Although the quality of evidence was low, the published literature since 2006 suggests that CHEST's 2006 Cough Guidelines and management algorithms for acute, subacute, and chronic cough in adults appeared useful in diagnosing and treating patients with cough around the globe. These same algorithms have been updated to reflect the advances in cough management as of 2017.
As not all 10 factors studied were predictive of osteoarthritis, the hypothesis was only partially proven. Preventing further meniscal and chondral damage in patients with anterior cruciate ligament deficiency is critical. Grafting using the hamstring tendons and restoration of quadriceps-to-hamstring strength balance are associated with less osteoarthritis.
Functional stability of the knee is dependent on an intact ligamentous system and the timely and efficient contraction of supporting musculature. The aim of this study was to assess the relationship between muscle strength and functional stability in 31 patients pre-and post-operatively, following a unilateral anterior cruciate ligament rupture. All subjects underwent reconstructive surgery using semitendonosis and gracilis tendons. Isokinetic strength assessment of quadriceps and hamstring muscles was performed at a rate of movement of 6Oo/s and 120°/s. Functional stability was determined by performance during five functional stability tests that included the shuttle run, side step, carioca, single and triple hop tests. Pearson's correlation coefficient statistics were applied to pre-operative and post-operative data respectively. These analyses demonstrated a significant positive correlation between quadriceps strength indices at both testing speeds and the two hop tests pre-operatively (p's < 0.007) and between quadriceps strength indices at both speeds and all five functional tests post-operatively (p's < 0.01). Assessed using Steiger's formula, there was a significant increase in the correlation between quadriceps strength indices and three functional tests post-operatively compared to pre-operatively (p < 0.05). No significant correlation between hamstring strength indices and functional scores existed pre-or post-operatively. This study has shown a significant correlation exists between quadriceps strength indices and functional stability both before and after surgery, this relationship does not reach significance between hamstring strength indices and functional stability.
Six-year outcomes were very satisfactory irrespective of graft source. However, reconstruction using the hamstring tendons resulted in improved functional performance and a lower incidence of osteoarthritis.
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