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Lower limb biomechanics during running in individuals with achilles tendinopathy: a systematic review
Shannon E Munteanu, Christian J Barton
Journal of Foot and Ankle Research , 2011, DOI: 10.1186/1757-1146-4-15
Abstract: We searched electronic bibliographic databases (Medline, EMBASE, Current contents, CINAHL and SPORTDiscus) in November 2010. All prospective cohort and case-control studies that evaluated biomechanical factors (temporospatial parameters, lower limb kinematics, dynamic plantar pressures, kinetics [ground reaction forces and joint moments] and muscle activity) associated with mid-portion Achilles tendinopathy were included. Quality of included studies was evaluated using the Quality Index. The magnitude of differences (effect sizes) between cases and controls was calculated using Cohen's d (with 95% CIs).Nine studies were identified; two were prospective and the remaining seven case-control study designs. The quality of 9 identified studies was varied, with Quality Index scores ranging from 4 to 15 out of 17. All studies analysed running biomechanics. Cases displayed increased eversion range of motion of the rearfoot (d = 0.92 and 0.67 in two studies), reduced maximum lower leg abduction (d = -1.16), reduced ankle joint dorsiflexion velocity (d = -0.62) and reduced knee flexion during gait (d = -0.90). Cases also demonstrated a number of differences in dynamic plantar pressures (primarily the distribution of the centre of force), ground reaction forces (large effects for timing variables) and also showed reduced peak tibial external rotation moment (d = -1.29). Cases also displayed differences in the timing and amplitude of a number of lower limb muscles but many differences were equivocal.There are differences in lower limb biomechanics between those with and without Achilles tendinopathy that may have implications for the prevention and management of the condition. However, the findings need to be interpreted with caution due to the limited quality of a number of the included studies. Future well-designed prospective studies are required to confirm these findings.Achilles tendinopathy is a common musculoskeletal disorder that can impair physical function in daily li
The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review
Katie Herman, Christian Barton, Peter Malliaras, Dylan Morrissey
BMC Medicine , 2012, DOI: 10.1186/1741-7015-10-75
Abstract: Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy.Nine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in military recruits.Effective implementation of practical neuromuscular warm-up strategies can reduce lower extremity injury incidence in young, amateur, female athletes and male and female military recruits. This is typically a warm-up strategy that includes stretching, strengthening, balance exercises, sports-specific agility drills and landing technique
Development and evaluation of a tool for the assessment of footwear characteristics
Christian J Barton, Daniel Bonanno, Hylton B Menz
Journal of Foot and Ankle Research , 2009, DOI: 10.1186/1757-1146-2-10
Abstract: Consideration of previously published tools, other footwear related literature, and clinical considerations of three therapists were used to assist in the development of the tool. The tool was developed to cover fit, general features, general structure, motion control properties, cushioning, and wear patterns. A total of 15 participants (who provided two pairs of shoes each) were recruited, and assessment using the scale was completed on two separate occasions (separated by 1 – 3 weeks) by a physiotherapist and a podiatrist on each participant's dominant foot. Intra-rater and inter-rater reliability were evaluated using intra-class correlation coefficients (ICCs) (model 2, 1) and the 95% limits of agreement (95% LOAs) for continuous items, and percentage agreement and kappa (κ) statistics for categorical items.All categorical items demonstrated high percentage agreement statistic for intra-rater (83 – 100%) and inter-rater (83 – 100%) comparisons. With the exception of last shape and objective measures used to categorise the adequacy of length, excellent intra-rater (ICC = 0.91 – 1.00) and inter-rater reliability (ICC = 0.90 – 1.00) was indicated for continuous items in the tool, including the motion control properties scale (0.91 – 0.95).A comprehensive footwear assessment tool with good face validity has been developed to assist future research and clinical footwear assessment. Generally good reliability amongst all items indicates that the tool can be used with confidence in research and clinical settings. Further research is now required to determine the clinical validity of each item in various patient populations.Footwear has been used by humans for thousands of years. Footwear characteristics have been developed and modified to provide protection from the environment, conform with fashion, assist function, accommodate foot deformities, and treat musculoskeletal injury [1]. Various footwear characteristics have been linked to falls in older people [2-7] and in
Pre-cooling for endurance exercise performance in the heat: a systematic review
Jones Paul R,Barton Christian,Morrissey Dylan,Maffulli Nicola
BMC Medicine , 2012, DOI: 10.1186/1741-7015-10-166
Abstract: Background Endurance exercise capacity diminishes under hot environmental conditions. Time to exhaustion can be increased by lowering body temperature prior to exercise (pre-cooling). This systematic literature review synthesizes the current findings of the effects of pre-cooling on endurance exercise performance, providing guidance for clinical practice and further research. Methods The MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus databases were searched in May 2012 for studies evaluating the effectiveness of pre-cooling to enhance endurance exercise performance in hot environmental conditions (≥ 28°C). Studies involving participants with increased susceptibility to heat strain, cooling during or between bouts of exercise, and protocols where aerobic endurance was not the principle performance outcome were excluded. Potential publications were assessed by two independent reviewers for inclusion and quality. Means and standard deviations of exercise performance variables were extracted or sought from original authors to enable effect size calculations. Results In all, 13 studies were identified. The majority of studies contained low participant numbers and/or absence of sample size calculations. Six studies used cold water immersion, four crushed ice ingestion and three cooling garments. The remaining study utilized mixed methods. Large heterogeneity in methodological design and exercise protocols was identified. Effect size calculations indicated moderate evidence that cold water immersion effectively improved endurance performance, and limited evidence that ice slurry ingestion improved performance. Cooling garments were ineffective. Most studies failed to document or report adverse events. Low participant numbers in each study limited the statistical power of certain reported trends and lack of blinding could potentially have introduced either participant or researcher bias in some studies. Conclusions Current evidence indicates cold water immersion may be the most effective method of pre-cooling to improve endurance performance in hot conditions, although practicality must be considered. Ice slurry ingestion appears to be the most promising practical alternative. Interestingly, cooling garments appear of limited efficacy, despite their frequent use. Mechanisms behind effective pre-cooling remain uncertain, and optimal protocols have yet to be established. Future research should focus on standardizing exercise performance protocols, recruiting larger participant numbers to enable direct comparisons of effectiveness and practicalit
Nasal Cannula Apneic Oxygenation Prevents Desaturation During Endotracheal Intubation: An Integrative Literature Review
Bill R. Christian,Erik D. Barton,Joshua M. Gleason
- , 2018, DOI: 10.5811/westjem.2017.12.34699
Abstract: Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e., arterial blood gas level, hemoglobin value, or chest radiograph). During pre-oxygenation, administering high-flow nasal oxygen in addition to a non-rebreather face mask can significantly boost the effective inspired oxygen. Similarly, with the apnea created by rapid sequence intubation (RSI) procedures, the same high-flow nasal cannula can help maintain or increase oxygen saturation during efforts to secure the tube (oral intubation). Thus, the use of nasal oxygen during pre-oxygenation and continued during apnea can prevent hypoxia before and during intubation, extending safe apnea time, and improve first-pass success attempts. We conducted a literature review of nasal-cannula apneic oxygenation during intubation, focusing on two components: oxygen saturation during intubation, and oxygen desaturation time. We performed an electronic literature search from 1980 to November 2017, using PubMed, Elsevier, ScienceDirect, and EBSCO. We identified 14 studies that pointed toward the benefits of using nasal cannula during emergency intubation
A Procedure for Trisecting an Acute Angle  [PDF]
Lyndon O. Barton
Advances in Pure Mathematics (APM) , 2022, DOI: 10.4236/apm.2022.122005
Abstract: This paper presents a graphical procedure, using an unmarked straightedge and compass only, for trisecting an arbitrary acute angle. The procedure, when applied to the 30˚ angle that has been “proven” to be not trisectable, produced a construction having the identical angular relationship with Archimedes’ Construction, in which the required trisection angle was found to be exactly one-third of the given angle (or ∠E'MA = 1/3∠E'CG = 10˚), as shown in Figure 1(D) and Figure 1(E) and Section 4 PROOF in this paper. Hence, based on this identical angular relationship between the construction presented and Archimedes’ Construction, one can only conclude that geometric requirements for arriving at an exact trisection have been met, notwithstanding the theoretical proofs of Wantzel, Dudley, and others.
Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome
Christian J Barton, Pazit Levinger, Kay M Crossley, Kate E Webster, Hylton B Menz
Journal of Foot and Ankle Research , 2011, DOI: 10.1186/1757-1146-4-10
Abstract: Twenty-six individuals (5 males, 21 females) with PFPS aged 25.1 ± 4.6 years and 20 control participants (4 males, 16 females) aged 23.4 ± 2.3 years were recruited into the study. Each participant underwent clinical evaluation of the FPI and kinematic analysis of the rearfoot and forefoot during walking using a three-dimensional motion analysis system. The association of the FPI score with rearfoot eversion, forefoot dorsiflexion, and forefoot abduction kinematic variables (magnitude, timing of peak and range of motion) were evaluated using partial correlation coefficient statistics with gait velocity entered as a covariate.A more pronated foot type as measured by the FPI was associated with greater peak forefoot abduction (r = 0.502, p = 0.013) and earlier peak rearfoot eversion relative to the laboratory (r = -0.440, p = 0.031) in the PFPS group, and greater rearfoot eversion range of motion relative to the laboratory (r = 0.614, p = 0.009) in the control group.In both individuals with and without PFPS, there was fair to moderate association between the FPI and some parameters of dynamic foot function. Inconsistent findings between the PFPS and control groups indicate that pathology may play a role in the relationship between static foot posture and dynamic function. The fair association between pronated foot posture as indicated by the FPI and earlier peak rearfoot eversion relative to the laboratory observed exclusively in those with PFPS is consistent with the biomechanical model of PFPS development. However, prospective studies are required to determine whether this relationship is causal.Foot posture assessment is frequently undertaken in clinical practice for the evaluation of individuals with lower limb overuse injuries, particularly when considering prescription of foot orthoses. One condition for which foot posture assessment is commonly performed is patellofemoral pain syndrome (PFPS) [1,2], as it is believed that individuals with PFPS who demonstrate si
Transcription Termination and Chimeric RNA Formation Controlled by Arabidopsis thaliana FPA
Céline Duc,Alexander Sherstnev,Christian Cole,Geoffrey J. Barton ,Gordon G. Simpson
PLOS Genetics , 2013, DOI: 10.1371/journal.pgen.1003867
Abstract: Alternative cleavage and polyadenylation influence the coding and regulatory potential of mRNAs and where transcription termination occurs. Although widespread, few regulators of this process are known. The Arabidopsis thaliana protein FPA is a rare example of a trans-acting regulator of poly(A) site choice. Analysing fpa mutants therefore provides an opportunity to reveal generic consequences of disrupting this process. We used direct RNA sequencing to quantify shifts in RNA 3′ formation in fpa mutants. Here we show that specific chimeric RNAs formed between the exons of otherwise separate genes are a striking consequence of loss of FPA function. We define intergenic read-through transcripts resulting from defective RNA 3′ end formation in fpa mutants and detail cryptic splicing and antisense transcription associated with these read-through RNAs. We identify alternative polyadenylation within introns that is sensitive to FPA and show FPA-dependent shifts in IBM1 poly(A) site selection that differ from those recently defined in mutants defective in intragenic heterochromatin and DNA methylation. Finally, we show that defective termination at specific loci in fpa mutants is shared with dicer-like 1 (dcl1) or dcl4 mutants, leading us to develop alternative explanations for some silencing roles of these proteins. We relate our findings to the impact that altered patterns of 3′ end formation can have on gene and genome organisation.
The Submental Island Flap Is a Viable Reconstructive Option for a Variety of Head and Neck Ablative Defects
Blair M. Barton,Brian A. Moore,Charles A. Riley,Christian P. Hasney,Jason D. Pou
- , 2018,
Abstract:
The complement of protein kinases of the microsporidium Encephalitozoon cuniculi in relation to those of Saccharomyces cerevisiae and Schizosaccharomyces pombe
Diego Miranda-Saavedra, Michael JR Stark, Jeremy C Packer, Christian P Vivares, Christian Doerig, Geoffrey J Barton
BMC Genomics , 2007, DOI: 10.1186/1471-2164-8-309
Abstract: A database search with a multi-level protein kinase family hidden Markov model library led to the identification of 29 conventional protein kinase sequences in the E. cuniculi genome, as well as 3 genes encoding atypical protein kinases. The microsporidian kinome presents striking differences from those of other eukaryotes, and this minimal kinome underscores the importance of conserved protein kinases involved in essential cellular processes. ~30% of its kinases are predicted to regulate cell cycle progression while another ~28% have no identifiable homologues in model eukaryotes and are likely to reflect parasitic adaptations. E. cuniculi lacks MAP kinase cascades and almost all protein kinases that are involved in stress responses, ion homeostasis and nutrient signalling in the model fungi S. cerevisiae and S. pombe, including AMPactivated protein kinase (Snf1), previously thought to be ubiquitous in eukaryotes. A detailed database search and phylogenetic analysis of the kinomes of the two model fungi showed that the degree of homology between their kinomes of ~85% is much higher than that previously reported.The E. cuniculi kinome is by far the smallest eukaryotic kinome characterised to date. The difficulty in assigning clear homology relationships for nine out of the twenty-nine microsporidian conventional protein kinases despite its compact genome reflects the phylogenetic distance between microsporidia and other eukaryotes. Indeed, the E. cuniculi genome presents a high proportion of genes in which evolution has been accelerated by up to four-fold. There are no orthologues of the protein kinases that constitute MAP kinase pathways and many other protein kinases with roles in nutrient signalling are absent from the E. cuniculi kinome. However, orthologous kinases can nonetheless be identified that correspond to members of the yeast kinomes with roles in some of the most fundamental cellular processes. For example, E. cuniculi has clear orthologues of virtuall
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