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Krenn P.J.,University of Graz | Titze S.,University of Graz | Oja P.,UKK Institute | Jones A.,University of East Anglia | And 2 more authors.
American Journal of Preventive Medicine | Year: 2011

Context: The GPS represents an innovative way to objectively assess the spatial locations of physical activity behavior. The aim of this systematic review was to determine the capability of GPS to collect high-quality data on the location of activities in research on the relationship between physical activity and the environment. Evidence acquisition: Published and unpublished articles identified from seven electronic databases, reference lists, bibliographies, and websites up to March 2010 were systematically searched for, appraised, and analyzed in summer 2010. Included studies used GPS to measure the spatial locations of physical activity and some form of environmental analysis related to the GPS data. The capability of GPS was expressed in terms of data quality, which in turn was defined as the proportion of GPS data lost in each study. Evidence synthesis: 24 studies met the inclusion criteria. Data loss was positively correlated with the measurement period for which participants were asked to wear the GPS device (r=0.81, p<0.001). Major reasons for data loss included signal drop-outs, loss of device battery power, and poor adherence of participants to measurement protocols. Data loss did not differ significantly between children and adults or by study sample size, year of publication, or GPS device manufacturer. Conclusions: GPS is a promising tool for improving understanding of the spatial context of physical activity. The current findings suggest that the choice of an appropriate device and efforts to maximize participant adherence are key to improving data quality, especially over longer study periods. © 2011 American Journal of Preventive Medicine. Source

Suomalainen P.,University of Tampere | Kannus P.,UKK Institute | Jarvela T.,Sports Clinic
International Orthopaedics | Year: 2013

Purpose: Anterior cruciate ligament (ACL) reconstruction has been under intensive discussion and debate, although the anatomy of this ligament was resolved thoroughly almost 200 years ago. The ACL consist of two bundles, anteromedial (AM) and posterolateral (PL). The conventional single-bundle method reconstructs the AM bundle only, while the modern double-bundle technique recreates both bundles for their anatomical sites. Methods: An English language literature search was undertaken over the years 2000-2012 for ACL reconstruction, double-bundle versus single bundle technique. The search found 14 RCTs and two meta-analyses published to date. Results: Two of the 14 studies (14 %) showed no difference between the two reconstruction methods while the remaining majority (12 trials, 86 %) concluded that the DB technique was better than the SB method. After the DB reconstruction, rotational stability of the knee was better in seven studies (50 %) and anteroposterior stability in six (43 %). No study spoke for the single-bundle technique. In addition, with the double-bundle technique knee scores were reported to be better in five (36 %) studies, and three trials (21 %) revealed less reoperations in the double-bundle group. Conclusions: The double-bundle ACL reconstruction technique was reported to have better or at least the same results as the conventional single-bundle method - even at a five-year follow-up. However, the majority of these studies had a rather short follow-up, and thus, longer studies are needed to confirm the true long-term results of ACL surgery. Long follow-up periods are also needed to find out whether double-bundle ACL reconstruction can eventually prevent knee osteoarthritis. © 2012 Springer-Verlag Berlin Heidelberg. Source

Stronegger W.J.,Medical University of Graz | Titze S.,University of Graz | Oja P.,UKK Institute
Health and Place | Year: 2010

The aim of our study was to identify perceptions of the residential environment and their association with physical activity for specific purposes and with self-rated health in an urban context. A representative survey of inhabitants of Graz (a mid-sized Austrian city) aged 15-60 years (n=997) was conducted. We found a perceived high social-environmental quality of the residential environment to be associated with higher levels of self-rated health and leisure time physical activity. Both leisure time physical activity and satisfaction with environmental quality were independently linked with self-rated health. Furthermore, a high level of satisfaction with the individual's local infrastructure may support the residents to engage in higher levels of physical activity for transportation, whereas the preferred mode of transportation may be gender-specific: men tend to use the bicycle while women walk. Our results suggest that local infrastructure facilities should be designed so as to ensure accessibility by both walking and cycling. © 2010 Elsevier Ltd. Source

Suomalainen P.,University of Tampere | Jarvela T.,Sports Clinic and Hospital Mehilainen | Paakkala A.,University of Tampere | Kannus P.,UKK Institute | Jarvinen M.,University of Tampere
American Journal of Sports Medicine | Year: 2012

Background: Surgical technique is essential in anterior cruciate ligament (ACL) reconstruction. Purpose: This randomized 5-year study tested the hypothesis that double-bundle ACL reconstruction with hamstring autografts and aperture screw fixation has fewer graft ruptures and rates of osteoarthritis (OA) and better stability than single-bundle reconstruction. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Ninety patients were randomized: double-bundle ACL reconstruction with bioabsorbable screw fixation (DB group; n = 30), single-bundle ACL reconstruction with bioabsorbable screw fixation (SBB group; n = 30), and single-bundle ACL reconstruction with metallic screw fixation (SBM group; n = 30). The following evaluation methods were used: clinical examination, KT-1000 arthrometer measurement, and International Knee Documentation Committee (IKDC) and Lysholm knee scores. Additionally, radiographic evaluation was made by a musculoskeletal radiologist who was unaware of the patients clinical and surgical data. A single orthopaedic surgeon performed all the operations, and clinical follow-up assessments were made in a blinded manner by an independent examiner. Results: Preoperatively, there were no differences between the groups. Eleven patients (7 in the SBB group, 3 in the SBM group, and 1 in the DB group) had a graft failure during the follow-up and went on to ACL revision surgery (P≤.043). Of the remaining 79 patients, a 5-year follow-up was performed for 65 patients (20 in the DB group, 21 in the SBB group, and 24 in the SBM group) who had their grafts intact. At 5 years, there was no statistically significant difference in the pivot-shift or KT-1000 arthrometer tests. In the DB group, 20% of the patients had OA in the medial femorotibial compartment and 10% in the lateral compartment, while the corresponding figures were 33% and 18% in the single-bundle groups, again an insignificant finding. Further, no significant group differences were found in the knee scores. Conclusion: The double-bundle surgery resulted in significantly fewer graft failures and subsequent revision ACL surgery than the single-bundle surgeries during the 5-year follow-up. Knee stability and OA rates were similar at 5 years. In view of the size of the groups, some caution should be exercised when interpreting the lack of difference in the secondary outcomes. © 2012 The Author(s). Source

Kurppa K.,University of Tampere | Paavola A.,University of Tampere | Collin P.,University of Tampere | Sievanen H.,UKK Institute | And 5 more authors.
Gastroenterology | Year: 2014

Background & Aims We investigated whether screen-detected and apparently asymptomatic adults with endomysial antibodies (EmA) benefit from a gluten-free diet (GFD). Methods We performed a prospective trial of 3031 individuals at risk for celiac disease based on screens for EmA. Of 148 seropositive individuals, 40 fulfilled inclusion criteria and were assigned randomly to groups placed on a GFD or gluten-containing diets. We evaluated ratios of small-bowel mucosal villous height:crypt depth, serology and laboratory test results, gastrointestinal symptom scores, physiologic well-being, perception of health by a visual analog scale, bone mineral density, and body composition at baseline and after 1 year. Thereafter, the group on the gluten-containing diet started a GFD and was evaluated a third time; subjects in the GFD group remained on this diet. Results After 1 year on the GFD, the mean mucosal villous height:crypt depth values increased (P <.001), levels of celiac-associated antibodies decreased (P <.003), and gastrointestinal symptoms improved to a greater extent than in patients on gluten-containing diets (P =.003). The GFD group also had reduced indigestion (P =.006), reflux (P =.05), and anxiety (P =.025), and better health, based on the visual analog scale (P =.017), than the gluten-containing diet group. Only social function scores improved more in the gluten-containing diet group than in the GFD group (P =.031). There were no differences between groups in laboratory test results, bone mineral density, or body composition. Most measured parameters improved when patients in the gluten-containing diet group were placed on GFDs. No subjects considered their experience to be negative and most expected to remain on GFDs. Conclusions GFDs benefit asymptomatic EmA-positive patients. The results support active screening of patients at risk for celiac disease. Clinicaltrials.gov no: NCT01116505. © 2014 by the AGA Institute. Source

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