 muscarinic receptors expressed presynaptically may modulate the efferent signal. Finally, expression by Deiters' cells of several muscarinic subtypes raises the possibility that cholinergic efferents couple to these non-sensory cells through muscarinic receptors.

Animals↗
PubMed2002

Achilles tendinopathy.

Achilles tendon injury (tendinopathy) and pain occur in active individuals, when the tendon is subject to high or unusual load. Achilles tendinopathy can be resistant to treatment, and symptoms may persist despite both conservative and surgical intervention. The pathology of overuse tendinopathy is non-inflammatory, with a degenerative or failed healing tendon response. The diagnosis of Achilles tendinopathy requires excellent differential diagnosis and an understanding of the role of tendon imaging. Conservative treatment must include exercise, with a bias to eccentric contractions. Surgical treatment is effective after complete tendon rupture, but may not assist recovery from overuse tendinopathy. Further research into the clinical aspects of Achilles tendinopathy is required.

Achilles Tendon↗
PubMed2002

Is there a critical period for bone response to weight-bearing exercise in children and adolescents? a systematic review.

This systematic review examines and compares the bone mineral changes in children and adolescents, as measured by dual energy x ray absorptiometry, reported in exercise intervention studies. The effects of hormonal factors and growth on bone mineral change during puberty are examined, and the possibility of a critical period during which bone is especially adaptable to exercise is discussed.

Absorptiometry, Photon↗
PubMed2002

A randomized school-based jumping intervention confers site and maturity-specific benefits on bone structural properties in girls: a hip structural analysis study.

We compared 7-month changes in bone structural properties in pre- and early-pubertal girls randomized to exercise intervention (10-minute, 3 times per week, jumping program) or control groups. Girls were classified as prepubertal (PRE; Tanner breast stage 1; n = 43 for intervention [I] and n = 25 for control [C]) or early-pubertal (EARLY; Tanner stages 2 and 3; n = 43 for I and n = 63 for C). Mean +/- SD age was 10.0 +/- 0.6 and 10.5 +/- 0.6 for the PRE and EARLY groups, respectively. Proximal femur scans were analyzed using a hip structural analysis (HSA) program to assess bone mineral density (BMD), subperiosteal width, and cross-sectional area and to estimate cortical thickness, endosteal diameter, and section modulus at the femoral neck (FN), intertrochanter (IT), and femoral shaft (FS) regions. There were no differences between intervention and control groups for baseline height, weight, calcium intake, or physical activity or for change over 7 months (p > 0.05). We used analysis of covariance (ANCOVA) to examine group differences in changes of bone structure, adjusting for baseline weight, height change, Tanner breast stage, and physical activity. There were no differences in change for bone structure in the PRE girls. The more mature girls (EARLY) in the intervention group showed significantly greater gains in FN (+2.6%, p = 0.03) and IT (+1.7%, p = 0.02) BMD. Underpinning these changes were increased bone cross-sectional area and reduced endosteal expansion. Changes in subperiosteal dimensions did not differ. Structural changes improved section modulus (bending strength) at the FN (+4.0%, p = 0.04), but not at the IT region. There were no differences at the primarily cortical FS. These data provide insight into geometric changes that underpin exercise-associated gain in bone strength in early-pubertal girls.

Biomechanical Phenomena↗
PubMed2002

Bone mineral response to a 7-month randomized controlled, school-based jumping intervention in 121 prepubertal boys: associations with ethnicity and body mass index.

We examined the effects of a 7-month jumping intervention (10 minutes, 3 times per week) on bone mineral gain in prepubertal Asian and white boys (10.3+/-0.6 years, 36.0+/-9.2 kg) at 14 schools randomized to control (n = 60) and intervention (n = 61) groups. Intervention and control groups had similar mean baseline and change in height, weight, lean mass and fat mass, baseline areal bone mineral density (aBMD; g/cm2), bone mineral content (BMC; g; dual-energy X-ray absorptiometry [DXA], QDR 4500W), and similar average physical activity and calcium intakes. Over 7 months, the intervention group gained more total body (TB) BMC (1.6%,p < 0.01) and proximal femur (PF) aBMD (1%, p < 0.05) than the control group after adjusting for age, baseline weight, change in height, and loaded physical activity. We also investigated the 41 Asian and 50 white boys (10.2+/-0.6 years and 31.9+/-4.4 kg) who were below the 75th percentile (19.4 kg/m2) of the cohort mean for baseline body mass index (BMI). Boys in the intervention group gained significantly more TB and lumbar spine (LS) BMC, PF aBMD, and trochanteric (TR) aBMD (+ approximately2%) than boys in the control group (adjusted for baseline weight, final Tanner stage, change in height, and loaded physical activity). Bone changes were similar between Asians and whites. Finally, we compared the boys in the control group (n = 16) and the boys in the intervention group (n = 14) whose baseline BMI fell in the highest quartile (10.5+/-0.6 years and 49.1+/-8.2 kg). Seven-month bone changes (adjusted as aforementioned) were similar in the control and intervention groups. In summary, jumping exercise augmented bone mineral accrual at several regions equally in prepubertal Asian and white boys of average or low BMI, and intervention effects on bone mineral were undetectable in high BMI prepubertal boys.

Asian People↗
PubMed2001

Plasminogen-mediated matrix invasion and degradation by macrophages is dependent on surface expression of annexin II.

Genetic evidence demonstrates the importance of plasminogen activation in the migration of macrophages to sites of injury and inflammation, their removal of necrotic debris, and their clearance of fibrin. These studies identified the plasminogen binding protein annexin II on the surface of macrophages and determined its role in their ability to degrade and migrate through extracellular matrices. Calcium-dependent binding of annexin II to RAW264.7 macrophages was shown using flow cytometry and Western blot analysis of EGTA eluates. Ligand blots demonstrated that annexin II comigrates with one of several proteins in lysates and membranes derived from RAW264.7 macrophages that bind plasminogen. Preincubation of RAW264.7 macrophages with monoclonal anti-annexin II IgG inhibited (35%) their binding of 125I-Lys-plasminogen. Likewise, plasmin binding to human monocyte-derived macrophages and THP-1 monocytes was inhibited (50% and 35%, respectively) when cells were preincubated with anti-annexin II IgG. Inhibition of plasminogen binding to annexin II on RAW264.7 macrophages significantly impaired their ability to activate plasminogen and degrade [3H]-glucosamine-labeled extracellular matrices. The migration of THP-1 monocytes through a porous membrane, in response to monocyte chemotactic protein-1, was blocked when the membranes were coated with extracellular matrix. The addition of plasminogen to the monocytes restored their ability to migrate through the matrix-coated membrane. Preincubation of THP-1 monocytes with anti-annexin II IgG inhibited (60%) their plasminogen-dependent chemotaxis through the extracellular matrix. These studies identify annexin II as a plasminogen binding site on macrophages and indicate an important role for annexin II in their invasive and degradative phenotype.

Animals↗
PubMed2001

Muscle cross-sectional area is associated with specific site of bone in prepubertal girls: a quantitative magnetic resonance imaging study.

It is well established that forces applied to bone are the result of muscle contraction. However, data regarding the contribution of muscle cross-sectional area (because muscle area is proportional to muscle strength) to cortical bone area before puberty are controversial. We tested the hypothesis that muscle cross-sectional area is associated with total cortical bone area, and whether there is a region-specific relationship between these parameters in prepubertal and early pubertal girls. Seventeen healthy (9-11 years, Tanner stages I-II) white girls participated in the study. We measured bone loading characteristics (maximal ground reaction forces; GRFs) for a drop jump (50 cm) and side-to-side jump (over a 20-cm-high fence) on a multicomponent force platform. Muscle cross-sectional area and bone cortical area (square centimeters) of the proximal third of the left and right lower leg was measured with a 1.5 T magnetic resonance system using a quadrature head coil. The sequence was T(1) weighted, with spin-echo in transverse (tibial) planes and 3 mm sections with no gap (ten slices). The tibial cross-sectional areas were subdivided into three anatomical sectors (SI-SIII), with the tibial centroid as origin. SI extended from the medial tibial border to the most anterior edge, SII extended from the anterior edge laterally to the interosseous border, and SIII extended posteromedially from the interosseous border to the medial tibial border. The nonparametric bone and muscle volume correlations demonstrated that the total muscle cross-sectional area correlated significantly with the total cortical area in both legs (left leg: r(s) = 0.59, p = 0.020; right leg: r(s) = 0.57, p = 0.016). Significant correlations were also found between left and right muscle area and cortical area in SII (r(s) = 0.68, p = 0.003, 0.67, and 0.003, respectively). There was no significant association between the muscle area and cortical area in SI or SIII. In addition, there was a significant correlation between GRFs of the side-to-side jump and total cortical area (left leg: r = 0.75, p < 0.01; right leg: r = 0.78, p < 0.01). Thus, we found that muscle area was most highly associated with bone cortical area in SII, the anterolateral sector of the tibia, which emphasizes the specific interplay of muscles and bone in the lower limb. This relationship was present in a regional, site-specific fashion.

Bone and Bones↗
PubMed2001

Asymptomatic hypoechoic regions on patellar tendon ultrasound: A 4-year clinical and ultrasound followup of 46 tendons.

Patellar tendon ultrasound appearance is commonly used in clinical practice to diagnose patellar tendinopathy and guide management. Using a longitudinal study design we examined whether or not the presence of a hypoechoic ultrasonographic lesion in an asymptomatic patellar tendon conferred a risk for developing jumper's knee compared with a tendon that was ultrasonographically normal. Ultrasonographic, symptomatic and anthropometric assessment was completed at baseline and followup. Magnetic resonance imaging was performed on four tendons that resolved ultrasonographically in the study period. Forty-six patellar tendons were followed over 47+/-11.8 months. Eighteen tendons were hypoechoic at baseline and 28 were ultrasonographically normal. Five tendons resolved ultrasonographically in the study period. Magnetic resonance imaging in four of these tendons was normal. Seven normal patellar tendons at baseline developed a hypoechoic area but only two became symptomatic. Analysis of ultrasonography at baseline and clinical outcome with Fisher's exact test shows there is no association between baseline ultrasound changes and symptoms at followup. In this study there is no statistically significant relationship between ultrasonographic patellar tendon abnormalities and clinical outcome in elite male athletes. Management of jumper's knee should not be solely based on ultrasonographic appearance; clinical assessment remains the cornerstone of appropriate management.

Adult↗