OPEN FILE !!!! 

DUE SATURDAY MARCH 28, 2020 (ON TIME PLEASE) 

Respond to the 6 post below. 100-200 WORDS for each post. At least include 4 sources.

APA FORMAT (NO TITLE PAGE)

DUE Saturday March 28, 2020 (on time please)

1. Lauren H

From what I have read and researched; I think that a proximal fracture would be more difficult to treat than a fracture in the midshaft region. There are a few reasons that I found that support this idea. One, midshaft fractures allow for greater angulation than proximal fractures do (Houglum, 2016). Due to excessive angulation, proximal fractures often require anatomical reductions to reduce angulation and allow for proper healing (Meena et al., 2014). Research indicates that people who have anatomical reductions may develop an overall decrease in range of motion, yet maintain optimal quality of life (Shi et al., 2018). Unfortunately, I do not have any personal experience working the patients in these scenarios but from what I understand, a fracture in the upper third of the radius may be more difficult to treat.

2. Adam J

In his writing, Forsh (2019) explains that forearm fractures are generally categorized by the location in which they occur.

Most commonly, these classifications include proximal third, middle third, or distal third, indicating the site at which they are located.  When I consider fractures located in either the middle of the radius or fractures located in the proximal third of the radius, I feel the fractures located in the middle of the radius would be “worse”. One major reason I feel a fracture in this area would be worse is due necessity for this area to be stable and rigid.  When we consider the muscles associated with the upper extremity, we can see that a large portion of these muscles interact with the radius to some degree.  One example is the Pronator teres, which insert in the middle of the radius and function to pronate the forearm and also assist in flexing the elbow (Palastanga & Soames, 2012).  Additionally, muscles like the Flexor digitorum superficialis, abductor pollicis longus, and extensor pollicis brevis each originate on the radius, with a least a portion of each muscle originating at the middle third of the bone.  When we consider each of these muscles, we can see that a fracture in the middle third of the radius would result in limitations in both elbow movement and movements of the hand.

3. Jordan W

The question asks us to consider a COMPLETE fracture in either the upper, proximal, third or the middle, I assume the middle third, of the radius. This can be quite broad as a proximal third complete fracture could be part of the radial head that articulates with the annular ligament or the articulation with the humerus involved in flexion and extension of the elbow and many other areas. However, a middle third fracture of the shaft basically means the shaft fractures and is displaced. Both can be quite difficult to rehabilitate depending on the exact location, severity, and if the fracture affected other structures. First, the proximal radius articulates with many other structures around the elbow that aid in supination, pronation, flexion, and extension as well as structures like the LCL, radial and median nerve, and radial artery. However, the shaft fracture could affect some of these same nerves and arteries while also affecting the wrist flexor and extensor muscles and tendons depending on the direction of the fracture. With all of this said, Arkader (date unknown) states that there are three common treatments for radial neck (proximal third) fractures which include “closed reduction, to percutaneous assisted reduction, to open treatment.”, while Veillette (2008) states “Non-operative treatment of radial shaft fractures is rare and outcomes of nonsurgical treatment in the past have been poor… Generally, the standard of care for radial shaft fractures is open reduction and internal fixation with 3.5mm dynamic compression plating is the treatment of choice.” I think these are important to consider when we think about the complexity of rehab. A proximal radial fracture could heal with open reduction or percutaneous assisted reduction which is the use of a wire inserted into the arm to help guide the pieces back into place. These could take less time to heal and are less complicated than a shaft fracture as that is more likely an open reduction that would require incisions into the arm and moving or cutting through muscle to get to the bone to then drill and place poles in the radial fragments to realign them.

4. Desiree Brown

In one article by Vikberk et al. (2019), they looked at the effect of resistance training on functional strength and muscle mass in older individuals with pre-sarcopenia. They recruited a predetermined sample size of 72 subjects (34 men and 38 women); yet due to time commitment only 67 subjects was able to finish the 10-week intervention. Requirements to be included was subjects had to be 70-years or older and meet a diagnosis criterion for pre-sarcopenia and sarcopenia laid out by the EWGSOP. In this population this means the range for appendicular lean mass index is 5.69-7.29 for men and 4.50-5.93 for women. Those in the intervention group participated in a 10-week instructor led progressive RT program consisting of three sessions per week for roughly 45 minutes. The control group continued with normal life and assessed after 10 weeks. In the first week, exercises were performed in 2 sets of 12 repetitions each, followed by 3 sets of 10 repetitions each in weeks 2 to 4. In weeks 5 to 7, participants performed 4 sets of 10 repetitions each. In weeks 8 to 10, the focus was on muscle power training using the same exercises, although participants were instructed to perform these exercises with faster muscle contractions. The lean body mass was analyzed using a Lunar iDXA device. Although not stating the average change in LBM, the intervention group seen an increased in LBM by 2.8%.

5. Zachary Lurz

· The individuals taking part in this study were all overweight women in their 20-40’s with a BMI over the obesity stat line. 

· Study was conducted over 8 weeks. 

· There were two different training/diet variables tested in this study. They wanted to see if ketogenic diet helped in the preservation of LBM or inhibited muscle growth. All individuals participated in 60-100min of resistance training twice weekly, while some had different diets compared to others. 

· LBM measurements were taken with a DEXA scanner. 

· They saw that a regular diet would increase LBM (avg. 1.7kg) but not change fat mass. Ketogenic saw no significant changes in LBM but saw a reduction (5.6 kg) in fat mass. 

· One thing to note, was that all participants in the study had to have been sedintary for the previous 6 months. So while the variable tested was diet, the previous 6 month widow plays a huge factor rate of change here. LBM increases about a 1lb/week with individuals and fat mass dropped about 2 lbs/week. 

6. Jala Stewart

Based on the article I found which was called,Branched-chain amino acid supplementation and resistance training maintains lean body mass during a caloric restricted diet. For this study the subjects were 17 males between the ages 21-28. All of the subjects self-reported they were all resistance trained in the last 2 years.There were randomized to a BCAA group or a carbohydrate group.  Each subject for the study performed a pregressive bodybuilding split style resistance training program. The study duration was 8 weeks and they performed 4 days per week. The subjects were prescribed a carbohydrate and calorically restricted diet based on each of their individual data.This diet was considered a cut diet. The BCAA group had to ingest a BCAA supplement and the carbohydrates had to intake a carbohydrate bases supplement. Each subject’s daily caloric and macronutrient intake was determined using the formula known as the Harris Benedict formula. The subjects had diet cards stating their work out days and their off days. For the muscular fitness assessment each subject performed 1RM bench press and 1RM parallel back squat.They were asked to do as many reps at 80% intensity. Following the study, the BCAA group lost fat mass and maintained lean mass while the carbohydrate group lost lean mass and body mass.From the study they also learned that BCAA supplements in an trained individual performing a resistance trained program on a cut diet can maintain lean mass and preserve skeletal muscle performance while losing fat mass.