PURPOSE OF THE STUDY The aim of this prospective study was to evaluate functional outcomes and knee joint stability after double-bundle anterior cruciate ligament reconstruction using three-tunnel quadriceps tendon-bone graft and four-tunnel hamstring graft (semi-tendinosus and gracilis muscles). MATERIAL Group 1 included 20 patients undergoing reconstruction with quadriceps tendon- bone graft group; 2 comprised of 20 patients treated by hamstring graft. There were 26 men and 14 women, with an average age of 27 (range, 16 to 44) years. The minimum follow-up period was one year. METHODS In group 1 patients, semi-anatomic anterior cruciate ligament reconstruction was performed by a three-tunnel technique (two tunnels in the femur and one in the tibia) using quadriceps femoris muscle graft. Group 2 patients were treated by anatomic four-tunnel reconstruction (two tunnels in the femur and two in the tibia) with the use of hamstring graft. Functional outcomes were evaluated on the basis of Lysholm and IKDC scores. Antero-posterior stability was measured with a KT-1000 arthrometer and rotational stability was assessed by the pivot-shift test. For statistical evaluation, the level of significance (p) was set at < 0.05. RESULTS The final evaluation showed an average Lysholm score of 88.9 + 12 (76-100) points for group 1, and 87.9 + 11 (62-100) points for group 2; there was no statistically significant difference. The rounded average result of the functional IKDC score after surgery was the same in the two groups (80 +10). The joints treated by the three-tunnel technique had on average better antero-posterior stability, but this was not statistically significant. The pivot-shift phenomenon was not seen in either of the groups. Operative times in both groups were comparable. An intra-operative fracture of the patella occurred in two patients of group 1. DISCUSSION No similar prospective study comparing the outcomes of the methods reported here has been found in the international literature. The studies so far published have not included any such comparison or they compared other techniques, such as single- versus double-bundle reconstructions. CONCLUSIONS Based on Lysholm and IKDC score evaluation and antero-posterior and rotational stability assessment, it can be concluded that both the three- and the four-tunnel technique of anterior cruciate ligament reconstruction gave similar results, with no significant differences, at one-year follow-up. However, these are only short-term results and only a long-term follow-up can prove or disprove the validity of this conclusion.

• MeSH
• čtyřhlavý sval stehenní chirurgie   MeSH
• dospělí MeSH
• lidé MeSH
• ligamentum cruciatum anterius chirurgie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• šlachy transplantace   MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

• MeSH
• koleno chirurgie   patologie   MeSH
• lidé MeSH
• ligamentum cruciatum anterius chirurgie   MeSH
• nestabilita kloubu chirurgie   MeSH
• transplantáty klasifikace   využití   MeSH
• Check Tag
• lidé MeSH

PURPOSE OF THE STUDY Anterior cruciate ligament reconstruction is one of the most common reconstruction surgeries. The unintended consequences of the surgery are hemarthrosis, blood loss, knee swelling and postoperative pain. The purpose of the study was to evaluate the effect of a single dose of intravenous tranexamic acid (TXA) on the postoperative parameters and functional status of the knee joint 3 months after surgery. MATERIAL AND METHODS It is a prospective randomised clinical study. An intravenous injection of TXA equivalent to 15 mg/kg in 100 ml of saline solution was administered to the test group during the surgery (20 minutes before the end of the surgery). The control group was administered 100 ml of saline solution without TXA. In both groups, the following parameters were evaluated preoperatively and postoperatively (on Day 1 and Day 10 and at 1 month and 3 months): thigh circumference at 1 cm above the patella, Coupens and Yates (CY) score for swelling, and pain score (VAS). At 24 hours after the surgery, the blood loss (secretion into the drain) and decrease in hemoglobin (Hb) and hematocrit (HCT) levels compared to the preoperative levels were assessed. The functional status of the knee joint was assessed based on the Lysholm knee scoring scale and the IKDC subjective knee evaluation form preoperatively, or at 1 and 3 months postoperatively. RESULTS In the test group, a significantly lower blood loss was detected 24 hours after the surgery. The mean difference of 128 ml compared to the control group was both statistically and practically significant (p < 0.001, d =1.42). The test group showed a lower decrease in Hb and HCT levels postoperatively compared to the control group, although with no statistical significance. On the first postoperative day, slightly better results of the thigh circumference at 1 cm above the patella and of the CY score were observed in the test group. However, during the follow-up check performed postoperatively on Day 10, the differences in the thigh circumference at 1 cm above the patella, CY score and pain VAS score were negligible. The differences in the functional status of the knee joint between the two groups ascertained during the check performed 1 month and 3 months after the surgery were insignificant. DISCUSSION Our study, just like other studies, confirms a significant effect of a single dose of intravenous TXA on the volume of blood loss and early postoperative swelling, which are the parameters affecting the early postoperative course. Even though the intervention does not affect the subsequent result of surgery, it can undoubtedly be of benefit perioperatively. There is a fairly limited number of randomised clinical studies on this topic in literature, with most of them published in the last 7 years. Further research should, among other things, optimise the protocol and identify a suitable candidate for TXA administration in patients undergoing an ACL reconstruction. CONCLUSIONS Our study confirmed the positive effect of a single dose of intravenous TXA during the reconstruction of anterior cruciate ligament using hamstrings on early postoperative blood loss and early postoperative swelling, which can have a positive effect on wound healing and prevent postoperative complications. Therefore, in agreement with available literature, we recom mend administering a single dose of intravenous TXA in ACL reconstruction, unless there is a contraindication to this therapy. Key words: anterior cruciate ligament reconstruction, hamstrings tranexamic acid, single intravenous administration, clinical evaluation.

• MeSH
• kolenní kloub chirurgie   MeSH
• kyselina tranexamová * MeSH
• lidé MeSH
• Lysholmovo skóre MeSH
• poranění předního zkříženého vazu * chirurgie   MeSH
• prospektivní studie MeSH
• rekonstrukce předního zkříženého vazu * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

• MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• sportovní úrazy patologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

V předloženém příspěvku je na základě literární rešerše odborné literatury shrnuta problematika týkající se aktivity hamstringů. Použitá literatura není až na výjimky starší deseti let. Příspěvek je rozdělen dle obsahu do jednotlivých kategorií: Hamstringy ve svalových řetězcích, kde je shrnuto zapojení hamstringů v rámci svalových řetězců, další kategorie popisuje rizika spojená se zraněním hamstringů, na což navazujeme nejčastějšími nálezy u sportovců s prodělaným zraněním hamstringů a možnosti preventivních programů u sportovců individuálních i kolektivních sportů a možnosti návratu k tréninkové činnosti po zranění. Dále je příspěvek doplněn o anketní šetření, které bylo provedeno mezi českými vrcholovými sportovci. Toto šetření bylo zaměřeno na problematiku četnosti a následné léčby, včetně doby potřebné k návratu do tréninkového procesu, a případné recidivy tohoto zranění.

To give a coherent view on the problems of hamstring injuries in sports. Make an inquiry into muscle injury occurence in elite athletes (athletics – sprints, soccer, basketball and handball) in the Czech republic and consequently regard the possibilities of prevention programe by means of physical therapy and other metodes to make the time necessary for returning an injured sportsmen to competition shorter. To establish the possibilities of prevention procedure; to describe various aspects of returning to training, including potential complications; and finally a brief outline of the possibilities of how to solve the problem in question in selected sport fields. To describe hamstrings in muscle chains. Literary review and processing the procured information from a sufficient Czech and foreign sources, mostly articles was published in specialized literature, journals, monographies and electronic database (mainly PEDro and PubMed as well as others sources from the National Health Library database). The work is divided into several chapters so that all the chapters flow from a beginning outline through imaginative line of „logistic“ sequence. There are no source quotations older than ten years with exceptions though. Furthermore, we carried out a survey among sportsmen in various sport branches (athletics, soccer, handball, basketball) in Czech conditions at the top level. The survey has been processed on the basic of simple statistics methods, by means of percentage calculation and verbal evaluation. The expert opinions on hamstring injury are generally similar and digger only a little. Injury are more common when movement is carried out at maximum speed (sprinters). In collective sports such soccer, handball, basketball and many others, there is also the factor of fatigue. There is a high risk of re-injury when treatment ended prematurely. The survey confirmed high incidence of hamstring injuries in elite athletes and high risk of reinjury (77,78% injured athletes). On the basis of this survey we consider the way doctors treat this injury to be underestimated.

• Klíčová slova
• ohybače kolenního kloubu, hamstringy,
• MeSH
• basketbal MeSH
• fotbal MeSH
• kosterní svaly * zranění   MeSH
• lidé MeSH
• poranění šlachy * prevence a kontrola   rehabilitace   MeSH
• primární prevence metody   MeSH
• průzkumy a dotazníky MeSH
• recidiva MeSH
• sportovní úrazy * prevence a kontrola   rehabilitace   MeSH
• sporty MeSH
• statistika jako téma MeSH
• stehno * zranění   MeSH
• techniky cvičení a pohybu MeSH
• terapie cvičením metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• artralgie * diagnóza   klasifikace   MeSH
• diferenciální diagnóza MeSH
• kyčelní kloub diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• sakroiliakální kloub diagnostické zobrazování   patologie   zranění   MeSH
• syndrom musculus piriformis diagnóza   MeSH
• zadní stehenní svaly diagnostické zobrazování   zranění   MeSH
• Check Tag
• lidé MeSH

Cílem studie bylo ověřit vliv statického a dynamického způsobu protahování hamstringů u probandů studující tělesnou výchovu a sport na PF UJEP. Flexibilita byla diagnostikována prostřednictvím modifikované Lassegueovy zkoušky (SLR). V předkládané studii byl sledován rozdíl mezi dosaženými úhly zadní strany stehna u dominantní dolní končetiny před aplikací a po aplikaci statických a dynamických protahovacích cvičení pomocí SLR provedené švihem nebo tahem. Pro sběr dat bylo využito videozá- znamu (2D), který byl zpracován softwarem Dartfish Team Pro Data. Pomocí tohoto programu byly hodnoty úhlu převedeny na vzdálenost v centimetrech a vyhodnoceny. Výsledky prokázaly, že nebyly zjištěny statisticky významné rozdíly v hodnotách ROM při působení statického a dynamického způsobu protahování. Signifikantní rozdíly se však projevily mezi výchozím a výsledným úhlem dominantní dolní končetiny při působení dynamického strečinku, kde byl u SLR pohyb proveden švihem.

The aim of the study was to assess the effect of static and dynamic way of stretching the hamstrings in probands studying physical education and sport at UJEP. Flexibility was diagnosed through a modified Lassegueovy test (SLR). In the present study, we evaluated the differences between the angles of the back of the thigh in the dominant lower limb before and after the application of static and dynamic stretching exercises performed using SLR push or pull. For data collection were used video (2D), which was developed software Dartfish Team Pro Data. With this program were converted to values of the angle distance in centimeters and evaluated. The results showed that there were no significant differences in ROM when exposed to static and dynamic stretching method. Significant differences, however, showed between the initial and final angle dominant lower limb when exposed to dynamic stretching, where the movement was executed swing.

• MeSH
• lidé MeSH
• mladý dospělý MeSH
• plnění a analýza úkolů MeSH
• rozsah kloubních pohybů * fyziologie   MeSH
• strečink * MeSH
• zadní stehenní svaly fyziologie   MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

Jedním z nejčastějších úrazů u sportovců je poranění svalů zadní skupiny stehna, tzv. hamstringů. Toto zranění vyžaduje dlouhou rekonvalescenci a je zatíženo velkým rizikem opětovného zranění po návratu ke sportu. V posledních letech mnoho studií ukázalo, že současným včasným cvičením svalu na zvýšení jeho pevnosti a současně cvičeními na stabilizaci trupu a odstranění svalové nerovnováhy se výrazně zkracuje doba léčby a minimalizuje nebezpečí obnovení zranění. Cílem tohoto článku je ukázat přesný plán léčby a jednotlivé cviky. Cvičení je rozvrženo do několika fází, sportovec se do další fáze přesunuje až po splnění přísných kritérií a díky tomu se minimalizuje nebezpečí obnovení zranění. Současně je v cvičeních zahrnuto i cvičení ke zlepšení stabilizace trupu a cvičení k odstranění svalových dysbalancí, které má největší vliv na to, že se úrazy svalů nevracejí. Při dodržení těchto doporučení se výrazně snižuje riziko obnovení zranění a doba nutná ke zhojení svalu se zkracuje. Tato cvičení se dají použít i jako prevence poranění svalů zadní skupiny stehna.

Of the most common injuries to athletes are injuries to the hamstring muscles. This injury requires a long reconvalescence and has a high risk of re-injury after returning to the sport. Many studies have recently shown that the current early exercise strengthens the muscle and at the same time the stabilization body and elimination muscle imbalance exercise significantly reduces treatment time and minimizes the risk of repeated injury of the hamstring. This article aims to show the exact treatment plan and individual exercises. This type of conditioning is scheduled in several phases, the athlete moves to the next stage after meeting stringent criteria and thus minimizes the risk of getting hurt again. It also includes the practice to stabilize the body and the drill to eliminate muscle imbalances that have the greatest influence on the fact that the muscle injury does not return. In following the above mentioned recommendations the risk of getting injured again is being substantially reduced and recovery time necessary for healing of the muscle shortens. These exercises can be used as a prevention of hamstrings injury.

• Klíčová slova
• poranění svalů, hamstringy, léčba,
• MeSH
• diagnostické techniky a postupy MeSH
• diferenciální diagnóza MeSH
• kosterní svaly zranění   MeSH
• kritické cesty MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• primární prevence MeSH
• rehabilitace metody   MeSH
• rentgendiagnostika MeSH
• sportovní úrazy diagnóza   patofyziologie   terapie   MeSH
• sporty MeSH
• stehno zranění   MeSH
• techniky cvičení a pohybu metody   MeSH
• ultrasonografie MeSH
• Check Tag
• lidé MeSH

Valdes, O, Inzulza, S, Collao, N, Garcia-Vicencio, S, Tufano, JJ, Earp, J, Venegas, M, and Peñailillo, L. Eccentric cycling is an alternative to Nordic hamstring exercise to increase the neuromuscular function of knee flexors in untrained men. J Strength Cond Res 37(11): 2158-2166, 2023-Nordic hamstring exercise (NHE) has been proposed to reduce knee flexor (KF) injuries. However, submaximal alternatives to NHE are necessary for the clinical or weaker population. The aim of this study was to compare the effects of Nordic hamstring training (NHT) and eccentric cycling (ECC) training on the neuromuscular function of the KF. Twenty healthy men (27.7 ± 3.5 years) were randomly assigned into 2 groups that performed 10 training sessions (2-3 sessions·week-1) of either NHT (n = 10) or ECC (n = 10). Maximal voluntary isometric contraction of the KF and knee extensor (KE) muscles (MVICKF and MVICKE) was measured, and the hamstring/quadriceps strength (H/Q) ratio was calculated. Furthermore, changes in NHE maximum reaction force (NHE-MRFKF), NHE break-point angle (NHE-BPA), and muscle activity of the semitendinosus (STEMG) and biceps femoris (BFEMG) during the NHE after the interventions were compared. Although no group × time effects were observed (p = 0.09-0.70), but time effects were found for all variables. Pairwise comparisons revealed that MVICKF (+16.9%; p = 0.02), H/Q ratio (+11.8%; p = 0.01), NHE-MRFKF (+19.8%; p = 0.005), and NHE-BPA (+30.8%; p = 0.001) increased after ECC, whereas NHE-MRFKF (+9.7%; p = 0.003), NHE-BPA (+35.5%; p = 0.0002), and STEMG (+33.7%; p = 0.02) increased after NHT. A group × time effect was observed (p = 0.003) in BFEMG, revealing an increase only after ECC (+41.1%; p < 0.0001). Similar neuromuscular adaptations were found after both training modalities. Therefore, ECC provides similar adaptations as NHT and may serve as an alternative form of KF training for those unable to perform NHE.

• MeSH
• cvičení fyziologie   MeSH
• kolenní kloub fyziologie   MeSH
• koleno MeSH
• lidé MeSH
• svalová síla fyziologie   MeSH
• zadní stehenní svaly * fyziologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

PURPOSE: Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. METHODS: We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. RESULTS: One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. CONCLUSIONS: General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.

• MeSH
• fotbal zranění   MeSH
• lidé MeSH
• návrat ke sportu * MeSH
• poranění dolní končetiny * MeSH
• rozhodování MeSH
• sportovní úrazy * MeSH
• zadní stehenní svaly zranění   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH