Publications by authors named "C Couppé"

58 Publications

Chronic hyperglycemia, hypercholesterolemia, and metabolic syndrome are associated with risk of tendon injury.

Scand J Med Sci Sports 2021 May 8. Epub 2021 May 8.

Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg and Frederiksberg and Center for Healthy Aging, Institute of Sports Medicine Copenhagen, University of Copenhagen, Copenhagen, Denmark.

Tendon injury is a considerable problem affecting both physically active and sedentary people. The aim of this study was to examine the relationship between markers for metabolic disorders (hyperglycemia, hypercholesterolemia, and metabolic syndrome) and the risk of developing tendon injuries requiring referral to a hospital. The Copenhagen City Heart Study is a prospective study of diabetic and non-diabetic individuals from the Danish general population with different physical activity levels. The cohort was followed for 3 years via national registers with respect to tendon injuries. Data from 5856 individuals (median age 62 years) were included. The overall incidence of tendon injury in both upper and lower extremities that required an out-patient or in-house visit to a hospital was ~5.7/1000 person years. Individuals with elevated HbA1c (glycated hemoglobin) even in the prediabetic range (HbA1c>5.7%) had a ~3 times higher risk of tendon injury in the lower extremities only, as compared to individuals with normal HbA1C levels. Hypercholesterolemia (total cholesterol>5 mmol/L) increased risk of tendon injury in the upper extremities by ~1.5 times, and individuals with metabolic syndrome had ~2.5 times higher risk of tendon injury in both upper and lower extremities. In conclusion, these data demonstrate for the first time in a large cohort with different physical activity levels that the indicators for metabolic syndrome are a powerful systemic determinant of tendon injury, and two of its components, hyperglycemia and hypercholesterolemia, each independently make tendons susceptible for damage and injury.
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http://dx.doi.org/10.1111/sms.13984DOI Listing
May 2021

Shoulder Rotational Strength Profiles of Danish National Level Badminton Players.

Int J Sports Phys Ther 2021 Apr 1;16(2):504-510. Epub 2021 Apr 1.

Department of Physical Therapy, Bispebjerg Hospital; Institute of Sports Medicine Copenhagen, Bispebjerg Hospital.

Background: Increased age has been shown to be associated with weaker external rotators and stronger internal rotators of the shoulder in pitchers and tennis players. Whether this age-associated change is present in elite badminton players is unknown.

Purpose: To compare the internal and external rotation strength of the shoulder in adolescent and adult elite badminton players.

Study Design: Cross-sectional.

Methods: Thirty-one adolescent (12 females aged 16.8 ± 1.6 years and 19 males aged 17.1 ± 1.6 years) and 29 adult (10 females aged 25 ± 2.9 years and 19 males aged 26.2 ± 4.6 years) national level badminton players were tested pre-seasonally for external rotation (ER) and internal rotation (IR) isometric muscle strength bilaterally, using a hand-held dynamometer. Within-group ER to IR strength ratios were calculated (ER/IR×100%).

Results: The adolescents had stronger shoulder ER than the adults on both sides (p < 0.05). The adult males tended to have stronger IR of the dominant shoulder than the adolescent males (p = 0.071). In the dominant shoulders, the strength ratios for adult females and males were 77% and 78%, respectively, while the same ratio for adolescent females and males were 85% and 99%, respectively. In the non-dominant shoulders, the ER/IR strength ratios for adult females and males were 90% and 87%, respectively, while the ratios for adolescent females and males were 116% and 102%, respectively.

Conclusion: This study is the first to demonstrate that in shoulder injury-free national team badminton players, adolescents have stronger shoulder ER than adults on both sides. Therefore, increased age appears to be associated with weaker shoulder ER muscles in elite badminton players.

Level Of Evidence: 3b.
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http://dx.doi.org/10.26603/001c.21531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016423PMC
April 2021

Acromio-Humeral Distance Is Associated with Shoulder External Strength in National Elite Badminton Players-A Preliminary Study.

Sports (Basel) 2021 Mar 31;9(4). Epub 2021 Mar 31.

Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400 Copehagen, Denmark.

Purpose: To examine acromio-humeral distance (AHD) and shoulder isometric strength for external rotation (ER) and internal rotation (IR) in national elite badminton players.

Methods: Seven elite badminton players with asymptomatic shoulders aged 24 ± 4 (mean ± SD) from the Danish national badminton team were investigated. Shoulder AHD, isometric strength in ER and IR were bilaterally assessed with ultrasonography and a hand-held dynamometer (HHD).

Results: AHD was greater on the dominant vs. the nondominant side ( = 0.018). Moreover, IR strength was greater on the dominant side vs. the nondominant side ( = 0.041). Furthermore, AHD and ER strength were highly correlated on the dominant side ( = 0.007, = 0.900). A correlation was also shown between AHD and the ER/IR strength ratio on the dominant side ( = 0.033, = 0.793).

Conclusion: This preliminary study demonstrates that shoulder ER strength is strongly associated with AHD size, largely reflecting supraspinatus tendon-muscle hypertrophy as a result of sport-specific adaptation in national elite badminton players with asymptomatic shoulders. These novel data also suggest that habitual loading of the shoulder improves the supraspinatus tendon size, which may lower the mechanical stress and potentially reduce the risk of injury. This warrants strengthening the shoulder external rotators as a potential strategy to reduce the risk of future shoulder injury.
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http://dx.doi.org/10.3390/sports9040048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065938PMC
March 2021

Effectiveness of Low-Level Laser Therapy Associated with Strength Training in Knee Osteoarthritis: Protocol for a Randomized Placebo-Controlled Trial.

Methods Protoc 2021 Mar 1;4(1). Epub 2021 Mar 1.

Department of Global Public Health and Primary Care, University of Bergen, 5009 Bergen, Norway.

Physical activity and low-level laser therapy (LLLT) can reduce knee osteoarthritis (KOA) inflammation. We are conducting a randomized placebo-controlled trial to investigate the long-term effectiveness of LLLT combined with strength training (ST) in persons with KOA, since it, to our knowledge, has not been investigated before. Fifty participants were enrolled. LLLT and ST was performed 3 times per week over 3 and 8 weeks, respectively. In the LLLT group, 3 Joules of 904 nm wavelength laser was applied to 15 spots per knee (45 Joules/knee/session). The primary outcomes are pain during movement, at night and at rest (Visual Analogue Scale) and global pain (Knee injury and Osteoarthritis Outcome Score, KOOS) pain subscale. The secondary outcomes are KOOS disability and quality-of-life, analgesic usage, global health change, knee active range of motion, 30 s chair stand, maximum painless isometric knee extension strength, knee pain pressure threshold and real-time ultrasonography-assessed suprapatellar effusion, meniscal neovascularization and femur cartilage thickness. All the outcomes are assessed 0, 3, 8, 26 and 52 weeks post-randomization, except for global health change, which is only evaluated at completed ST. This study features the blinding of participants, assessors and therapists, and will improve our understanding of what occurs with the local pathophysiology, tissue morphology and clinical status of persons with KOA up to a year after the initiation of ST and a higher 904 nm LLLT dose than in any published trial on this topic.
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http://dx.doi.org/10.3390/mps4010019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931026PMC
March 2021

Assessment of content validity and psychometric properties of VISA-A for Achilles tendinopathy.

PLoS One 2021 11;16(3):e0247152. Epub 2021 Mar 11.

Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.

A recent COSMIN review found that the Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire (VISA-A) has flawed construct validity. The objective of the current study was to assess specifically the process of how VISA-A was constructed and validated, and whether the Danish version of VISA-A is a valid patient-reported outcome measure (PROM) for measuring the perceived impact of Achilles tendinopathy. The original item generation strategy for content validity and the process for confirming the scaling properties (construct validity) were examined. In addition, construct validity was evaluated directly using several psychometric methods (Rasch analysis, confirmatory factor analysis (CFA), and multivariable linear regression) in a cohort of 318 persons with Achilles tendinopathy with symptom duration groups ranging from less than 3 months to more than 1 year of chronicity, and a group of 120 healthy persons. We found that the item generation and item reduction in the original construction of VISA-A was based on literature review and clinician consensus with little or no patient involvement. We determined that 1) VISA-A consists of ambiguous conceptual item themes and thus lacks content validity, 2) there was no thorough investigation of the psychometric properties of the original version of VISA-A, which thus lacks construct validity, and 3) rigorous direct assessment of the psychometric properties of the Danish VISA-A revealed inadequate psychometric properties. In agreement with the COSMIN study, we conclude that when used as a single score, VISA-A is not an adequate scale for measuring self-reported impact of Achilles tendinopathy.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247152PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951845PMC
March 2021