Examinando por Autor "De la Fuente, Carlos"
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Ítem Anatomical Repair With Achilles Tendon Allograft Augmentation for Distal Medial Collateral Ligament Ruptures(Elsevier B.V., 2024-07) Yáñez, Roberto; Saravia, Anthony; Zamorano, Hector; Caracciolo, Gaston; Neira, Alejandro; De la Fuente, CarlosSeveral conditions may require medial collateral ligament (MCL) surgery, especially when high physical demands are required. Thus, we described a technique for anatomical repair of distal MCL rupture using a distal anchor and MCL augmentation through Achilles tendon allograft with proximal bone block and interference screw. This procedure fixes an anchor distally at the tibia. Then, the ligament endings are sutured using a continuous simple-type technique. Subsequently, a low-radiated Achilles tendon allograft is attached proximally and fixed through an interference screw. Finally, the allograft is sutured using a continuous simple-type technique. Our anatomical MCL repair and augmentation allows a reinforced anatomical technique to control the valgus instability caused by MCL distal ruptures, considering the MCL axial traction and posterior oblique ligament fiber orientations.Ítem Association between the home-to-healthcare center distance and hearing aid abandonment among older adults(Frontiers Media SA, 2024-03) Fuentes-López, Eduardo; Galaz-Mella, Javier; Ayala, Salvador; De la Fuente, Carlos; Luna-Monsalve, Manuel; Nieman, Carrie; Marcotti, AnthonyBackground: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. Objective: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. Methods: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. Results: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04–1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. Conclusion: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).Ítem Exploratory Anterior Cruciate Ligament Graft Stress during Medial Knee Rotation with and without Iliotibial Band–Intermuscular Septum Lateral Extra-Articular Tenodesis for Transtibial and Anteromedial Femoral Tunnels(Multidisciplinary Digital Publishing Institute (MDPI), 2024-06) Yañez, Roberto; Silvestre, Rony; Roby, Matias; Neira, Alejandro; Madera, Samuel; De la Fuente, CarlosTraditional lateral extra-articular tenodesis (LET) using fixation elements constrains medial knee rotation laxity after anterior cruciate ligament reconstruction (ACLr). However, the mechanical behavior of an LET made with an iliotibial band–intermuscular septum is unknown using different anterior cruciate ligament (ACL) reconstruction drillings and would be crucial for constraining the rotatory components of direction change movements. Thus, this study aimed to explore the maximum principal stresses and their distribution in grafts during medial knee rotation with and without iliotibial band–intermuscular septum lateral extra-articular tenodesis for the transtibial technique (TT), hybrid transtibial technique (HTT), and anteromedial portal technique (AM) in single-bundle ACLr. The maximum von Mises principal stresses and their distribution under medial knee rotation were described using a finite element model generated from a healthy knee. LET with HTT, TT, and AM decreases stress by 97%, 93%, and 86% during medial rotation compared to each technique without LET, respectively. The stress concentration for the AM portal and TT techniques was located at the femoral tunnel, and for HTT with LET, it was located across the distal thirds of the anterior aspect of the graft. In conclusion, the HTT with LET diminishes graft stress more than the HTT, TT, and AM without LET, and the TT and AM with LET during medial knee rotation. The AM portal, HTT, and TT techniques without LET show higher stress concentration patterns at the femoral tunnel, establishing a biomechanical risk of femoral tunnel enlargement when LET is not performed.Ítem Finite element graft stress for anteromedial portal, transtibial, and hybrid transtibial femoral drillings under anterior translation and medial rotation: an exploratory study(Scientific Reports, Volume 14, Issue 1 December 2024 Article number 11922, 2024-12) Yañez, Roberto; Silvestre, Rony; Roby, Matias; Neira, Alejandro; Azar, Camilo; Madera, Samuel; Ortiz-Bernardin, Alejandro; Carpes, Felipe P.; De la Fuente, CarlosStress concentration on the Anterior Cruciate Ligament Reconstruction (ACLr) for femoral drillings is crucial to understanding failures. Therefore, we described the graft stress for transtibial (TT), the anteromedial portal (AM), and hybrid transtibial (HTT) techniques during the anterior tibial translation and medial knee rotation in a finite element model. A healthy participant with a non-medical record of Anterior Cruciate Ligament rupture with regular sports practice underwent finite element analysis. We modeled TT, HTT, AM drillings, and the ACLr as hyperelastic isotropic material. The maximum Von Mises principal stresses and distributions were obtained from anterior tibial translation and medial rotation. During the anterior tibia translation, the HTT, TT, and AM drilling were 31.5 MPa, 34.6 Mpa, and 35.0 MPa, respectively. During the medial knee rotation, the AM, TT, and HTT drilling were 17.3 MPa, 20.3 Mpa, and 21.6 MPa, respectively. The stress was concentrated at the lateral aspect of ACLr,near the femoral tunnel for all techniques independent of the knee movement. Meanwhile, the AM tunnel concentrates the stress at the medial aspect of the ACLr body under medial rotation. The HTT better constrains the anterior tibia translation than AM and TT drillings, while AM does for medial knee rotation. © The Author(s) 2024.Ítem Local experience of laboratory activities in a BS physical therapy course: integrating sEMG and kinematics technology with active learning across six cohorts(Frontiers Media SA, 2024-04) De la Fuente, Carlos; Neira, Alejandro; Machado, Álvaro S.; Delgado-Bravo, Mauricio; Kunzler, Marcos R.; de Andrade, André Gustavo P.; Carpes, Felipe P.Introduction: Integrating technology and active learning methods into Laboratory activities would be a transformative educational experience to familiarize physical therapy (PT) students with STEM backgrounds and STEM-based new technologies. However, PT students struggle with technology and feel comfortable memorizing under expositive lectures. Thus, we described the difficulties, uncertainties, and advances observed by faculties on students and the perceptions about learning, satisfaction, and grades of students after implementing laboratory activities in a PT undergraduate course, which integrated surface-electromyography (sEMG) and kinematic technology combined with active learning methods. Methods: Six cohorts of PT students (n = 482) of a second-year PT course were included. The course had expositive lectures and seven laboratory activities. Students interpreted the evidence and addressed different motor control problems related to daily life movements. The difficulties, uncertainties, and advances observed by faculties on students, as well as the students’ perceptions about learning, satisfaction with the course activities, and grades of students, were described. Results: The number of students indicating that the methodology was “always” or “almost always,” promoting creative, analytical, or critical thinking was 70.5% [61.0–88.0%]. Satisfaction with the whole course was 97.0% [93.0–98.0%]. Laboratory grades were linearly associated to course grades with a regression coefficient of 0.53 and 0.43 R-squared (p < 0.001). Conclusion: Integrating sEMG and kinematics technology with active learning into laboratory activities enhances students’ engagement and understanding of human movement. This approach holds promises to improve teaching-learning processes, which were observed consistently across the cohorts of students. Copyright © 2024 De la Fuente, Neira, Machado, Delgado-Bravo, Kunzler, de Andrade and Carpes.Ítem Unique case study: Impact of single-session neuromuscular biofeedback on motor unit properties following 12 days of Achilles tendon surgical repair(American Physiological Society, 2024-01) De la Fuente, Carlos; Silvestre, Rony; Botello, Julio; Neira, Alejandro; Soldan, Macarena; Carpes, Felipe P.We explored the first evidence of a single-session neuromuscular biofeedback effect on motor unit properties, neuromuscular activation, and the Achilles tendon (AT) length 12 days after undergoing AT surgical repair. We hypothesized that immediate neuromuscular biofeedback enhances motor unit properties and activation without causing AT lengthening. After 12 days AT surgical repair, Medial Gastrocnemius (MG) motor unit decomposition was performed on a 58-year-old male before and after a neuromuscular biofeedback intervention (surface electromyography (sEMG) and ultrasonography), involving unressited plantar flexion. The analysis included motor unit population properties, sEMG amplitude, force paradigm, and AT length. There were increased MG motor unit recruitment, peak and average firing rate, coefficient of variation, and sEMG amplitude, and decreased recruitment and derecruitment threshold in the repaired AT limb. The non-injured limb increased the motor unit recruitment, and decreased the coefficient of variation, peak and average firing rate, inter-pulse interval, derecruitment threshold and sEMG amplitude. The AT length experienced −0.4 and 0.3 cm changes in the repaired AT and non-injured limb, respectively. This single-session neuromuscular biofeedback 12 days after AT surgery shows evidence of enhanced motor unit properties and activation without signs of AT lengthening when unresisted plantar flexion is performed in the repaired AT limb. © 2024 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.