Publications (90) View all
-
Article: Skating Crossovers on a Motorized Flywheel: An Experimental Design to Test Effect on Speed and on Crossovers.
[show abstract] [hide abstract]
ABSTRACT: Ice hockey requires frequent skater crossovers to execute turns. Our investigation aimed to determine the effectiveness of training crossovers on a motorized, polyethylene, high-resistance flywheel. We hypothesized that high school hockey players training on the flywheel would perform as well as their peers training on ice. Participants were 23 male high school hockey players (age 15-19 years). The study used an experimental prospective design to compare players who trained for 9 sessions on the 22-foot flywheel with players who trained for 9 sessions on a similarly-sized on-ice circle. Both groups were compared with control subjects who were randomly selected from the same participant pool as those training on ice. All players were tested before and after their 3-week training regimens and control subjects were asked to not practice crossovers between testing. Group 1 trained in a hockey training facility housing the flywheel, and Group 2 trained in the ice hockey arena where testing occurred. Primary outcome measures tested in both directions were: (a) speed (time in seconds) required to skate crossovers for 3 laps of a marked face-off circle, (b) cadence of skating crossovers on the similarly-sized circles, and (c) a Repeat Interval Speed Test, which measures anaerobic power. No significant changes were found between groups in on-ice testing before and after training. Among Group 1 players, 7 of 8 believed they benefitted from flywheel training. Group 2 players, who trained on ice, did not improve performance significantly over Group 1 players. Despite the fact that no significant on-ice changes in performance were observed in objective measures, players who trained on the flywheel subjectively reported that the flywheel is an effective, cost-effective alternative to training on ice. This is a relevant finding when placed in context with limited availability of on-ice training.The Journal of Strength and Conditioning Research 03/2013; · 1.83 Impact Factor -
Article: Immunoglobulin M Monoclonal Gammopathy of Undetermined Significance and Smoldering Waldenström Macroglobulinemia.
[show abstract] [hide abstract]
ABSTRACT: Monoclonal gammopathy of undetermined significance of the immunoglobulin M class was diagnosed in 213 patients at the Mayo Clinic, 29 (14%) of whom developed lymphoma, Waldenström macroglobulinemia, or a related disorder over 1567 person-years of follow-up. The cumulative probability of progression was 10% at 5 years, 18% at 10 years, and 24% at 15 years, or approximately 1.5% per year. The concentration of serum monoclonal protein at diagnosis and the initial serum albumin value were the only independent predictors of progression with multivariate analysis. By contrast, during 285 person-years of follow-up, 34 (71%) of 48 patients with smoldering Waldenström macroglobulinemia (SWM) progressed to Waldenström macroglobulinemia (WM), which required therapy, along with amyloid light chain (AL) amyloidosis (1) and lymphoma (1). The cumulative probability of progression was 6% at 1 year, 39% at 3 years, 59% at 5 years, and 65% at 10 years. The percentage of lymphoplasmacytic cells in the bone marrow, size of the serum monoclonal (M) spike, and hemoglobin value were significant independent risk factors for progression.Clinical lymphoma, myeloma & leukemia 03/2013; -
Article: The effect of suture preloading on the force to failure and gap formation after flexor tendon repair.
[show abstract] [hide abstract]
ABSTRACT: Gap formation is a common and severe complication after flexor tendon repair that can affect the outcome and prolong tendon healing. The purpose of this study was to investigate the effect that a pretensional force applied to the suture during tendon repair has on the repair strength and force that causes gap formation. We used a total of 48 flexor digitorum profundus tendons from 12 human cadaver hands. We employed a core tendon suture, using the modified Pennington technique, and a running suture for flexor tendon repair. Before tying the knots of the core suture, we preloaded the sutures in each tendon end 0, 5, 10, or 15 N for 10 seconds to compare the effect of loading magnitude on repaired tendon peak force to failure and force causing gap formation. The force to form a gap of 2 mm in the 15-N preload group was significantly increased compared with the 0-N and 5-N preload groups. At the 3-mm gap formation, the force of all preload groups was significantly higher than the nonpreload group. The peak force with a preload of 10 N and 15 N was significantly higher than 0-N preload. These findings suggest that pretensioning with 10 to 15 N at the suture-tendon interface before tying the knot has a beneficial effect on both the tendon gap formation and the peak force to failure. When the surgeons perform tendon repair, pretensioning at the suture-tendon conjunction will increase the repair strength.The Journal of hand surgery 01/2013; 38(1):56-61. · 1.33 Impact Factor -
Article: Myocardial Infarction After Hip Fracture Repair: A Population-Based Study.
[show abstract] [hide abstract]
ABSTRACT: OBJECTIVES: To quantify the occurrence of myocardial infarction (MI) occurring in the early postoperative period after surgical hip fracture repair and estimate the effect on 1-year mortality. DESIGN: A population-based, historical cohort study of individuals who underwent surgical repair of a hip fracture that used the computerized medical record linkage system of the Rochester Epidemiology Project. SETTING: Academic and community hospitals, outpatient offices, and nursing homes in Olmsted County, Minnesota. PARTICIPANTS: Over the 15-year study period (1988-2002), 1,116 elderly adults underwent surgical repair of a hip fracture. MEASUREMENTS: At the end of the first 7 days after hip fracture repair, participants were classified into one of three groups: clinically verified MI (cv-MI), subclinical myocardial ischemia, and no myocardial ischemia. One-year mortality was compared between these groups. Multivariate models assessed risk factors for early postoperative cv-MI and 1-year mortality. RESULTS: Within the first 7 days after hip fracture repair, 116 (10.4%) participants experienced cv-MI and 41 (3.7%) subclinical myocardial ischemia. Overall 1-year mortality was 22%, with no difference between those with subclinical myocardial ischemia and those with no myocardial ischemia. One-year mortality for those with cv-MI (35.8%) was significantly higher than for the other two groups. Occurrence of early postoperative cv-MI, male sex, and history of heart failure or dementia were independently associated with greater 1-year mortality, whereas prefracture home residence and preoperative higher hemoglobin were protective. CONCLUSION: Rates of early postoperative, cv-MI after hip fracture repair exceed rates after other major orthopedic surgeries and are independently associated with greater 1-year mortality.Journal of the American Geriatrics Society 10/2012; · 3.74 Impact Factor -
Article: Clinical presentation and outcome of perioperative myocardial infarction in the very elderly following hip fracture surgery.
[show abstract] [hide abstract]
ABSTRACT: BACKGROUND: Patterns of clinical symptoms and outcomes of perioperative myocardial infarction (PMI) in elderly patients after hip fracture repair surgery are not well defined. METHODS: A retrospective 1:2 case-control study in a cohort of 1212 elderly patients undergoing hip fracture surgery from 1988 to 2002 in Olmsted County, Minnesota. RESULTS: The mean age was 85.3 ± 7.4 years; 76% female. PMI occurred in 167 (13.8%) patients within 7 days, of which 153 (92%) occurred in first 48 hours; 75% of patients were asymptomatic. Among patients with PMI, in-hospital mortality was 14.4%, 30-day mortality was 29 (17.4%), and 1-year mortality was 66 (39.5%). PMI was associated with a higher inpatient mortality rate (odds ratio [OR], 15.1; confidence interval [CI], 4.6-48.8), 30-day mortality (hazard ratio [HR], 4.3; CI, 2.1-8.9), and 1-year mortality (HR, 1.9; CI, 1.4-2.7). CONCLUSION: Elderly patients, after hip fracture surgery, have a higher incidence of PMI and mortality than what guidelines indicate. The majority of elderly patients with PMI did not experience ischemic symptoms and required cardiac biomarkers for diagnosis. The results of our study support the measurement of troponin in postoperative elderly patients for the diagnosis of PMI, in order to implement in-hospital preventive strategies to reduce PMI-associated mortality. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine.Journal of Hospital Medicine 09/2012; · 1.40 Impact Factor
