AIM To identify best practice features of an anterior cruciate ligament(ACL) and lower limb injury prevention programs(IPPs) to reduce osteoarthritis(OA).METHODS This consensus statement started with us performing a s...AIM To identify best practice features of an anterior cruciate ligament(ACL) and lower limb injury prevention programs(IPPs) to reduce osteoarthritis(OA).METHODS This consensus statement started with us performing a systematic literature search for all relevant articles from 1960 through January 2017 in PubM ed, Web of Science and CINAHL. The search strategy combined the Medical Subject Heading(Me SH) and keywords for terms:(1) ACL OR "knee injury" OR "anterior cruciate ligament";(2) "prevention and control" OR "risk reduction" OR "injury prevention" OR "neuromuscular training"; and(3) meta-analysis OR "systematic review" OR "cohort study" OR randomized. We found 166 different titles. The abstracts were reviewed for pertinent papers. The papers were reviewed by at least two authors and consensus of best practice for IPP to prevent OA was obtained by conference calls and e-mail discussions. All authors participated in the discussion.RESULTS The best practice features of an IPP have the following six components:(1) lower extremity and core strengthening;(2) plyometrics;(3) continual feedback to athletes regarding proper technique;(4) sufficient dosage;(5) minimal-to-no additional equipment; and(6) balance training to help prevent injuries. Exercises focused on preventing ankle sprains, hamstring injuries and lateral trunk movements are important. Plyometric exercises should focus on correcting knee valgus movement.Exercises should focus on optimizing the hamstring to quadriceps strength ratio. In order for IPP to be successful, there should be increased education and verbal feedback along with increased athletic compliance. Additional equipment is not necessary. Balance training alone does not significantly reduce injuries, but is beneficial with other exercises. Not enough evidence to recommend stretching and agility exercises, with no ill effects identified. Therefore, we suggest making these optional features.CONCLUSION Best practice features for ACL and lower limb IPPs to help prevent OA contain six key components along with two optional.展开更多
<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic dra...<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.展开更多
Based on the lower bound theorem of limit analysis, a solution procedure for limit analysis of three_dimensional elastoplastic structures was established using conventional boundary element method (BEM). The elastic s...Based on the lower bound theorem of limit analysis, a solution procedure for limit analysis of three_dimensional elastoplastic structures was established using conventional boundary element method (BEM). The elastic stress field for lower bound limit analysis was computed directly by three_dimensional boundary element method (3_D BEM). The self_equilibrium stress field was constructed by the linear combination of several self_equilibrium “basis vectors” which can be computed by elastic_plastic incremental iteration of 3_D BEM analysis. The lower bound limit analysis problem was finally reduced to a series of nonlinear programming sub_problems with relatively few optimal variables. The complex method was used to solve the nonlinear programming sub_problems. The numerical results show that the present solution procedure has good accuracy and high efficiency.展开更多
基金Supported by Cooperative Agreement Number DP006262 from the Centers for Disease Control and Prevention
文摘AIM To identify best practice features of an anterior cruciate ligament(ACL) and lower limb injury prevention programs(IPPs) to reduce osteoarthritis(OA).METHODS This consensus statement started with us performing a systematic literature search for all relevant articles from 1960 through January 2017 in PubM ed, Web of Science and CINAHL. The search strategy combined the Medical Subject Heading(Me SH) and keywords for terms:(1) ACL OR "knee injury" OR "anterior cruciate ligament";(2) "prevention and control" OR "risk reduction" OR "injury prevention" OR "neuromuscular training"; and(3) meta-analysis OR "systematic review" OR "cohort study" OR randomized. We found 166 different titles. The abstracts were reviewed for pertinent papers. The papers were reviewed by at least two authors and consensus of best practice for IPP to prevent OA was obtained by conference calls and e-mail discussions. All authors participated in the discussion.RESULTS The best practice features of an IPP have the following six components:(1) lower extremity and core strengthening;(2) plyometrics;(3) continual feedback to athletes regarding proper technique;(4) sufficient dosage;(5) minimal-to-no additional equipment; and(6) balance training to help prevent injuries. Exercises focused on preventing ankle sprains, hamstring injuries and lateral trunk movements are important. Plyometric exercises should focus on correcting knee valgus movement.Exercises should focus on optimizing the hamstring to quadriceps strength ratio. In order for IPP to be successful, there should be increased education and verbal feedback along with increased athletic compliance. Additional equipment is not necessary. Balance training alone does not significantly reduce injuries, but is beneficial with other exercises. Not enough evidence to recommend stretching and agility exercises, with no ill effects identified. Therefore, we suggest making these optional features.CONCLUSION Best practice features for ACL and lower limb IPPs to help prevent OA contain six key components along with two optional.
文摘<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.
文摘Based on the lower bound theorem of limit analysis, a solution procedure for limit analysis of three_dimensional elastoplastic structures was established using conventional boundary element method (BEM). The elastic stress field for lower bound limit analysis was computed directly by three_dimensional boundary element method (3_D BEM). The self_equilibrium stress field was constructed by the linear combination of several self_equilibrium “basis vectors” which can be computed by elastic_plastic incremental iteration of 3_D BEM analysis. The lower bound limit analysis problem was finally reduced to a series of nonlinear programming sub_problems with relatively few optimal variables. The complex method was used to solve the nonlinear programming sub_problems. The numerical results show that the present solution procedure has good accuracy and high efficiency.
