Classifiers of anterior cruciate ligament status in female and male adolescents using return-to-activity criteria

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-30 DOI:10.1002/ksa.12462

Céline I. Girard, Nicholas J. Romanchuk, Michael J. Del Bel, Sasha Carsen, Adrian D. C. Chan, Daniel L. Benoit

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Abstract

Purpose

A lack of standardization exists for functional tasks in return-to-activity (RTA) guidelines for adolescents with anterior cruciate ligament injury (ACLi). Identifying the variables that discern ACLi status among adolescents is a first step in the creation of such guidelines following surgical reconstruction. This study investigated the use of classification models to discern ACLi status of adolescents with and without injury using spatiotemporal variables from functional tasks typically used in RTA guidelines for adults.

Methods

Sixty-four adolescents with ACLi and 70 uninjured adolescents completed single-limb hops, lunges, squats, countermovement jumps and drop-vertical jumps. Jumping distances, heights, and depths were collected. Decision trees (DTs) were used to classify ACLi status and were evaluated using the F-measure (F₁), kappa statistic (ĸ) and area under the precision–recall curve (PRC). Independent t tests and effect sizes were calculated for each important classifier of the DT models.

Results

A five-variable model classified ACLi status with an accuracy of 67.5% (F₁ = 0.6842; ĸ = 0.350; PRC = 0.491) with sex as a classifier. Significant differences were found in three of the four spatiotemporal variables (p ≤ 0.002). Separate models then classified ACLi status in males and females with an accuracy of 53.3% (F₁ = 0.5882; ĸ = 0.0541; PRC = 0.476) and 76.9% (F₁ = 0.7692; ĸ = 0.541; PRC = 0.528), respectively, with significant differences for all variables (p ≤ 0.013).

Conclusions

Among the DT models, females were better able to classify ACLi status compared to males, highlighting the importance of sex-specific rehabilitation guidelines for adolescents.

Level of Evidence

Level III.

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使用恢复活动标准对女性和男性青少年的前十字韧带状况进行分类。

目的：前交叉韧带损伤（ACLi）青少年恢复活动（RTA）指南中的功能任务缺乏标准化。确定青少年前交叉韧带损伤状态的变量是在手术重建后制定此类指南的第一步。本研究调查了分类模型的使用情况，利用时空变量来判别有无损伤青少年的前交叉韧带状态，这些时空变量来自通常用于成人 RTA 指南的功能任务：64名患有前交叉韧带损伤的青少年和70名未受伤的青少年完成了单肢跳、肺活量、深蹲、反向运动跳和垂直落体跳。收集了跳跃距离、高度和深度。使用决策树（DT）对前交叉韧带损伤状态进行分类，并使用F测量（F1）、卡帕统计量（ĸ）和精确度-回忆曲线下面积（PRC）进行评估。针对 DT 模型的每个重要分类器计算了独立 t 检验和效应大小：以性别为分类器，五变量模型对 ACLi 状态的分类准确率为 67.5%（F1 = 0.6842；ĸ = 0.350；PRC = 0.491）。在四个时空变量中，有三个变量存在显著差异（p ≤ 0.002）。然后，单独的模型对男性和女性的 ACLi 状态进行分类，准确率分别为 53.3% (F1 = 0.5882; ĸ = 0.0541; PRC = 0.476) 和 76.9% (F1 = 0.7692; ĸ = 0.541; PRC = 0.528)，所有变量均存在显著差异（p ≤ 0.013）：结论：在DT模型中，与男性相比，女性能更好地对前交叉韧带状态进行分类，这凸显了针对青少年性别制定康复指南的重要性：证据等级：三级

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).