The aims of the current study were to explore the pattern of the force-velocity (F-V) relationship of leg muscles, evaluate the reliability and concurrent validity of the obtained parameters, and explore the load associated changes in the muscle work and power output. Subjects performed maximum vertical countermovement jumps with a vest ranging 0-40% of their body mass. The ground reaction force and leg joint kinematics and kinetics were recorded. The data revealed a strong and approximately linear F-V relationship (individual correlation coefficients ranged from 0.78-0.93). The relationship slopes, F- and V-intercepts, and the calculated power were moderately to highly reliable (0.67 < ICC < 0.91), while the concurrent validity F- and V-intercepts, and power with respect to the directly measured values, was (on average) moderate. Despite that a load increase was associated with a decrease in both the countermovement depth and absolute power, the absolute work done increased, as well as the relative contribution of the knee work. The obtained findings generally suggest that the loaded vertical jumps could not only be developed into a routine method for testing the capacities of leg muscles, but also reveal the mechanisms of adaptation of multijoint movements to different loading conditions.
Hypothesis
Posterior positioning of medialization thyroplasty provides the best acoustic and aerodynamic outcomes.
Study Design
Ex vivo excised canine larynx.
Methods
Unilateral thyroplasty windows were cut in the thyroid cartilages of 10 excised canine larynges. Each larynx was mounted on an artificial lung and the vocal fold opposite the thyroid window was adducted by medializing its arytenoid cartilage. Then, medialization thyroplasty was simulated with a probe placed anterior, central, and posterior in the thyroid window. The glottal area, airway reduction, medialization force, phonation threshold pressure and flow, aerodynamic power, intensity, efficiency, jitter, shimmer, and signal-to-noise ratio (SNR) were measured at each medialization position.
Results
Posterior medialization probe placement minimized the glottal area, provided the best voice as determined by perturbation measures and SNR, reduced the work of phonation, and increased efficiency. Anterior and middle probe placement minimized the work of phonation but provided only modest gains in sound quality and decreased sound intensity. Medializing the vocal fold with posterior probe placement required twice as much force as central and anterior probe placement.
Conclusions
The results suggest that posterior medialization provides the greatest improvement in acoustic parameters and efficiency in patients who can tolerate the airway reduction. Middle and anterior medialization can decrease work of phonation, but in this experiment objective improvement in sound quality was limited. Subtle changes in displacement shim contour, especially in middle and anterior locations, have a substantial impact on voice outcome, affirming the value of intraoperative voice assessment.
Compared with a continuous femoral nerve block, a continuous adductor canal block did not appreciably decrease the time to overall discharge readiness even though it did decrease the time until adequate mobilization, primarily because both groups experienced similar analgesia and intravenous opioid requirements that--in most cases--exceeded the time to mobilization.
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