PURPOSE: STereotactic Arrhythmia Radioablation (STAR) showed promising results in patients with refractory ventricular tachycardia. However, clinical data are scarce and heterogeneous. The STOPSTORM.eu consortium was established to investigate and harmonize STAR in Europe. The primary goal of this benchmark study was to investigate current treatment planning practice within the STOPSTORM project as a baseline for future harmonization. METHODS AND MATERIALS: Planning target volumes (PTVs) overlapping extracardiac organs-at-risk and/or cardiac substructures were generated for 3 STAR cases. Participating centers were asked to create single-fraction treatment plans with 25 Gy dose prescriptions based on in-house clinical practice. All treatment plans were reviewed by an expert panel and quantitative crowd knowledge-based analysis was performed with independent software using descriptive statistics for International Commission on Radiation Units and Measurements report 91 relevant parameters and crowd dose-volume histograms. Thereafter, treatment planning consensus statements were established using a dual-stage voting process. RESULTS: Twenty centers submitted 67 treatment plans for this study. In most plans (75%) intensity modulated arc therapy with 6 MV flattening filter free beams was used. Dose prescription was mainly based on PTV D95% (49%) or D96%-100% (19%). Many participants preferred to spare close extracardiac organs-at-risk (75%) and cardiac substructures (50%) by PTV coverage reduction. PTV D0.035cm3 ranged from 25.5 to 34.6 Gy, demonstrating a large variety of dose inhomogeneity. Estimated treatment times without motion compensation or setup ranged from 2 to 80 minutes. For the consensus statements, a strong agreement was reached for beam technique planning, dose calculation, prescription methods, and trade-offs between target and extracardiac critical structures. No agreement was reached on cardiac substructure dose limitations and on desired dose inhomogeneity in the target. CONCLUSIONS: This STOPSTORM multicenter treatment planning benchmark study not only showed strong agreement on several aspects of STAR treatment planning, but also revealed disagreement on others. To standardize and harmonize STAR in the future, consensus statements were established; however, clinical data are urgently needed for actionable guidelines for treatment planning.

• MeSH
• Benchmarking * MeSH
• Radiotherapy Dosage MeSH
• Tachycardia, Ventricular surgery   radiotherapy   MeSH
• Consensus * MeSH
• Organs at Risk * radiation effects   MeSH
• Humans MeSH
• Radiotherapy Planning, Computer-Assisted * standards   methods   MeSH
• Radiosurgery * standards   methods   MeSH
• Radiotherapy, Intensity-Modulated methods   standards   MeSH
• Heart radiation effects   MeSH
• Arrhythmias, Cardiac MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Geographicals
• Europe MeSH

Účel studie: Radiosynoviortéza (RSO), dříve též nazývána slovem radiosynovektomie (RS), je metoda zaměřená na léčbu bolesti a otoku kloubů způsobených synovitidou u artritid a dekompenzovaných artróz prostřednictvím lokální aplikace beta zářičů. Zářením vyvolaná povrchová nekróza části buněk v synoviální membráně ve svém výsledku může zmírnit bolest, snížit otoky a zlepšit funkci kloubů. Materiál a metoda: V období 2013–2024 bylo RSO léčeno celkem 436 pacientů, z toho 291 pro otok kolenního kloubu vzniklý v důsledku dekompenzované artrózy a 172 kvůli artritidě. Kolenní kloub byl RSO ošetřen 268krát a malé a střední klouby 50krát. Používalo se yttrium u kolenních kloubů, rhenium u středních nebo erbium u malých kloubů. Samotný zákrok spočíval v punkci kloubu a odsátí případného kloubního výpotku, následné aplikaci radiofarmaka a imobilizaci kloubu po dobu 2–3 dnů. Výsledky: K hodnocení klinického efektu RSO jsme vybrali aplikace v letech 2022 a 2023. V roce 2022 bylo provedeno 45 ošetření a v roce 2023 dalších 26. Po jednom roce bylo 61 % pacientů s léčbou kolenních kloubů zcela spokojeno, přičemž uváděli zmenšení otoku a zlepšení rozsahu pohybu. U pacientů léčených s malými a středně velkými klouby se celkové zlepšení objevilo u 57 % z nich. Někteří zaznamenali recidivující výpotek menšího objemu nebo jen částečné zlepšení. Závěr: Radiosynoviortéza je účinná léčba otoků a bolesti kloubů způsobených synovitidou s pozitivními výsledky jak u kolenních, tak i menších kloubů, což je doloženo jak objektivními, tak subjektivními zlepšeními.

Purpose of the study: Radiosynoviorthesis (RSO), previously also called radiosynovectomy (RS), is a method focused on the treatment of joint pain and swelling caused by synovitis in arthritis and decompensated osteoarthrosis using beta emitters. Radiation-induced surface necrosis of part of the cells in the synovial membrane can, as a result, relieve pain, reduce swelling, and improve joint function. Material and method: Between 2013-2024, 436 patients were treated with RSO, primarily for knee joint swelling due to decompensated osteoarthrosis (291 patients) and arthritis (172 patients). RSO was performed on the knee (268 cases) and on small/medium joints (50 cases), using yttrium for knee joints, rhenium for medium joins or erbium for small joints. The procedure involved puncture of the joint and suction of any joint effusion, injecting the radioactive isotope, and subsequently immobilizing the joint for 2–3 days. Results: We selected treatments in 2022 and 2023 to evaluate the clinical effect of RSO. In 2022, 45 treatments were performed, and in 2023 another 26. One year post-treatment, 61 % of patients with knee joint involvement were fully satisfied, reporting reduced swelling and improved range of motion. Among patients treated for small and medium-sized joints, 57 % experienced overall improvement. Some patients observed recurring effusions of smaller volume or only partial improvement. Conclusion: Radiosynoviorthesis is an effective treatment for joint swelling and pain caused by synovitis, with positive outcomes seen in knee as well as smaller joints. Both objective and subjective assessments confirmed significant benefits.

• Keywords
• radiosynoviortéza,
• MeSH
• Arthritis diagnostic imaging   radiotherapy   MeSH
• Erbium administration & dosage   therapeutic use   MeSH
• Injections, Intra-Articular MeSH
• Clinical Trials as Topic MeSH
• Osteoarthritis diagnostic imaging   radiotherapy   MeSH
• Radiopharmaceuticals * administration & dosage   therapeutic use   MeSH
• Yttrium Radioisotopes administration & dosage   therapeutic use   MeSH
• Rhenium administration & dosage   therapeutic use   MeSH
• Synovitis * diagnostic imaging   radiotherapy   MeSH

BACKGROUND: Ice hockey players experience groin pain and imbalances in the muscles of the hip joint, possibly because of the condition of the intercartilage space (ICS). PURPOSE: To describe the lateral differences in size of the articular ICS, range of motion, and adductor/abductor muscle strength between elite and subelite ice hockey players and a control group of participants who did not play ice hockey. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: 33 elite hockey players, 26 subelite hockey players, and 30 non-ice hockey player controls were compared in terms of ICS thickness, isometric hip abductor muscle strength, hip range of motion, functional test results, and pain score. Two-way analysis of variance was used to identify differences in laterality and performance levels. RESULTS: The ICS of the hip joint was smaller (P < .001) in both groups of ice hockey players than in the control group (0.97 ± 0.11 mm) and smaller (P = .005) on the backhand side (elite 0.66 ± 0.24 mm; subelite 0.65 ± 0.15 mm) than on the forehand side (elite 0.78 ± 0.18 mm; subelite 0.74 ± 0.24 mm) in both groups of hockey players. Compared with the control (41.6°± 4°) and subelite groups, the elite group had less (P < .001) hip external rotation (elite 30.4°± 6.1°; subelite 35°± 6.5°) and internal rotation (elite 31.5°± 5.1°; subelite 35.1°± 6.5°), with no differences in laterality (P > .05). Both hockey groups had positive hip pain provocation tests and greater (P < .001) hip adduction (elite 457 ± 85 N; subelite 450 ± 82 N) and abduction (elite 429 ± 60 N; subelite 422 ± 63 N) muscle strength than the controls (adduction 347 ± 70 N; abduction 346 ± 75 N). Elite players had a greater (P = .008) adductor strength ratio on the backhand side (1.16 ± 19) than the control group (1.02 ± 0.15). CONCLUSION: Ice hockey players had a smaller ICS of the hip joint, particularly on the backhand side. These structural changes were accompanied by reduced range of motion in the hip joint, increased pain, and asymmetries in muscle strength. Hip range of motion and symmetry of adductor/abductor muscle strength should be considered when diagnosing ice hockey players. ICS assessment via sonography might become a useful tool for the evaluation of structural changes in the hip. Research on ice hockey-related injuries should focus more on the structural and functional condition of the backhand side of the hip.

• Publication type
• Journal Article MeSH

BACKGROUND: Muscle strength and postural control are essential components for performing daily living activities, particularly in older adults, and can therefore serve as screening tools for assessing fall risk in this population. METHODS: The aim of this quasi-experimental study was to evaluate the impact of a 12-week exercise intervention followed by a 2-week detraining period on lower limb strength and postural stability in older adults. The study involved 38 community-dwelling participants of Central European origin over 60 years of age. Participants underwent the measurements consisting of assessments of knee flexors and extensors strength (isokinetic dynamometer, 90° range of motion, 60°/s angular velocity, Humac Norm CSMI, Stoughton MA, USA), toe grip strength (toe grip dynamometer, Takei Scientific Instruments, Niigata, Japan), and postural stability (narrow stand, 30 s, Kistler, Switzerland). Testing was repeated three times during the study (pre-intervention, post-intervention, and post-detraining). Participants were separated into 3 groups according to the type of training: resistance training group (n = 13), proprioceptive training group (n = 14), and endurance training group (n = 11). The intervention program lasted 12 weeks, two 60-min sessions per week. A linear mixed model (LMM) predicted a change in postural stability after the resistance, proprioceptive, and endurance exercise interventions were applied. RESULTS: Results showed that knee extensor strength normalized to body mass significantly increased in the resistance training group post-intervention (p = 0.01). Toe grip strength was significantly higher after the intervention in the endurance training group (p = 0.02). A statistically significant increase in knee flexor strength was observed in the proprioceptive training group (p = 0.01). The 2-weeks detraining period revealed no statistically significant loss in training gains. The LMM found different predictions of postural stability changes related to knee extensor strength after each type of training intervention. The final LMM model explains well the variability of the dependent variable R2 = 0.866. CONCLUSIONS: These results highlight the unique characteristics of specific exercise interventions in enhancing muscular strength and postural stability, which are critical for fall prevention among older adults.

• MeSH
• Time Factors MeSH
• Exercise * physiology   MeSH
• Lower Extremity * physiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Linear Models MeSH
• Resistance Training * methods   MeSH
• Postural Balance * physiology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Muscle Strength * physiology   MeSH
• Exercise Therapy * methods   MeSH
• Accidental Falls prevention & control   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVES: The aim of this study was to investigate the long-term effects of computer-assisted CiTM navigation on clinical, radiological, and functional results versus conventional total knee arthroplasty (TKA). PATIENTS AND METHODS: Between January 2005 and July 2011, a total of 85 patients (36 males, 49 females; mean age: 66.2±5.2 years; range, 59 to 84 years) who underwent P.F.C. SigmaTM knee system implantation using computer-assisted CiTM navigation system (BrainLAB®, DePuy International, Leeds, UK) and completed a minimum follow-up of eight years were included in the study. In the control group, a total of 100 patients (40 males, 60 females; mean age: 68.3±3.9 years; range, 60 to 79 years) who completed a minimum follow-up of eight years were randomly selected from a dataset of implanted P.F.C. SigmaTM knee systems in the same period using Specialist® 2 instrumentation without navigation. An implant survival analysis was used to compare implant survivorship between the groups throughout 12 years. The Knee Society Score (KSS) and range of motion (ROM) were assessed. Based on long-format X-ray images, the implant position in the frontal and sagittal planes was evaluated. RESULTS: The ratio for navigation to control group survival is approximately 1.01 at 12 years. The clinical outcomes showed no significant difference between the groups (knee scores, p=0.707 and functional scores, p=0.485). In the measured angles analysis, we observed a consistent pattern in both groups. In the control group, there was a trend toward implanting the tibial component with slight varus alignment (p=0.038) and a higher posterior slope (p<0.001). On average, the operation was prolonged by 13 min in the navigated group (p<0.001). CONCLUSION: In conclusion, our study results demonstrate that while kinematic navigation in TKA improves the precision of implant alignment, it does not provide significant benefits in terms of long-term implant survival or functional outcomes compared to conventional TKA methods. The use of the computer-assisted CiTM navigation system is associated with prolonged operation duration, although no technical complications related to the navigation device's software can be observed. Therefore, although navigation offers theoretical advantages in component positioning, its use may be more justifiable in cases with challenging alignment requirements rather than as a routine practice.

• MeSH
• Osteoarthritis, Knee * surgery   physiopathology   diagnostic imaging   MeSH
• Time Factors MeSH
• Surgery, Computer-Assisted * adverse effects   methods   instrumentation   MeSH
• Knee Joint * surgery   diagnostic imaging   physiopathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Recovery of Function MeSH
• Knee Prosthesis MeSH
• Retrospective Studies MeSH
• Range of Motion, Articular MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Arthroplasty, Replacement, Knee * methods   instrumentation   adverse effects   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

BACKGROUND: The use of statistical parameter mapping (SPM) to compare gait kinematics of children at different ages seems to be a more appropriate tool to describe the differences than simply describing the maxima and minima on the curves. RESEARCH QUESTION: Does lower limb kinematic waveforms differ during gait in normally developing preschool children? METHODS: In a cross-sectional study, SPM was used to compare kinematic waveforms of typically developing preschool children at ages 2, 3, and 6 years (n = 42). RESULTS: Differences in internal rotation foot angle between 2-year-olds and 3-, 6-year-olds in 22-55 % lower in 2-year-olds but 85-100 % greater in 2-year-olds. Greater internal rotation of the knee in 2-year-olds versus 6-year-olds in 13-25 % of the stance phase. Lower knee abduction in 2-year-olds versus 6-year-olds in the first 13 % of the stance phase. SIGNIFICANCE: Comparison of the waveforms of the angle may provide a clearer understanding of the differences in gait kinematics in children at different ages.

• MeSH
• Biomechanical Phenomena MeSH
• Gait * physiology   MeSH
• Child MeSH
• Knee Joint * physiology   MeSH
• Humans MeSH
• Child, Preschool MeSH
• Cross-Sectional Studies MeSH
• Range of Motion, Articular * physiology   MeSH
• Age Factors MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

PURPOSE OF THE STUDY: Rhizarthrosis-osteoarthritis of the thumb carpometacarpal (CMC) joint is usually a primary idiopathic disease. Total joint arthroplasty (TJA) is one of the surgical treatment options for symptomatic advanced thumb CMC arthritis. This retrospective study aims to evaluate the mid-term functional and radiological results of TJA with the minimum follow-up period of 3 years after the surgery. MATERIAL AND METHODS: Presented are the results of 136 total trapeziometacarpal joint replacements in the group of 105 patients consisted of 96 women and 9 men. Used prostheses were ELiS® implant (27 cases), Ivory® implant (42 cases), Touch® Dual mobility (67 cases). The follow-up period was minimally 3 years postoperatively. In all the patients, along with range of motion and radiologic evaluation of implant position, the function and pain of operated joint were evaluated using DASH and VAS score at regular intervals pre- and postoperatively. RESULTS: At a mean of 85 months (range 38-126 months) post-operatively, patients in 116 cases (85%) reported full satisfaction and absence of symptoms and difficulties. In 12 cases (9%) some slight residual post-exercise pain was reported. In eight cases (6%) patients suffered from episodic rest-pain, but with a lower intensity than in the preoperative period. Postoperatively, the patients declared subjective improvement in hand function. The total DASH score and VAS score decreased in all patients, while ROM increased. The course of all of TJA surgeries was complication-free. Five patients needed revision surgery. In two patients a dislocation has occurred and in three cases a loosening of the cup's implant was reported. The most frequent postoperative complication was the occurrence of transient paraesthesias of the thumb in eight cases (6%). CONCLUSIONS: TJA is the method of choice in management of advanced symptomatic osteoarthritis of the thumb CMC joint. Mastering surgical technique, TJA represents safe and effective treatment method in advanced degenerative changes of the thumb CMC joint and it's benefits exceed possible perioperative and postoperative risks.

• MeSH
• Arthroplasty, Replacement * methods   MeSH
• Adult MeSH
• Carpometacarpal Joints * surgery   MeSH
• Middle Aged MeSH
• Humans MeSH
• Osteoarthritis * surgery   MeSH
• Thumb * surgery   MeSH
• Joint Prosthesis MeSH
• Retrospective Studies MeSH
• Range of Motion, Articular MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Radiation therapy manages pancreatic cancer in various settings; however, the proximity of gastrointestinal (GI) luminal organs at risk (OARs) poses challenges to conventional radiation therapy. Proton beam therapy (PBT) may reduce toxicities compared to photon therapy. This consensus statement summarizes PBT's safe and optimal delivery for pancreatic tumors. Our group has specific expertise using PBT for GI indications and has developed expert recommendations for treating pancreatic tumors with PBT. Computed tomography (CT) simulation: Patients should be simulated supine (arms above head) with custom upper body immobilization. For stomach/duodenum filling consistency, patients should restrict oral intake within 3 hours before simulation/treatments. Fiducial markers may be implanted for image guidance; however, their design and composition require scrutiny. The reconstruction field-of-view should encompass all immobilization devices at the target level (CT slice thickness 2-3 mm). Four-dimensional CT should quantify respiratory motion and guide motion mitigation. Respiratory gating is recommended when motion affects OAR sparing or reduces target coverage. Treatment planning: Beam-angle selection factors include priority OAR-dose minimization, water-equivalent-thickness stability along the beam path, and enhanced relative biological effect consideration due to the increased linear energy transfer at the proton beam end-of-range. Posterior and right-lateral beam angles that avoid traversing GI luminal structures are preferred (minimizing dosimetric impacts of variable anatomies). Pencil beam scanning techniques should use robust optimization. Single-field optimization is preferable to increase robustness, but if OAR constraints cannot be met, multifield optimization may be used. Treatment delivery: Volumetric image guidance should be used daily. CT scans should be acquired ad hoc as necessary (at minimum every other week) to assess the dosimetric impacts of anatomy changes. Adaptive replanning should be performed as required. Our group has developed recommendations for delivering PBT to safely and effectively manage pancreatic tumors.

• MeSH
• Radiotherapy Dosage MeSH
• Four-Dimensional Computed Tomography MeSH
• Respiration MeSH
• Immobilization methods   MeSH
• Consensus MeSH
• Organs at Risk * diagnostic imaging   radiation effects   MeSH
• Humans MeSH
• Pancreatic Neoplasms * radiotherapy   diagnostic imaging   MeSH
• Radiotherapy Planning, Computer-Assisted methods   MeSH
• Organ Motion MeSH
• Movement MeSH
• Proton Therapy * methods   adverse effects   standards   MeSH
• Radiation Injuries prevention & control   MeSH
• Radiotherapy, Image-Guided methods   MeSH
• Stomach diagnostic imaging   MeSH
• Fiducial Markers MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Consensus Development Conference MeSH

Rhizarthrosis is accompanied by decreased mobility, poor grip, and progressive pain. Surgical treatment, which involves various techniques, is the only definitive solution sparing the joint. First carpometacarpal (CMC) joint arthroplasty helps reduce the discomfort associated with rhizarthrosis and restores joint function. From 2020 to the end of March 2024, 35 arthroplasties of the first CMC joint have been performed. In this study, the implant survival was recorded at a five-year follow-up. Evaluation of functional outcomes was conducted using preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand (DASH), visual analogue scale (VAS), and Kapandji scores. Two types of implants were used, and their postoperative DASH and Kapandji scores were compared. The one-year implant survival was 0.97, and the three-year implant survival was 0.86. Range of motion showed significant improvement in patients after the first CMC arthroplasty. The VAS score, which assesses pain, and the DASH score, used to subjectively assess upper extremity disability, showed similar postoperative improvement. There is no significant difference in postoperative outcomes (DASH score and Kapandji score) between the "standard" and "dual mobility" implant types when evaluating postoperative outcomes. One intraoperative and two postoperative complications were observed in this study. First CMC joint arthroplasty effectively relieves pain, improves range of motion, and enhances functional outcomes in patients with rhizarthrosis. Both implant types demonstrated similar postoperative results in terms of DASH and Kapandji scores. While the study observed a few complications, the overall results support the efficacy of first CMC joint arthroplasty as a reliable treatment option for restoring joint function and reducing pain.

• Publication type
• Journal Article MeSH

BACKGROUND AND PURPOSE: Warm-up (WU) is a commonly practiced technique aimed at preparing athletes for physical activity. Although coaches and athletes consider WU essential, there is still an ongoing debate about its effectiveness. This might be due to the fact that WU procedures often rely on experiences rather than scientific research. During WU, athletes may pursue intermediate goals such as ensuring proper ranges of motion in joints, which seem crucial particularly for runners' ankle joints. Hence, the aim of this study was to evaluate influence of whole-body vibration (WBV), drop jump (DJ), and a combination of both (WBV + DJ) in terms of ankle dorsiflexion and running parameters among recreational runners. METHODS: Sixteen runners performed as a WU: five sets of 30 s calf raises without WBV (CTRL), five sets of 30 s calf raises during WBV, five sets of six DJ, five sets of 30 s calf raises during WBV followed by 6 DJ. Range of motion (ROM) of the ankle joint was measured in a prone position using an inclinometer for the soleus and gastrocnemius muscles, separately. Measurements were conducted before and after WU, and after a 3000 m run. RESULTS: There was no interaction for time and WU for left (p = 0.926) and right (p = 0.738) soleus muscle as well as for left (p = 0.748) and right (p = 0.197) gastrocnemius muscles. No difference (p = 0.914) for the running time was found. DISCUSSION: WBV, drop jumps, or a combination of both did not affect ankle dorsiflexion and running time.

• MeSH
• Running * physiology   MeSH
• Adult MeSH
• Ankle Joint * physiology   MeSH
• Cross-Over Studies * MeSH
• Muscle, Skeletal physiology   MeSH
• Humans MeSH
• Young Adult MeSH
• Range of Motion, Articular * physiology   MeSH
• Vibration * MeSH
• Warm-Up Exercise physiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH