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The Clinical Utility of the Seated Wall Angel as a Test with Scoring. 将 "坐墙天使 "作为一种带评分的测试方法的临床实用性。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123512
Chad Kofoed, Allison Palmsten, Jonathon Diercks, Michael Obermeier, Marc Tompkins, Terese L Chmielewski

Background: The seated wall angel (SWA) is an intervention to improve upper quarter mobility but has not been described as a clinical test with scoring.

Hypothesis/ purpose: To explore the clinical utility of the SWA as a test with scoring. The authors hypothesized that SWA test scores would be lower on the injured than uninjured side, improve over time, and show stronger association with patient-reported shoulder function than shoulder mobility tests.

Study design: Prospective cohort.

Methods: Patients diagnosed with anterior shoulder instability and referred to physical therapy participated. Testing occurred after physical therapy examination (initial) and six weeks later (follow-up). Rehabilitation was not controlled. Testing included clinical tests (SWA, passive shoulder external rotation range of motion, total arc of motion) and patient-reported outcomes including the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, (ASES) and the Western Ontario Shoulder Instability Index (WOSI). The SWA test was scored 0 to 3 points bilaterally based on number of body contacts with the wall (i.e., elbows and fingertips, posterior fingers, posterior forearm). Passive range of motion was measured with a standard goniometer. SWA scores were compared between sides at initial testing and compared between testing timepoints on the injured side. Associations among injured side clinical test values and patient-reported outcome scores were examined.

Results: Mean (SD) SWA score on the injured side was significantly lower than the uninjured side at initial testing [1.6 (1.0) vs 2.2 (1.1), p = 0.045] and significantly increased at follow-up testing [2.4 (1.0), p = 0.041]. Only SWA test score was significantly correlated with ASES (r=0.597) and WOSI (r=-0.648) scores at initial testing, and SWA test score was significantly correlated with WOSI score at follow-up testing (r=-0.611).

Conclusions: The clinical utility of the SWA test is supported by distinguishing the injured and uninjured sides and having stronger associations with patient-reported shoulder function than shoulder mobility tests.

背景:坐壁天使(SWA)是一种改善上半身活动度的干预方法,但尚未被描述为一种带评分的临床测试。假设/目的:探讨SWA作为一种带评分测试的临床实用性。作者假设,与肩关节活动度测试相比,受伤侧的 SWA 测试得分低于未受伤侧,且随着时间的推移会有所改善,并与患者报告的肩关节功能有更强的关联:研究设计:前瞻性队列:研究设计:前瞻性队列研究。测试在理疗检查(初始)和六周后(随访)进行。康复治疗不受控制。测试包括临床测试(SWA、肩关节被动外旋活动范围、总活动弧度)和患者报告结果,包括美国肩肘外科医生标准化肩关节评估表(ASES)和西安大略省肩关节不稳定指数(WOSI)。根据身体与墙壁接触的次数(即肘部和指尖、手指后侧、前臂后侧),SWA 测试的双侧得分从 0 分到 3 分不等。被动活动范围用标准动态关节角度计测量。在初始测试时对两侧的 SWA 评分进行比较,并在受伤一侧的测试时间点之间进行比较。研究了受伤侧临床测试值与患者报告结果评分之间的关联:结果:在初次测试时,受伤侧的平均(标清)SWA 评分明显低于未受伤侧[1.6 (1.0) vs 2.2 (1.1),p = 0.045],而在后续测试时则明显升高[2.4 (1.0),p = 0.041]。在初次测试时,只有SWA测试得分与ASES(r=0.597)和WOSI(r=-0.648)得分有明显相关性,而在后续测试时,SWA测试得分与WOSI得分有明显相关性(r=-0.611):结论:与肩关节活动度测试相比,SWA测试能区分受伤侧和未受伤侧,与患者报告的肩关节功能有更强的相关性,因此具有临床实用性。
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引用次数: 0
Relationship of Physical Factors to the Occurrence of Injuries in Young Gymnasts. 年轻体操运动员受伤与身体因素的关系。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123475
Yuria Kobayashi, Yasuharu Nagano, Makoto Suzukawa

Background: There is a large population of young athletes who participate in gymnastics, and the prevention of injury in junior athletes is considered important. However, few studies have prospectively investigated the relationship between physical factors and the occurrence of injury.

Purpose: To investigate the physical characteristics that are factors in the injury occurrence in elementary and junior high school gymnasts.

Study design: Prospective observational study.

Methods: A total of 36 healthy young gymnasts (at national competition level) were enrolled in the study. Once a week for 23 weeks, injuries were prospectively investigated using self-report questionnaires under the supervision of a research staff. Joint range of motion (hip, ankle, shoulder, and wrist), tightness (Thomas test, Ely test, straight leg raise [SLR], triceps surae, combined abduction test [CAT], horizontal flexion test [HFT]), and muscle elasticity (multifidus) were assessed to compare differences in physical function between injured and non-injured participants.

Results: Injuries occurred most commonly in the wrist (42.1%), lower back (30.2%), and foot (9.5%) among males, whereas heel (22.2%), knee (16.0%), and lower back (12.8%) were the most common injury sites among females. Wrist injuries in male athletes showed decreased shoulder joint range of motion, and lower back injuries showed decreased hip and shoulder joint range of motion. Lower back injuries in female athletes showed decreased hip extension mobility. Heel and knee joint injuries in females also showed increased range of motion and decreased tightness.

Conclusions: The results of this study indicate that the factors related to flexibility differ according to injury location. Further studies are required to clarify the physical factors that influence injury occurrence by examining the effects of the gymnasts' muscle strength, age, individual factors, and left-right differences.

Level of evidence: 3.

背景:参加体操运动的青少年运动员人数众多,预防青少年运动员受伤被认为非常重要。然而,很少有研究前瞻性地调查体能因素与损伤发生之间的关系。目的:调查小学和初中体操运动员损伤发生的体能特征因素:研究设计:前瞻性观察研究:共有 36 名健康的青少年体操运动员(国家级比赛水平)参与研究。在研究人员的监督下,每周一次使用自我报告问卷对受伤情况进行前瞻性调查,为期 23 周。对关节活动范围(髋关节、踝关节、肩关节和腕关节)、紧绷程度(托马斯测试、伊利测试、直腿抬高[SLR]、肱三头肌、联合外展测试[CAT]、水平屈伸测试[HFT])和肌肉弹性(多侧肌)进行了评估,以比较受伤和未受伤参与者在身体功能方面的差异:男性最常受伤的部位是手腕(42.1%)、腰部(30.2%)和脚部(9.5%),而女性最常受伤的部位是脚跟(22.2%)、膝盖(16.0%)和腰部(12.8%)。男性运动员的腕部受伤表现为肩关节活动范围减小,腰部受伤表现为髋关节和肩关节活动范围减小。女性运动员的下背部损伤表现为髋关节伸展活动度下降。女性脚跟和膝关节损伤也表现出活动范围增大和紧绷感减弱:本研究结果表明,与柔韧性有关的因素因受伤部位而异。需要进一步研究体操运动员的肌肉力量、年龄、个体因素和左右差异的影响,以明确影响损伤发生的物理因素:3.
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引用次数: 0
Clinical Utility of Qualitative Change of Direction Movement Assessment in ACL Injury Risk Evaluation. 前交叉韧带损伤风险评估中改变方向运动定性评估的临床实用性。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123483
Evan Andreyo, Casey Unverzagt, Thomas Dos'Santos, J Jay Dawes

Anterior cruciate ligament (ACL) injuries are complex and influenced by numerous internal and external risk factors that should be considered to effectively mitigate injury and facilitate informed return to sport decision-making. Among these risk factors, movement quality exhibited during sport-specific tasks has been identified as a significant predictor of injury occurrence. Particularly, change of direction (COD) movements, when performed with sub-optimal movement quality, such as knee valgus and lateral trunk flexion, are prominent mechanisms of ACL injury in multidirectional sports. Unfortunately, the formal and objective assessment of COD movement quality is underutilized in clinical and sports practice, with existing methods often confined to expensive, sophisticated laboratory settings impractical for everyday clinicians. The purpose of this clinical commentary is to demonstrate the necessity of integrating COD movement assessments to screen for potential ACL injury risk, particularly among higher-risk populations. The authors will review cost-effective and clinic-friendly objective tests used to qualitatively screen COD movements, such as the Cutting Movement Assessment Score and The Expanded Cutting Alignment Tool. Additionally, this commentary will discuss key considerations when assessing COD movement.

Level of evidence: 5.

前十字韧带(ACL)损伤是一种复杂的损伤,受到众多内部和外部风险因素的影响,要想有效减轻损伤并促进做出明智的重返运动场决策,就必须考虑到这些风险因素。在这些风险因素中,在特定运动任务中表现出的运动质量被认为是预测损伤发生的重要因素。尤其是在多方向运动中,如果在运动质量不达标的情况下进行变向(COD)运动,如膝关节外翻和躯干侧屈,是前交叉韧带损伤的主要机制。遗憾的是,在临床和运动实践中,对改变方向运动质量的正式和客观评估并没有得到充分利用,现有的方法往往局限于昂贵、复杂的实验室环境,对日常临床医生来说并不实用。本临床评论的目的是证明综合 COD 运动评估以筛查潜在前交叉韧带损伤风险的必要性,尤其是在高风险人群中。作者将评述用于定性筛查 COD 运动的具有成本效益且便于临床使用的客观测试,如切削运动评估评分和扩展切削对齐工具。此外,本评论还将讨论评估 COD 运动时的主要注意事项:5.
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引用次数: 0
Risk Factors for Musculoskeletal Health: A Review of the Literature and Clinical Application. 肌肉骨骼健康的风险因素:文献综述与临床应用》。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123485
Kyle Kiesel, Kyle Matsel, Garrett Bullock, Todd Arnold, Phil Plisky

Context: Musculoskeletal disorders (MSKD) are currently the leading contributor to disability worldwide. Unlike other prevalent and disabling healthcare conditions such as CVD, risk factors associated with MSKD are not commonly discussed or integrated into current medical practice, rehabilitation practice or wellness programs. The primary purpose of this review is to describe the known risk factors most closely associated with MSKD. The secondary purpose is to propose a clinical model to manage MSK health aimed at maximizing the healthy pursuit of a physically active and healthy lifestyle.

Evidence acquisition: In this review the most common MSKD risk factors, with a focus on those that can be easily screened in clinical practice are presented. The importance of understanding the magnitude and number of risk factors present as well as the multidimensional nature of MSKD risk is discussed.

Results: A total of 11 MSKD risk factors were identified. Most of the risk factors are modifiable, and the evidence associated with modifiability for the most prominent risk factors is reviewed.Researchers have found that often patients are discharged from care with several known MSKD risk factors. In such instances, local pain and dysfunction are managed well, but expanding our rehabilitation care to include comprehensive risk factor management would ultimately benefit the patient and reduce healthcare costs.

Conclusion: The most common MSKD risk factors are discussed and a clinical framework to individualize intervention is proposed. Addressing key risk factors within rehabilitation may be an important step to reduce the enormous and growing burden these disorders are having on society.

Level of evidence: 5.

背景:肌肉骨骼疾病(MSKD)是目前全球致残率最高的疾病。与心血管疾病等其他普遍的致残性疾病不同,与 MSKD 相关的风险因素并未得到普遍讨论,也未被纳入当前的医疗实践、康复实践或健康计划中。本综述的主要目的是描述与 MSKD 关系最密切的已知风险因素。其次是提出一种管理 MSK 健康的临床模式,旨在最大限度地促进人们对积极锻炼和健康生活方式的健康追求:本综述介绍了最常见的 MSKD 风险因素,重点是那些在临床实践中可以轻松筛查的因素。讨论了了解存在的风险因素的程度和数量以及 MSKD 风险的多面性的重要性:结果:共发现了 11 个 MSKD 风险因素。研究人员发现,患者在出院时往往带有几个已知的 MSKD 危险因素。在这种情况下,局部疼痛和功能障碍得到了很好的控制,但将我们的康复护理扩展到包括全面的风险因素管理,最终将使患者受益并降低医疗成本:结论:本文讨论了最常见的 MSKD 危险因素,并提出了个性化干预的临床框架。结论:本文讨论了最常见的 MSKD 危险因素,并提出了个体化干预的临床框架。在康复治疗中解决关键危险因素可能是减少这些疾病对社会造成的巨大且日益增长的负担的重要一步:5.
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引用次数: 0
Physical and Muscular Performance in a Professional Soccer Player with a Posterior Cruciate Ligament Injury Following an Isokinetic Exercise Program: A Case Report. 一名后十字韧带受伤的职业足球运动员在接受等速运动训练后的体能和肌肉表现:病例报告。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123471
Fernanda Qrc Mostagi, Pedro Ac Silva, Giovana R Munaro, Raiane G Marcato, Daniel B Nampo, Gabriel F Santiago, Karen Obara, Jefferson R Cardoso

Background and purpose: The comprehensive treatment for an athlete who sustains a complete posterior cruciate ligament (PCL) injury remains unclear. The purpose of this case report is to describe the effects of an isokinetic exercise program on muscle performance and physical function in a professional soccer player with a PCL injury.

Study design: Case Report.

Case description: A 23-year-old male professional soccer player injured his right knee (non-dominant) during a soccer match, with magnetic resonance imaging confirming a complete PCL rupture. The athlete completed 23 sessions of isokinetic treatment over nine weeks to improve physical function and muscle performance. The concentric mode was used to evaluate quadriceps and hamstrings performance isokinetically at angular velocities of 60 °/s, 120 °/s, and 300 °/s. The LEFS questionnaire was used to evaluate physical function. The assessment occurred before starting the treatment and at the end of nine weeks. An athlete with similar anthropometric characteristics was invited to participate and serve as a control, in order to better understand the athlete's assessment results.

Outcomes: After nine weeks, peak torque normalized to body mass (PT/BM) improved to 4.0 N.m/kg for knee extensors (control: 3.6 Nm/kg) and 2.3 N.m/kg for knee flexors (control: 1.9 Nm/kg) at 60 °/s. This increase in PT was reflected in the hamstrings-to-quadriceps (H:Q) ratio post-treatment (57 %). At the end of treatment, the athlete returned to sports activities with 98.7 % restored physical function as measured by the LEFS (Score: 79 points).

Discussion: The results demonstrated that the isokinetic treatment improved knee functional capacity, with increased PT/BM for knee extensors and flexors and enhanced torque-holding capacity, indicating improved muscle performance.

Level of evidence: 5.

研究背景和目的:对于完全性后交叉韧带(PCL)损伤运动员的综合治疗方法仍不明确。本病例报告旨在描述等速运动项目对一名 PCL 受伤的职业足球运动员的肌肉表现和身体功能的影响:研究设计:病例报告:一名 23 岁的男性职业足球运动员在一次足球比赛中右膝(非主膝)受伤,磁共振成像证实 PCL 完全断裂。为了改善身体功能和肌肉表现,该运动员在九周的时间里完成了 23 次等速运动治疗。采用同心模式评估股四头肌和腘绳肌在 60°/s、120°/s 和 300°/s角速度下的等速运动表现。LEFS 问卷用于评估身体功能。评估在治疗开始前和九周结束时进行。为了更好地了解运动员的评估结果,还邀请了一名具有相似人体测量特征的运动员作为对照:九周后,膝关节伸肌的峰值扭矩(PT/BM)提高到 4.0 牛米/公斤(对照组:3.6 牛米/公斤),膝关节屈肌的峰值扭矩(PT/BM)提高到 2.3 牛米/公斤(对照组:1.9 牛米/公斤),速度为 60°/秒。治疗后,腘绳肌与股四头肌(H:Q)的比率(57%)反映出 PT 的增加。治疗结束后,运动员恢复了体育活动,身体功能恢复了 98.7%,以 LEFS(得分:79 分)来衡量:讨论:结果表明,等动治疗提高了膝关节的功能能力,膝关节伸肌和屈肌的PT/BM增加,扭矩保持能力增强,表明肌肉性能得到改善:5.
{"title":"Physical and Muscular Performance in a Professional Soccer Player with a Posterior Cruciate Ligament Injury Following an Isokinetic Exercise Program: A Case Report.","authors":"Fernanda Qrc Mostagi, Pedro Ac Silva, Giovana R Munaro, Raiane G Marcato, Daniel B Nampo, Gabriel F Santiago, Karen Obara, Jefferson R Cardoso","doi":"10.26603/001c.123471","DOIUrl":"10.26603/001c.123471","url":null,"abstract":"<p><strong>Background and purpose: </strong>The comprehensive treatment for an athlete who sustains a complete posterior cruciate ligament (PCL) injury remains unclear. The purpose of this case report is to describe the effects of an isokinetic exercise program on muscle performance and physical function in a professional soccer player with a PCL injury.</p><p><strong>Study design: </strong>Case Report.</p><p><strong>Case description: </strong>A 23-year-old male professional soccer player injured his right knee (non-dominant) during a soccer match, with magnetic resonance imaging confirming a complete PCL rupture. The athlete completed 23 sessions of isokinetic treatment over nine weeks to improve physical function and muscle performance. The concentric mode was used to evaluate quadriceps and hamstrings performance isokinetically at angular velocities of 60 °/s, 120 °/s, and 300 °/s. The LEFS questionnaire was used to evaluate physical function. The assessment occurred before starting the treatment and at the end of nine weeks. An athlete with similar anthropometric characteristics was invited to participate and serve as a control, in order to better understand the athlete's assessment results.</p><p><strong>Outcomes: </strong>After nine weeks, peak torque normalized to body mass (PT/BM) improved to 4.0 N.m/kg for knee extensors (control: 3.6 Nm/kg) and 2.3 N.m/kg for knee flexors (control: 1.9 Nm/kg) at 60 °/s. This increase in PT was reflected in the hamstrings-to-quadriceps (H:Q) ratio post-treatment (57 %). At the end of treatment, the athlete returned to sports activities with 98.7 % restored physical function as measured by the LEFS (Score: 79 points).</p><p><strong>Discussion: </strong>The results demonstrated that the isokinetic treatment improved knee functional capacity, with increased PT/BM for knee extensors and flexors and enhanced torque-holding capacity, indicating improved muscle performance.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 10","pages":"1244-1254"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship Between Single-Leg Vertical Jump and Drop Jump Performance, and Return to Sports After Primary Anterior Cruciate Ligament Reconstruction Using Hamstring Graft. 使用腘绳肌移植进行原发性前十字韧带重建术后,单腿垂直跳高和落跳成绩与恢复运动能力之间的关系。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123479
Shunsuke Ohji, Junya Aizawa, Kenji Hirohata, Takehiro Ohmi, Tomoko Kawasaki, Hideyuki Koga, Kazuyoshi Yagishita

Background: After anterior cruciate ligament reconstruction (ACLR), asymmetry is likely to persist in single-leg (SL) vertical jump and drop jump performance than in SL hop distance. However, its relationship with the return to sport (RTS) remains unclear.

Hypothesis/purpose: This study aimed to determine the association between vertical jump performance after primary ACLR using hamstring tendon autograft and RTS at a pre-injury competitive level.

Study design: Cross-sectional study.

Methods: Patients who underwent primary ACLR using hamstring tendon autograft were recruited for this study. Participants who returned to pre-injury competition after ACLR were recruited at least eight months postoperatively. Knee condition was assessed, including joint laxity, range of motion, muscle strength, and knee pain intensity during sports activities. Performance variables were also assessed, including SL hop distance, jump height in SL vertical jump, and reactive strength index (RSI; jump height/contact time) in SL drop jump. Participants were asked to subjectively report whether they had returned to the same level of competition as pre-injury and their perceived sport performance intensity. Those who answered "Yes" to the dichotomous question and had a postoperative subjective athletic performance of > 80% were categorized into the Yes-RTS group. The primary outcome was the ability to achieve RTS at the preinjury level.

Results: Sixty-five patients (female, 35; male, 30) at 13.0 (13.0) [median (interquartile)] months after ACLR participated in this study. Thirty-nine (60%) were assigned to the Yes-RTS group. Regarding knee conditions, the No-RTS group had a significantly higher knee pain intensity, as assessed using a numerical rating scale (p<0.001, effect size -0.45). In the performance tests, the No-RTS group exhibited a significantly lower limb symmetry index of RSI during the SL drop jump compared to the Yes-RTS group (p=0.002, effect size 0.81).

Conclusion: Patients unable to achieve RTS after primary ACLR using hamstring grafts are more likely to exhibit asymmetric performance during the SL drop jump test, suggesting the significance of assessing jump symmetry when evaluating post-ACLR rehabilitation success.

Level of evidence: 3c.

背景:前交叉韧带重建(ACLR)后,单腿(SL)立定跳远和下蹲跳远成绩的不对称可能会持续存在,而单腿跳远距离的不对称则会持续存在。假设/目的:本研究旨在确定使用腘绳肌腱自体移植进行初级前交叉韧带重建术后的垂直跳跃成绩与受伤前竞技水平的 RTS 之间的关系:研究设计:横断面研究:本研究招募了使用腘绳肌腱自体移植进行初级 ACLR 的患者。招募在前交叉韧带置换术后至少八个月恢复到受伤前竞技水平的参与者。对膝关节状况进行了评估,包括关节松弛度、活动范围、肌肉力量和运动时膝关节疼痛的强度。此外,还对运动表现变量进行了评估,包括单杠跳远距离、单杠纵跳高度和单杠落跳的反应力量指数(RSI;起跳高度/接触时间)。参与者被要求主观报告他们是否已恢复到受伤前的竞技水平以及他们认为的运动表现强度。对二分法问题回答 "是 "且术后主观运动表现大于 80% 的参与者被归入是-RTS 组。主要结果是达到受伤前水平的 RTS 能力:65名患者(女性,35人;男性,30人)在前交叉韧带置换术后13.0(13.0)[中位数(四分位间)]个月参加了这项研究。39人(60%)被分配到Yes-RTS组。在膝关节状况方面,根据数字评分量表评估,No-RTS 组患者的膝关节疼痛强度明显更高(p 结论:使用腘绳肌移植物进行初级前交叉韧带修复术后无法达到RTS的患者更有可能在SL下蹲跳跃测试中表现出不对称,这表明在评估前交叉韧带修复术后康复成功率时,评估跳跃对称性具有重要意义:3c.
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引用次数: 0
Inferior-Medial Dry Needling at the Thoracolumbar Junction: A Cadaveric Study. 胸腰交界处的下内侧干针疗法:尸体研究。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123477
Christi L Williams, Sue E Curfman, Stacey R Lindsley, Christian R Falyar, Ryan C McConnell

Background: Dry needling (DN) has emerged as a popular therapeutic intervention for managing musculoskeletal pain. While major adverse events are generally rare, those that have been reported in vulnerable areas such as the spine and thorax can be serious and warrant further investigation regarding safe techniques in and around these areas.

Purpose: The purpose of this study was to reproduce the methods employed by Williams et al. but with an inferior-medial multifidus DN technique to determine if a dry needle can penetrate the ligamentum flavum (LF) and breach the spinal canal at the thoracolumbar junction.

Study design: Descriptive Cadaveric study.

Methods: The procedure was performed on a cadaver in the prone position. The needle was advanced under ultrasound guidance to determine if a 0.30 x 40 mm dry needle inserted lateral to the spinous process of T12 and directed inferior-medially could penetrate the LF and enter the spinal canal.

Results: A 0.30 x 40 mm dry needle inserted 1.9 cm lateral to the spinous process of T12 was able to traverse the space between the vertebral laminae of T12 and L1, penetrate the LF, and enter the spinal canal with an inferior-medial needle angulation of 33-degrees medial and 18-degrees inferior.

Conclusion: The results of this study demonstrate the feasibility of a dry needle entering the spinal canal at the thoracolumbar junction using an inferior-medial technique. These findings support the potential role of ultrasound guidance in the training and clinical practice of DN, especially in regions where safety issues have been documented.

Level of evidence: Level IV.

背景:干针疗法(DN)已成为一种治疗肌肉骨骼疼痛的流行疗法。目的:本研究的目的是重现威廉姆斯等人采用的方法,但采用下内侧多裂肌 DN 技术,以确定干针是否能穿透黄韧带 (LF) 并在胸腰椎交界处突破椎管:研究设计:尸体描述性研究:方法:对一具尸体进行俯卧位手术。在超声引导下推进针头,以确定 0.30 x 40 毫米干针插入 T12 脊柱棘突外侧并指向内下方是否能穿透 LF 并进入椎管:结果:0.30 x 40 毫米干针插入 T12 椎棘突外侧 1.9 厘米处,能够穿过 T12 和 L1 椎板之间的间隙,穿透 LF,并以内侧 33 度、外侧 18 度的下-中角度进入椎管:本研究结果表明,干针采用下-内侧技术进入胸腰椎交界处的椎管是可行的。这些研究结果支持了超声引导在 DN 培训和临床实践中的潜在作用,尤其是在存在安全问题的地区:证据等级:IV 级。
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引用次数: 0
Rehabilitation Protocol Variability Following Arthroscopic Bankart Repair and Remplissage for Management of Anterior Shoulder Instability: A Systematic Review. 关节镜下 Bankart 修复和再植术治疗肩关节前方失稳后的康复方案变异性:系统回顾
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123481
Juan B Villarreal-Espinosa, Michael M Reinold, Mohammad Khak, Mohammad J Shariyate, Carol Mita, Jeffrey Kay, Arun J Ramappa

Background: Augmentation of an arthroscopic Bankart repair with the remplissage (ABR) procedure has shown to confer a decrease in recurrence rates, yet, at the expense of potentially compromising shoulder motion.

Purpose/hypothesis: The purpose was to examine clinical studies that described a post-operative rehabilitation protocol after an arthroscopic Bankart repair and remplissage procedure. It was hypothesized that a review of the literature would find variability among the studies and that, among comparative studies, there would be a limited distinction from protocols for isolated Bankart repairs.

Study design: Systematic Review.

Materials and methods: A search was conducted using three databases (PubMed, EMBASE, and CINAHL) according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The following terms were combined while utilizing Boolean operators: (Bankart lesion OR labral tear) AND (remplissage). Studies evaluating patients after arthroscopic stabilization for unidirectional anterior glenohumeral instability with the addition of the remplissage procedure and at least 1 year follow-up were included for analysis.

Results: A total of 41 studies (14 Level IV, 24 Level III, 2 Level II, and 1 Level I) were included with a total of 1,307 patients who underwent ABR. All patients had <30% glenoid bone loss and a range of 10-50% humeral head size Hill-Sachs lesion. Type and position of immobilization were the most reported outcomes (41/41) followed by time of immobilization (40/41). Moreover, 23/41 studies described their initial post-operative shoulder range of motion restrictions, while 17/41 specified any shoulder motion allowed during this restrictive phase. Time to return to sport was also described in 37/41 of the retrieved studies. Finally, only two of the 27 comparative studies tailored their rehabilitation protocol according to the specific procedure performed, underscoring the lack of an individualized approach (i.e. same rehabilitation protocol for different procedures).

Conclusion: The results of the present systematic review expose the variability among rehabilitation protocols following ABR. This variability prompts consideration of the underlying factors influencing these disparities and underscores the need for future research to elucidate optimal rehabilitation. Based on the results of this systematic review and the senior authors´ clinical experience, a rehabilitation approach similar to an isolated Bankart repair appears warranted, with additional precautions being utilized regarding internal rotation range of motion and external rotation strengthening.

Level of evidence: Level 3.

背景:在关节镜下进行Bankart修复术后再植术(ABR)可降低复发率,但其代价是可能会影响肩关节的活动:目的/假设:旨在研究描述关节镜下 Bankart 修复和再接合术后康复方案的临床研究。假设文献综述会发现各研究之间存在差异,并且在比较研究中,与孤立的 Bankart 修复术方案之间的差异有限:研究设计:系统综述:根据系统性综述和荟萃分析首选报告项目(PRISMA)指南,使用三个数据库(PubMed、EMBASE 和 CINAHL)进行了检索。在使用布尔运算符时,将以下术语进行了组合:(Bankart病变或唇裂) AND (remplissage)。纳入分析的研究评估了单向盂肱关节前侧不稳定的关节镜稳定术后患者的情况,并增加了remplissage术,且随访至少1年:共纳入 41 项研究(14 项 IV 级研究、24 项 III 级研究、2 项 II 级研究和 1 项 I 级研究),共有 1307 名患者接受了 ABR。所有患者都有结论:本系统综述的结果揭示了 ABR 术后康复方案之间的差异。这种差异促使人们考虑影响这些差异的潜在因素,并强调了未来研究阐明最佳康复方案的必要性。根据本系统综述的结果和资深作者的临床经验,似乎有必要采用类似于孤立Bankart修复术的康复方法,并在内旋活动范围和外旋加强方面采取额外的预防措施:证据等级:3 级。
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引用次数: 0
Relationship between Peak Eccentric Force during the Nordic Hamstring Exercise and One Repetition Maximum Deadlift Performance. 北欧式腘绳肌训练中的峰值偏心力与单次最大举重成绩之间的关系。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.123473
Satoru Nishida, Wataru Ito, Taisuke Ohishi, Riku Yoshida, Shigeru Sato, Masatoshi Nakamura

Background: The Nordic hamstring exercise (NHE) is useful for preventing hamstring strain injuries. However, its adoption rates in the sports field are currently low, necessitating a safe and efficient introduction.

Hypothesis/purpose: The purpose was to examine the relationship between the eccentric force during the NHE and the one repetition maximum of deadlift. It was hypothesized that the eccentric force during the NHE would be correlated with the one repetition maximum (1RM) of the deadlift.

Study design: Cross-sectional study.

Methods: Healthy student rugby players with no history of hamstring tears were recruited to participate. The peak eccentric forces during the NHE, which is the vertical peak force on the part holding the leg, were measured in both legs, while gradually leaning forward to a prone position over three seconds. The 1RM of deadlift was calculated from the weight that could be raised three times during a deadlift (x kg) using the estimated formula (x kg / 0.93). The correlation between the left and right peak eccentric forces during the NHE, the total left and right forces, and the 1RM of the deadlift was examined using Spearman's rank correlation coefficient, with all values corrected for body mass.

Results: During the NHE, the peak eccentric force of the right and left legs and the total peak eccentric force of both legs were 3.8 ± 1.1 N/BM, 3.8 ± 1.2 N/BM, and 7.6 ± 2.1 N/BM, respectively. The 1RM of deadlift was 1.9 ± 0.3 kg/BM. Weak correlations (r = 0.34-0.37) were found between the 1RM of the deadlift and the peak eccentric force in the right and left legs and the total peak eccentric force of both legs.

Conclusion: The present study revealed a weak correlation between the peak eccentric force during the NHE and 1RM of deadlift.

Level of evidence: 2c.

背景:北欧腿筋运动(NHE)有助于预防腿筋拉伤。假设/目的:本研究旨在探讨北欧式腿筋运动中的偏心力与举重单次最大重量之间的关系。假设 NHE 时的偏心力与负重举的单次最大重量(1RM)相关:方法:招募无腿筋撕裂史的健康学生橄榄球运动员参加。测量两条腿在 NHE 期间的偏心峰值力(即握腿部位的垂直峰值力),同时逐渐前倾至俯卧姿势,持续三秒钟。负重举起的 1RM 是根据负重举起三次所能举起的重量(x 千克),用估算公式(x 千克/0.93)计算得出的。使用斯皮尔曼等级相关系数检验了NHE期间左右偏心力峰值、左右总力量和负重举的1RM之间的相关性,所有数值均根据体重进行了校正:在NHE过程中,左右腿的偏心力峰值和双腿的偏心力总峰值分别为3.8±1.1 N/BM、3.8±1.2 N/BM和7.6±2.1 N/BM。举重的 1RM 为 1.9 ± 0.3 kg/BM。研究发现,负重举的 1RM 与左右腿的偏心力峰值以及双腿的偏心力总峰值之间存在微弱的相关性(r = 0.34-0.37):本研究揭示了NHE时的偏心力峰值与负重举的1RM之间的微弱相关性。
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引用次数: 0
Injury Patterns in Fencing Athletes - A Retrospective Review. 击剑运动员的受伤模式--回顾性综述。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122322
Emily R Cross, Sloane M Lynch, Patricia E Miller, Danielle L Hunt, Cynthia J Stein

Background: Fencing is a unique and increasingly popular sport, but limited data exist regarding related injuries.

Purpose: To examine the types of injuries incurred by fencing athletes, and to analyze associations between age, sex, and hand dominance with type and location of injury.

Study design: Cross-sectional.

Methods: Retrospective chart reviews were performed to evaluate fencing related injuries in athletes evaluated in the sports medicine and orthopedic clinics of a large teaching hospital.

Results: One hundred and eighty-six patients (98 male, 88 female) were included. Average age at time of injury was 14.6 years (range 9 - 32 years). 73% of injuries involved the lower extremity, 16% involved the upper extremity and 10% affected the back. In the lower extremity, the knee (49%), ankle (16%) and hip (11%) were most commonly affected. 80% of injuries were treated with physical therapy. Only 5% required surgical intervention. Injuries of both upper and lower extremities were more commonly seen on the athlete's dominant side, and the majority of injuries (77%) occurred in athletes 13 years or older.

Conclusion: The majority of injuries in these fencing athletes affected the lower extremity, most commonly the knee. Extensor mechanism dysfunction, primarily patellofemoral pain, was the most common diagnosis. Hand dominance, patient age, and patient sex did affect different injury characteristics.

Level of evidence: 2b.

背景:目的:研究击剑运动员受伤的类型,分析年龄、性别、手部优势与受伤类型和部位之间的关系:研究设计:横断面:方法:对病历进行回顾性分析,评估一家大型教学医院运动医学和骨科门诊中接受评估的运动员中与击剑相关的损伤:结果:共纳入 186 名患者(98 名男性,88 名女性)。受伤时的平均年龄为 14.6 岁(9 - 32 岁不等)。73%的受伤部位为下肢,16%为上肢,10%为背部。在下肢受伤中,膝关节(49%)、踝关节(16%)和髋关节(11%)最常见。80%的受伤者接受了物理治疗。只有 5%需要手术治疗。上肢和下肢的损伤更常见于运动员的优势侧,大多数损伤(77%)发生在 13 岁或以上的运动员身上:结论:这些击剑运动员的大部分损伤都发生在下肢,最常见的是膝关节。伸展机制功能障碍,主要是髌骨股骨痛,是最常见的诊断。手部优势、患者年龄和患者性别确实会影响不同的损伤特征。
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引用次数: 0
期刊
International Journal of Sports Physical Therapy
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