International Journal of Sports Physical Therapy最新文献

Hip OA is becoming more common, with a greater number of younger individuals undergoing total hip arthroplasty (THA). These individuals have the desire to return to considerable loading and in some instances return to sport. The purpose of this review was to investigate the current guidelines and/or protocols for hypertrophy or strengthening in individuals who have undergone total hip arthroplasty. A total of 16 papers were identified, some of which also addressed total knee arthroplasty. There is no consensus for the best practice for a hypertrophy program following THA especially regarding when a direct anterior approach was used during hip arthroplasty. Further research is needed as this is a growing area in rehabilitation. This review aims to bridge the gap by offering a comprehensive synthesis of the available literature on postoperative rehabilitation after THA, with a specific emphasis on identifying the most effective muscular strengthening and hypertrophy training programs for patients undergoing anterior approach hip surgery.

Background: The benefit of performing the Nordic Hamstring Exercise (NHE) on an inclined board has been described, however, isometric hamstring activation in different knee and hip angles has not yet been thoroughly explored.

Purpose: This study investigated the effect of variations in knee and hip angles during the isometric performance of the NHE on electromyographic activity of the hamstring muscles.

Study design: Crossover study.

Methods: Thirteen male volunteers performed isometric contractions during the NHE with the knee (30°, 50°, 60°) and the hip (0°, 30°, and 45°) in various angles of flexion on a leg support platform which was inclined at 30°. An electrical goniometer was used to monitor the knee and hip joint angles during 5-s isometric contractions. A multivariate analysis of variance with repeated measures was used to compare normalized electromyographic values of each muscle across different knee and hip angles, followed by pairwise comparisons.

Results: The electromyographic activity of the biceps femoris, semitendinosus, and semimembranosus at a knee angle of 30° and hip angle of 0° were significantly higher than those observed with a knee angle of 50° and hip angle of 0°, or a knee angle of 60° and hip angle of 0° (p<0.05). The electromyographic activity of the semimembranosus at a knee angle of 60° and hip angle of 45° was significantly higher than values obtained with knee and hip angles of 60° and 0°, respectively (p<0.05).

Conclusions: The results indicate that using a knee flexion of 30° and a hip flexion of 0°, while isometrically performing the NHE on a platform inclined at 30°, may optimize electromyographic activity of the hamstrings.

Level of evidence: 3.

Background: Adolescent dancers are at high risk for injuries due to the physical demands of dance training and the physiological changes that occur during adolescence. Though studies report high injury rates, there are few standardized screening tools available for adolescent dancers.

Hypothesis/purpose: To develop and describe a standardized, feasible, evidence-based, and clinically relevant screen for adolescent dancers.

Study design: Descriptive Epidemiology Study.

Methods: Dancers at two suburban pre-professional dance studios, in two cohorts, participated in the Columbia Adolescent Dancer Screen (CADS) that includes dance injury history, health questionnaires (EAT-26, SF-36, DFOS), aerobic capacity, range of motion, strength, balance/orthopedic special tests, and dance technique. Participants were asked to complete a weekly injury surveillance questionnaire derived from the Dance-Specific Oslo Sports Trauma Research Centre Questionnaire on Health Problems for 14 weeks following the screening. Feasibility was assessed using process and content analysis in four areas: practicality, demand, implementation, and adaptation.

Results: Descriptive data were collected from 32 female dancers aged 11-17 with cohort one averaging 18.57 dance hours per week and cohort two averaging 10.6 dance hours per week. The screen was practical, able to screen seven to eight dancers per hour utilizing nine assessors and requiring a one-hour commitment from dancers. Cost and space requirements were considered and kept to a minimum while utilizing portable equipment. All screening slots were filled with all dancers agreeing to follow-up injury surveillance, indicating high demand. The screen was implemented with two cohorts with revisions to improve efficiency applied for the second cohort.

Conclusion: The CADS is a feasible screening tool for adolescent dancers that overcomes barriers by being pragmatic, evidence-based, and efficient. Screening can be implemented to obtain baseline values, inform wellness recommendations, and establish relationships with medical professionals.

Level of evidence: Level 3b.

Accurately diagnosing pectoralis major injuries, particularly in athletes, often presents a challenge for healthcare practitioners. Although pectoralis muscle injuries are relatively uncommon, the diagnosis of a tear may be overlooked without careful screening by a thorough physical examination of both the injured and uninjured sides. While magnetic resonance imaging (MRI) has traditionally held the gold standard, musculoskeletal ultrasound (MSKUS) has emerged as a viable alternative. This article delves into the power of MSKUS in evaluating and diagnosing pectoralis major injuries, highlighting its dynamic capabilities, real-time visualization, and cost-effectiveness in comparison to MRI. By equipping healthcare professionals with a thorough understanding of MSKUS's potential, this article aims to empower them to confidently diagnose and manage pectoralis major injuries, ultimately improving patient outcomes and facilitating a faster return to function.

After anterior cruciate ligament reconstruction (ACLR), return to sprint is poorly documented in the literature. In soccer, return to sprint is an essential component of return to play and performance after ACLR. The characteristics of running in soccer are specific (velocity differences, nonlinear, intensity). It is important to address these particularities, such as curvilinear running, acceleration, deceleration, changes of direction, and variations in velocity, in the patient's rehabilitation program. Force, velocity, and acceleration capacities are key elements to sprint performance. Velocity-based training (VBT) has gained much interest in recent years and may have a role to play in optimizing return to play and return to sprint after ACLR. Force, velocity, and acceleration can be assessed using force-velocity-power and acceleration-speed profiles, which should inform rehabilitation. The purpose of this commentary is to describe a velocity-based return to sprint program which can be used during ACLR rehabilitation.

Deon Bührs, Managing Director of Genie Health SA, on launching a hybrid healthcare delivery model in South Africa.

Anterior cruciate ligament (ACL) tears are one of the most common knee injuries experienced by active individuals engaging in cutting sports. Despite improved surgical techniques and rehabilitation, the return to sport rate and re-tear rates remain unsatisfactory. Lateral extra-articular tenodesis (LET) is a procedure that has been growing in interest when performed in conjunction with ACL reconstruction. The benefits of adding an LET procedure to an ACL surgery may include greater rotational stability, decreased re-tear rates, and improved return to play. Level of evidence: V.

Background: Interval throwing programs (ITP) have been used for decades to enable baseball pitchers to return to competition after injury or surgery by gradually applying load to the throwing arm. Past programs have been based on personal experience; however, advances in our understanding of the biomechanics and workloads of throwing allow for a more modern data-based program to be developed.

Hypothesis/purpose: To 1) develop a updated ITP for rehabilitation of modern baseball pitchers based upon biomechanical and throwing workload data, and 2) compare the updated program with a past program to determine differences in chronic workload and acute:chronic workload ratios (ACWR).

Study design: Cross-sectional study.

Methods: Workloads (i.e. daily, acute, chronic, and ACWR) for the original ITP were built from the prescribed throwing schedule. Elbow varus torque per throw was calculated based upon a relationship between elbow varus torque and throwing distance. Throw counts, daily/chronic/acute workloads, and ACWR were calculated and plotted over time. A new ITP was built to model current pitcher's throwing schedules and gradually increased ACWR over time.

Results: The original ITP had a throwing schedule of 136 days, final chronic workload 15.0, and the ACWR above or below the "safe" range (i.e. 0.7 - 1.3) for 18% of the program with a peak of 1.61. The updated ITP was built to consist of a 217-day schedule, final chronic workload of 10.8, and deviated from the safe range for 9% of the program, with a peak of 1.33.

Conclusion: The newly created ITP is more familiar to modern baseball pitchers while exhibiting a more gradual buildup of chronic workload than traditional ITP programs. This ITP may be used to return baseball pitchers back to competition as safely and efficiently as possible, and potentially with less risk of setbacks or reinjury. The ITP may be used following common injuries or surgeries to the throwing shoulder and elbow, such as Tommy John surgery, while also serving as a basis for future development of shorter duration ITPs.

Level of evidence: 2c.

Background and purpose: Hamstring strength testing is crucial in assessing this important muscle group during rehabilitation and injury prevention. The purpose of this study was to evaluate the reliability and validity of measuring strength in a maximally lengthened position using a handheld dynamometer (HHD) compared to isokinetic testing.

Methods: Twenty healthy and active participants were recruited, and isometric strength testing was performed both on the Biodex machine and isometric end-range hamstring testing with the HHD on two occasions.

Results: Significant strong correlations (r= 0.87, p < 0.0001) were found between strength testing on the Biodex machine and the HHD for both the right and left sides. Bland-Altman plots demonstrated agreement between the two measurements. Excellent intra-rater reliability (ICC= 0.91-0.93) and moderate to good inter-rater reliability (ICC = 0.71-0.83) for the HHD test was demonstrated.

Conclusions: The HHD provides a reliable and valid alternative to isokinetic testing for assessing hamstring strength in a maximally lengthened position. This assessment can be valuable in monitoring rehabilitation progress and detecting deficits before and after returning to play. The HHD is an accessible and cost-effective option for assessing hamstring strength at long lengths in a clinical setting.

Level of evidence: 3.