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Biomedical subjects

P Hölmich

Publications and source records attributed to P Hölmich.

17 recordsLinked to original sources
PubMed2006

Ultrasound guided electrocoagulation in patients with chronic non-insertional Achilles tendinopathy: a pilot study.

BACKGROUND: High resolution colour Doppler ultrasound shows intratendinous Doppler activity in patients with chronic Achilles tendinopathy. Treatment of this neovascularisation with sclerosing therapy seems to relieve the pain. However, the procedure often has to be repeated. OBJECTIVE: To investigate the effect of electrocoagulation of the neovessels on tendon pain and tendon vascularity in patients with chronic Achilles tendinopathy. METHODS: Colour Doppler ultrasound guided electrocoagulation was used on vessels in the ventral portion of the Achilles tendon in 11 patients (seven men, four women, mean age 41 years) with painful chronic mid-portion Achilles tendinosis. A unipolar coagulation device was used. RESULTS: One patient dropped out after two months (dissatisfied with the results). The remaining 10 patients (91%) were satisfied. These 10 patients were still satisfied at six months of follow up and had returned to their previous level of activity. All 10 patients were "cured" after one treatment. The patient who dropped out received two treatments because of lack of progress. There was significantly reduced pain (Likert pain scale, 0-10) during activity, from a median of 7 (range 4 to 10) at baseline to 0 (0 to 8) at six months' follow up (p<0.005); and at rest, from 1.5 (1 to 5) to 0 (0 to 8) (p = 0.005). In all patients, vascularisation was unchanged at the six months follow up, with no significant change in semiquantitative or quantitative colour scoring. CONCLUSIONS: Coagulation in the area with vessels entering the tendon appears to be effective treatment for painful chronic mid-tendinous Achilles tendinopathy. No effect on the intratendinous Doppler activity could be detected, suggesting that the effect is independent of changes in blood flow. Localisation of hyperaemia appears to be the key to the pathology and for targeting the treatment. One explanation could be that the effect is obtained by destruction of nerves accompanying the vessels.

Achilles Tendon↗
PubMed2006

The effect of protein and carbohydrate supplementation on strength training outcome of rehabilitation in ACL patients.

Patients with anterior cruciate ligament (ACL) injury experience atrophy and weakening of the extensor as well as the hamstrings muscles at the injured leg. Especially, the weakness of the quadriceps muscle has been ascribed to hamper daily physical tasks. The purpose of the present study was therefore to investigate if nutrient supplementation during 12 weeks of conservative rehabilitation strength training could enhance hypertrophy and strength of the quadriceps muscle in ACL-injured patients. Twenty-six ACL-injured men and women were included and randomly distributed into three supplementation groups: Protein+Carbohydrate (PC), Isocaloric-Carbohydrate (IC), or Placebo (PL), ingesting the supplementation immediately after each of 36 training sessions. Determined from images of thigh cross-sections (magnetic resonance imaging) the hypertrophy of the quadriceps muscle differed significantly between groups at the distal part, with the PC group demonstrating the largest hypertrophy. Peak torque of the quadriceps muscle at constant velocity 60 degrees.s-1 was significantly elevated in the PC group only, and the time to reach peak torque tended to decrease as well only in the PC group. The results from this study demonstrate that restoration of the distal vasti muscle mass and knee extension muscle strength with resistance training is promoted further by protein-containing nutrient supplementation immediately after single exercise sessions. Thus, exercise-related protein supplementation may seem important for surgery-related rehabilitation of skeletal muscle.

Adolescent↗
PubMed2006

Reproducibility of ultrasound and magnetic resonance imaging measurements of tendon size.

PURPOSE: To investigate the intra- and inter-tester reproducibility of measurements of the Achilles tendon, tibialis anterior tendon, and the tibialis posterior tendon in football players using ultrasound (US) and magnetic resonance imaging (MRI). MATERIAL AND METHODS: Eleven asymptomatic football players were examined. Using a standardized US scanning protocol, the tendons were examined by two observers with US for thickness, width, and cross-sectional area. One observer conducted the procedure twice. The subjects also underwent an MRI examination, and the assessment of tendon size was conducted twice by two observers. RESULTS: The best reproducibility judged by coefficient of variation (CV) and 95% confidence interval was determined for the Achilles tendon on both US and MRI. The variability of US on measurements on the tibialis anterior and tibialis posterior tendons was less than that when using MRI. In 12 out of 18 measurements, there were systematic differences between observers as judged by one-sided F-test. CONCLUSION: The reproducibility of the three tendons was limited. Precaution should be taken when looking for minor quantitative changes, i.e., training-induced hypertrophy, and when doing so, the Achilles tendon should be used.

Achilles Tendon↗
PubMed2005

Evidence based prevention of hamstring injuries in sport.

A common soft tissue injury in sports involving sprinting and jumping is the hamstring strain. A major problem with hamstring strains is the high incidence of reinjury. Muscle injuries can be classified as direct or indirect and are typically grouped into three categories according to severity. A number of potential risk factors have been proposed for hamstring strains. Only a few are evidence based and some are mainly based on theoretical assumptions. There is a lack of clinical research on the effectiveness of rehabilitation programmes for hamstring strains. Although the initial treatment of rest, ice, compression, and elevation is accepted for muscle strains, no consensus exists for their rehabilitation. Not much evidence based research has been carried out on prevention of hamstring strain. To our knowledge only two prospective studies have so far been published. As the injuries are common in football and other sports involving sprinting and jumping, there is a need for further research preferably in the form of randomised controlled trials.

Athletic Injuries↗
PubMed2004

Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study.

BACKGROUND: Groin pain is a diagnostic and therapeutic challenge to sports medicine. The literature provides no consensus on definitions of or diagnostic criteria for groin pain in athletes. To compare the results of research and treatments, the methods used to diagnose and evaluate the degree of groin pain must be clearly defined and reproducible. OBJECTIVES: To describe clinical examination techniques for groin pain in athletes and evaluate the intraobserver and interobserver reliability of these. METHODS: Eighteen athletes, nine with sports related groin pain and nine without groin pain, were examined by two doctors and two physiotherapists. The examiners were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the subjects. The subjects were examined twice by each examiner in random order. The examinations included evaluation of adductor muscle related pain and strength, iliopsoas muscle related pain, strength, and flexibility, abdominal muscle related pain, and strength and pain at the symphysis joint. Kappa statistics and percentage of agreement were used to evaluate the data. RESULTS: Overall, the kappa values and percentage of agreement were in accordance and showed good reliability of the examinations. The kappa values for the intraobserver agreement were above 0.60 in 11 of 14 tests, and those for the interobserver agreement of the pain tests were above 0.60 in eight of 10 tests. The only test without acceptable interobserver reliability was the strength test for iliopsoas muscle. CONCLUSION: All but one of the tests investigated were reproducible and subject only to limited intraobserver and interobserver variation.

Adult↗
PubMed1999

Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial.

BACKGROUND: Groin pain is common among athletes. A major cause of long-standing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with a physiotherapy treatment without active training (PT) in the treatment of adductor-related groin pain in athletes. METHODS: 68 athletes with long-standing (median 40 weeks) adductor-related groin pain--after examination according to a standardised protocol--were randomly assigned to AT or PT. The treatment period was 8-12 weeks. 4 months after the end of treatment a standardised examination was done. The examining physician was unaware of the treatment allocation. The ultimate outcome measure was full return to sports at the same level without groin pain. Analyses were by intention to treat. FINDINGS: 23 patients in the AT group and four in the PT group returned to sports without groin pain (odds ratio, multiple-logistic-regression analysis, 12.7 [95% CI 3.4-47.2]). The subjective global assessments of the effect of the treatments showed a significant (p=0.006) linear trend towards a better effect in the AT group. A per-protocol analysis did not show appreciably different results. INTERPRETATION: AT with a programme aimed at improving strength and coordination of the muscles acting on the pelvis, in particular the adductor muscles, is very effective in the treatment of athletes with long-standing adductor-related groin pain. The potential preventive value of a short programme based upon the principles of AT should be assessed in future, randomised, clinical trials.

Adolescent↗
PubMed1995

[Eye injuries during hobby-work using machine tools].

Data from the EU-project EHLASS (European Home and Leisure Accident Surveillance System) collected from five Danish hospitals during the period 1989-1991 contained 185,551 accidents occurring at home and during leisure time. The population in the catchment area is approximately 700,000. Of these accidents, 9900 involved eye-injury, 2940 of these occurred during hobby-activities, and 1460 of these while the subject was using either drilling-, welding- or grinding-equipment. The incidence of eye-injuries occurring during the use of these machines has risen from 0.6/1000/year in 1989 to 0.7/1000/year in 1990 and to 0.8/1000/year in 1991. In 98% of the cases the patients were men, 30% were between 20 and 29 years of age. A common activity at the time of the accident was "car-repairing". Foreign-body-lesions were seen in 60% of the cases, and actinic conjunctivitis in 30%. None of the injuries were serious, but they were often very painful and demanding of resources. All the injuries could have been avoided by the use of proper eye protection.

Accidents, Home↗
PubMed1992

Isolated ulnar shaft fractures. Comparison of treatment by a functional brace and long-arm cast.

In a prospective study, we randomly allocated 39 patients with isolated fractures of the lower two-thirds of the ulnar shaft to treatment either by a prefabricated functional brace or a long-arm cast. Significantly better wrist function and a higher percentage of satisfied patients were found in the braced group. Thirteen patients returned to employment while still wearing the brace but only one was able to work in a cast.

Age Factors↗
PubMed1991

On circadian rhythms in human epidermal cell proliferation.

The ascertainment of consistent diurnal variations in human epidermal cell proliferation may have important implications for the treatment of many skin diseases. For the evaluation of diurnal rhythms in the growth of human epidermis, skin biopsies were taken every 4th hour for 48 h from each of two persons under synchronized living conditions. The epidermal cell proliferation was assessed by the fraction of cells in S and in G2-M phase as determined by measurements of the DNA content in the individual cells in single-cell suspensions. The existence of diurnally consistent body functions in the test persons was verified by monitoring the excretion of cortisol by urine. The fraction of cells in G2-M phase indicated circadian rhythmicity for the first 32 h of the test period. No regular variation according to time of day could be established in the fraction of cells in S-phase.

Adult↗
PubMed1988

The elite marathon runner: problems during and after competition.

Two questionnaires were given to the participants of the Danish national marathon championship to obtain information on health, training habits, previous injuries and the medical problems sustained during and after the competition. All 60 participants replied to both questionnaires. The elite runner is training between 90-150 km per week, using one daily training session. He is generally careful about stretching and warming up and down. Forty-three per cent of runners sustained injuries in the last year that prevented them from training, but only 3% needed to stay off work. The most common reasons for not completing the race were exhaustion and injuries to the lower extremities. Sixty-one per cent of the runners who did not drink at all refreshment stations dropped out, whereas only 27% of those who did dropped out. There was no difference in relation to results or medical problems between the group who used a special diet before the run and those who did not. The major medical problems were gastrointestinal disturbances, skin lesions and pain or cramps in the lower extremities. No serious injuries were reported.

Adolescent↗
PubMed1985

Dislocation following total hip arthroplasty.

The rate of postoperative dislocation after Stanmore total hip arthroplasty in 427 cases was 4.9%; 1.4% were classified as recurrent cases. Retroversion of the acetabular component and postoperative joint laxity were the only factors that were found to predispose to dislocation. The importance of preserving the effective femoral neck length during total hip arthroplasty is emphasized.

Adult↗
PubMedDate not supplied

The use and handling of acrylic bone cement in Danish orthopaedic departments.

In order to evaluate the use and handling of acrylic bone cement, questionnaire were presented to all Danish orthopaedic departments in 1987 and again in 1992. Marked improvements in the environmental safety precautions for handling of bone cement had taken place during the 5-year period. In 1992, the intraoperative handling and use of bone cement is thus generally considered safe. Further improvements are still to be advocated in some departments. The exposure to methylmethacrylate monomer (MMA) vapour during the cementation procedures should be eliminated by local punctual field suction or change to a bone cement with a lower content of monomer (MMA/n-decylmethacrylate/isobornylmethylacrylate bone cement). Unnecessary manual contact with the cement should be avoided, and if contact is necessary, special protective gloves (butyl rubber gloves or 4H-gloves) should be used in addition to ordinary surgical gloves.

Air Pollutants, Occupational↗