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A Qualitative Study of Factors Perceived to Influence Physical Activity among Young Athletes after ACL Reconstruction. 关于前交叉韧带重建后年轻运动员认为影响体育锻炼的因素的定性研究。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122324
Christin Zwolski, Timothy Rethorn, Staci Thomas, Jacqueline Goodway, Mark Paterno, Catherine Quatman-Yates, Laura Schmitt

Background: Despite evidence of alarming declines in physical activity levels after anterior cruciate ligament reconstruction (ACLR), very little is known about how young athletes perceive their experiences with engagement in sports and physical activity in the years following ACLR.

Hypothesis/purpose: The purpose of this study was to answer the research question, "what are the lived experiences and perceptions of factors that facilitate or hinder physical activity among young athletes following ACLR?".

Study design: Qualitative Study.

Methods: Ten participants were included in this qualitative study at a median of 5.9 (4.3-10.2) years after adolescent ACLR. Using an interpretive phenomenological methodology, semi-structured interviews were conducted with each participant. Data collection focused on participants' lived experiences related to physical activity participation in the years after ACLR. Iterative coding with two independent coders and a peer debriefing process were used to identify themes from the data.

Results: Factors perceived to influence physical activity after ACLR spanned all levels of the socioecological framework. Three overarching themes were generated during thematic analysis: 1) navigation of barriers (common obstacles, injury-related limitations, unique adaptations), 2) movement motives (ingrained desire to move, external motivators, internal motivation), and 3) movement mindset (envisions for future physical activity, perceived impact of injury, belief in the power of sports).

Conclusion: The themes identified in this study indicate that the adolescent ACLR experience has the potential to significantly influence one's physical activity into young adulthood, both positively and negatively. These findings serve as an important foundation for future studies to explore the psychological and environmental factors identified as important to one's physical activity participation in the years following adolescent ACLR.

Level of evidence: Level 3.

背景:假设/目的:本研究的目的是回答 "前交叉韧带重建术(ACLR)后的年轻运动员对促进或阻碍体育锻炼的因素的生活经验和看法是什么?定性研究:这项定性研究共纳入了 10 名参与者,他们在青少年前交叉韧带损伤后的中位数为 5.9(4.3-10.2)年。采用解释现象学方法,对每位参与者进行了半结构化访谈。数据收集的重点是参与者在前交叉韧带置换术后数年内参与体育活动的生活经历。两位独立的编码员进行了迭代编码,并采用了同伴汇报的方式来确定数据的主题:影响前交叉韧带撕裂术后体育锻炼的因素涉及社会生态框架的各个层面。在主题分析过程中产生了三大主题:1)障碍导航(常见障碍、与受伤有关的限制、独特的适应性);2)运动动机(根深蒂固的运动愿望、外部动机、内部动机);3)运动心态(对未来体育活动的设想、对受伤影响的感知、对运动力量的信念):本研究确定的主题表明,青少年的前交叉韧带损伤经历有可能对其成年后的体育锻炼产生积极或消极的重大影响。这些研究结果为今后的研究奠定了重要的基础,有助于探索对青少年前交叉韧带损伤后几年参加体育活动有重要影响的心理和环境因素:证据等级:3 级。
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引用次数: 0
Dynamic Functional Ability in Lacrosse Players in Relation to Development of Sport-Related Onset of Musculoskeletal Pain. 长曲棍球运动员的动态功能能力与与运动相关的肌肉骨骼疼痛发病的关系。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122323
Zane Thompson, Joseph G Wasser, Kevin R Vincent, Heather K Vincent

Background: Unlike other sports, the relationship between performance deficits and pain/injury in lacrosse players has not been well-investigated.

Purpose: The purposes of this study were to: 1) determine whether age and sex differences exist in dynamic physical function tests and drop jump performance among lacrosse players, and 2) determine whether pre-seasonal physical function scores predict onset of either lower extremity or low back pain over time.

Study design: Prospective observational study.

Methods: Lacrosse players (N=128) were stratified into three groups: 12-14.9 yrs, 15-18 yrs and >18 yrs. Thomas test (hip flexibility), Ober's test (iliotibial band tightness), and Ely's test (rectus femoris tightness) were performed. Landing Error Scoring System (LESS) scores were collected while players performed drop jumps. Sagittal and frontal plane movement from 2D video during single and double legged squats was assessed. Musculoskeletal pain symptoms or injury were tracked for six months. Age bracket, sex and physical function scores were entered into logistic regression models to determine risk factors that predicted onset of lower extremity pain and low back pain onset.

Results: LESS scores and single-leg squat movement quality test scores were lowest in the 12-14.9 yr groups and highest in the >18 yr group (all p<0.05). Single leg squat performance score increased the odds risk (OR) for lower extremity pain (OR=2.62 [95% CI 1.06-6.48], p=.038) and LESS scores elevated risk for low back pain onset over six months (OR = 2.09 [95% CI 1.07- 4.06], p= .031).

Conclusions: LESS scores and single legged squat performance may help identify lacrosse players at risk for musculoskeletal pain or injury onset. Detecting these pertinent biomechanical errors and subsequently developing proper training programs could help prevent lower extremity and low back pain onset.

Level of evidence: III.

背景:目的:本研究的目的是:1)确定长曲棍球运动员在动态身体功能测试和落跳表现方面是否存在年龄和性别差异;2)确定赛季前身体功能评分是否可预测下肢或腰背部疾病的发生:1)确定长曲棍球运动员在动态身体功能测试和落跳成绩方面是否存在年龄和性别差异;2)确定赛季前身体功能评分是否能预测下肢或腰背疼痛的发病时间:研究设计:前瞻性观察研究:将长曲棍球运动员(128 人)分为三组:12-14.9 岁组、15-18 岁组和 18 岁以上组。进行托马斯测试(髋关节柔韧性)、奥伯氏测试(髂胫束紧张度)和伊利氏测试(股直肌紧张度)。在球员进行下蹲跳跃时,收集着陆误差评分系统(LESS)的分数。评估了单腿和双腿深蹲时二维视频中的矢状面和额面运动情况。对肌肉骨骼疼痛症状或受伤情况进行了为期六个月的跟踪调查。将年龄段、性别和身体功能评分输入逻辑回归模型,以确定预测下肢疼痛和腰背痛发病的风险因素:结果:12-14.9 岁组的 LESS 得分和单腿深蹲运动质量测试得分最低,18 岁以上组的得分最高(均为 p 结论:12-14.9 岁组的 LESS 得分和单腿深蹲运动质量测试得分最低,18 岁以上组的得分最高:LESS得分和单腿深蹲表现可能有助于识别有肌肉骨骼疼痛或受伤风险的长曲棍球运动员。检测这些相关的生物力学错误并随后制定适当的训练计划有助于预防下肢和腰背疼痛的发生:证据等级:III.
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引用次数: 0
Are Anthropometric Measures, Range of Motion, or Movement Control Tests Associated with Lumbopelvic Flexion during Barbell Back Squats? 人体测量、运动范围或运动控制测试是否与杠铃后蹲时的腰椎屈曲有关?
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122637
Lars Berglund, Fredrik Öhberg, Edit Strömbäck, Daniel Papacosta

Background: Resistance training with the barbell back squat (BBS) exercise is practiced in sports, recreation, and rehabilitation. Although extensively debated, it is commonly believed and recommended that maintaining a neutral lumbopelvic alignment during BBS is an important technical aspect that might reduce the risk of injury. There is limited knowledge of how objectively measurable factors affect the extent to which the lumbopelvic region moves into flexion during a BBS.

Purpose: The aim of the study was to investigate the association among anthropometric measurements, range of motion in the hips and ankle joints, lumbopelvic movement control tests, and flexion of the lumbopelvic region during execution of the BBS.

Study design: Observational, cross sectional.

Methods: Eighteen experienced powerlifters and Olympic weightlifters were included and measurements of lumbopelvic movements were collected with inertial measurement units during BBS performed at 70 % of 1RM. Examination of anthropometric properties, range of motion in the hip and ankle joints, and lumbopelvic movement control tests were collected as independent variables. Linear regression analysis was used to investigate which independent variables were associated with lumbopelvic flexion during a BBS.

Results: The linear regression showed that a higher range of motion in ankle dorsiflexion could statistically significantly explain an increased amplitude of lumbopelvic flexion during the BBS. Anthropometrics, range of motion of the hips, and performance in lumbopelvic movement control tests did not show any statistically significant associations.

Conclusions: The results suggest that strength and conditioning professionals and clinicians who instruct and assess lifting technique in the BBS and/or use the BBS to assess performance or as an intervention should recognize that a higher range of motion in the ankle joints might affect lumbopelvic flexion during the BBS. In practice, the value of an individual assessment of lifting technique focusing on the goal of the movement should be emphasized.

Level of evidence: 3.

背景:杠铃深蹲(BBS)阻力训练在体育、娱乐和康复中都有应用。尽管存在广泛的争论,但人们普遍认为并建议在进行 BBS 时保持腰椎中立对齐是一个重要的技术方面,可以降低受伤的风险。目的:本研究旨在调查人体测量、髋关节和踝关节的运动范围、腰椎运动控制测试以及在进行 BBS 时腰椎弯曲程度之间的关联:观察、横断面:研究对象包括 18 名经验丰富的力量举运动员和奥林匹克举重运动员,在以 70% 的 1RM 进行 BBS 运动时,使用惯性测量装置收集腰椎运动的测量数据。作为自变量,收集了人体测量特性、髋关节和踝关节的活动范围以及腰盆运动控制测试的检查结果。线性回归分析用于研究哪些自变量与 BBS 期间腰椎屈曲相关:线性回归结果表明,踝关节背屈的运动范围越大,在统计学上就越能解释BBS期间腰椎骨盆屈曲幅度增大的原因。人体测量学、髋关节活动范围和腰椎运动控制测试成绩在统计学上没有显示出任何明显的关联:研究结果表明,力量与调理专业人员以及在BBS中指导和评估举重技术和/或使用BBS评估成绩或作为干预措施的临床医生应认识到,踝关节的运动范围越大,可能会影响BBS中的腰椎屈曲。在实践中,应强调以动作目标为重点的个人移位技术评估的价值:3.
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引用次数: 0
Relationship Between the Results of the Landing Error Scoring System and Trunk Muscle Thickness. 着陆误差评分系统结果与躯干肌肉厚度之间的关系
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122639
Yuki Muramoto, Hironobu Kuruma

Background: A landing error scoring system (LESS) is widely used to evaluate landing maneuvers. Poor landing maneuvers, such as lateral bending of the trunk, are thought to be associated with a risk of lower-extremity injury. However, no studies have examined the association between landing and trunk muscle function, which is associated with a high risk of lower-extremity injury.

Hypothesis/purpose: This study examined whether an association exists between landing movements and a high risk of lower-extremity injury and trunk muscle function. It was hypothesized that athletes with poor activation of deep trunk muscle (transversus abdominis and internal oblique) would have lower LESS scores.

Study design: Cross-sectional study.

Methods: The trunk muscle thickness at rest and during the plank was measured using ultrasonography. The percent of change in muscle thickness (during plank/at rest) was calculated. The LESS was measured using the Physimax. Based on the LESS scores, patients were divided into high- (LESS > 6) and low-risk (5 > LESS) groups for lower extremity injury. The relationship between the high-risk group and trunk muscle thickness was examined using a stepwise regression analysis.

Results: The high-risk group had significantly lower muscle thicknesses of the transversus abdominis (p=0.02) and transversus abdominis plus internal oblique abdominis (p=0.03) muscles during the plank. Additionally, the high-risk group showed significantly lower percent of change in muscle thickness of the internal oblique (p=0.02) and transversus abdominis plus internal oblique (p=0.01) muscles. Only the percentage of change in the thickness of the internal oblique and transverse abdominal muscles was extracted from the regression as a factor.

Conclusion: The findings indicated that athletes with landing movements and a high risk of injury, as determined based on the LESS results, had low trunk muscle function, and a relationship was observed between the change in thickness of transversus abdominis and internal oblique abdominis muscles.

Level of evidence: 3B.

背景:着陆错误评分系统(LESS)被广泛用于评估着陆动作。躯干侧弯等不良着陆动作被认为与下肢受伤的风险有关。假设/目的:本研究探讨了着地动作与下肢受伤高风险和躯干肌肉功能之间是否存在关联。假设躯干深层肌肉(腹横肌和腹内斜肌)激活不良的运动员的 LESS 分数较低:研究设计:横断面研究:研究设计:横断面研究。方法:使用超声波测量静止时和平板支撑时的躯干肌肉厚度。计算肌肉厚度变化的百分比(平板运动时/静止时)。使用 Physimax 测量 LESS。根据 LESS 分数,患者被分为下肢损伤高风险组(LESS > 6)和低风险组(5 > LESS)。采用逐步回归分析法研究了高风险组与躯干肌肉厚度之间的关系:结果:在平板运动中,高危组腹横肌(P=0.02)和腹横肌加腹内斜肌(P=0.03)的肌肉厚度明显较低。此外,高风险组腹内斜肌(p=0.02)和腹横肌加腹内斜肌(p=0.01)的肌肉厚度变化百分比明显较低。只有腹内斜肌和腹横肌的厚度变化百分比作为一个因子被从回归中提取出来:研究结果表明,根据 LESS 结果确定的有落地动作且受伤风险高的运动员,其躯干肌肉功能较低,腹横肌和腹内斜肌的厚度变化之间存在关系:3B.
{"title":"Relationship Between the Results of the Landing Error Scoring System and Trunk Muscle Thickness.","authors":"Yuki Muramoto, Hironobu Kuruma","doi":"10.26603/001c.122639","DOIUrl":"10.26603/001c.122639","url":null,"abstract":"<p><strong>Background: </strong>A landing error scoring system (LESS) is widely used to evaluate landing maneuvers. Poor landing maneuvers, such as lateral bending of the trunk, are thought to be associated with a risk of lower-extremity injury. However, no studies have examined the association between landing and trunk muscle function, which is associated with a high risk of lower-extremity injury.</p><p><strong>Hypothesis/purpose: </strong>This study examined whether an association exists between landing movements and a high risk of lower-extremity injury and trunk muscle function. It was hypothesized that athletes with poor activation of deep trunk muscle (transversus abdominis and internal oblique) would have lower LESS scores.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>The trunk muscle thickness at rest and during the plank was measured using ultrasonography. The percent of change in muscle thickness (during plank/at rest) was calculated. The LESS was measured using the Physimax. Based on the LESS scores, patients were divided into high- (LESS > 6) and low-risk (5 > LESS) groups for lower extremity injury. The relationship between the high-risk group and trunk muscle thickness was examined using a stepwise regression analysis.</p><p><strong>Results: </strong>The high-risk group had significantly lower muscle thicknesses of the transversus abdominis (p=0.02) and transversus abdominis plus internal oblique abdominis (p=0.03) muscles during the plank. Additionally, the high-risk group showed significantly lower percent of change in muscle thickness of the internal oblique (p=0.02) and transversus abdominis plus internal oblique (p=0.01) muscles. Only the percentage of change in the thickness of the internal oblique and transverse abdominal muscles was extracted from the regression as a factor.</p><p><strong>Conclusion: </strong>The findings indicated that athletes with landing movements and a high risk of injury, as determined based on the LESS results, had low trunk muscle function, and a relationship was observed between the change in thickness of transversus abdominis and internal oblique abdominis muscles.</p><p><strong>Level of evidence: </strong>3B.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 9","pages":"1080-1087"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127002","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
Rehabilitation and Return to Sports after Achilles Tendon Repair. 跟腱修复后的康复和重返运动场。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122643
William Marrone, Robert Andrews, Aaron Reynolds, Patrick Vignona, Snehal Patel, Martin O'Malley

Rehabilitation protocols post-Achilles tendon repair vary widely, particularly regarding weight bearing (WB) and immobilization duration, impacting recovery trajectories significantly. This commentary focuses on rehabilitation strategies following acute Achilles tendon repair (ATR), emphasizing early mobilization and progressive loading. Techniques such as blood flow restriction training (BFRT) and progressive loading to restore strength and tendon mechanical properties are discussed in the context of optimizing recovery, minimizing tendon elongation and facilitating safe return to sport (RTS). This manuscript highlights current evidence and clinical insights to guide practitioners in optimizing rehabilitation protocols for athletes recovering from ATR, aiming to improve functional outcomes and support safe return to athletic activity.

跟腱修复术后的康复方案千差万别,尤其是负重(WB)和固定时间的长短,对恢复轨迹影响很大。这篇评论主要关注急性跟腱修复术(ATR)后的康复策略,强调早期活动和逐步负重。文章讨论了血流限制训练(BFRT)和渐进加载等恢复肌力和肌腱机械特性的技术,以优化恢复、减少肌腱伸长并促进安全重返运动场(RTS)。本手稿重点介绍了当前的证据和临床见解,以指导从业人员优化从 ATR 恢复的运动员的康复方案,从而改善功能结果并支持运动员安全重返运动场。
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引用次数: 0
Utilization of Blood Flow Restriction Therapy with a Former Triathlete After Total Knee Arthroplasty: A Case Report. 对一名全膝关节置换术后的前铁人三项运动员使用血流限制疗法:病例报告。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122488
Christopher Keating, Stephanie Muth, Cameron Hui, Lisa T Hoglund
<p><strong>Introduction and purpose: </strong>Knee osteoarthritis (OA) is a common condition that limits function and reduces quality of life. Total knee arthroplasty (TKA) is a surgical procedure that replaces the joint surfaces to address anatomical changes due to knee OA. While TKA improves symptoms and function, postoperative impairments are common, including reduced quadriceps strength. Blood flow restriction (BFR) may be a viable option for patients following TKA, as it can improve strength with a minimal amount of joint loading compared to traditional strength training. The purpose of this case report is to describe the impact of BFR use in an individual after TKA, employing pain measurements, quantitative sensory testing, patient-reported outcome measures, physical performance tests, and muscle strength and power testing to explore potential treatment effects and identify potential predictors of response for future studies.</p><p><strong>Case description: </strong>A 49-year-old former female triathlete with a history of knee injury and arthroscopic surgery underwent a right TKA and sought physical therapy (PT) due to pain, limited range of motion (ROM), and knee instability during weight bearing activity. PT interventions included manual therapy, gait training, and a home program. Despite participating in supervised PT, she had persistent pain, ROM deficits, and muscle weakness 16 weeks following TKA. BFR was incorporated into her home program, 16-weeks postoperatively. The Short Form McGill Pain Questionnaire-2 (SF-MPQ-2) and Numeric Pain Rating Scale (NPRS) were used to measure pain. Quantitative sensory testing included pressure pain threshold (PPT) and two-point discrimination (TPD) to measure change in sensory perception. Patient-reported outcome measures to assess perceived physical function were the Knee injury and Osteoarthritis Outcome Score (KOOS) and the KOOS- Joint Replacement (KOOS-JR). Physical performance was measured through the 30-second fast walk test (30SFW), timed stair climb test (SCT), 30-second chair standing test (CST), and the timed up and go (TUG). Knee ROM was assessed through standard goniometry. Knee extensor and flexor muscle strength and power were measured with an instrumented dynamometer for isokinetic and isometric testing, generating a limb symmetry index (LSI).</p><p><strong>Outcomes: </strong>Pain and quantitative sensory testing achieved clinically meaningful improvement suggesting reduced sensitivity during and after BFR utilization. Perceived physical function and symptoms significantly improved, particularly in sports and recreation activities, and were best captured in the KOOS, not the KOOS-JR. Physical performance reached clinically meaningful improvement in walking speed, chair stand repetitions, and timed stair climb tests after BFR. Isokinetic and isometric strength and power in knee extensors and flexors increased significantly after BFR compared to the uninvolved leg as determined by LSI.</
简介和目的:膝关节骨性关节炎(OA)是一种常见疾病,会限制患者的功能并降低生活质量。全膝关节置换术(TKA)是一种外科手术,通过置换关节表面来解决膝关节 OA 引起的解剖学变化。全膝关节置换术可改善症状和功能,但术后损伤也很常见,包括股四头肌力量减弱。血流限制(BFR)可能是 TKA 术后患者的一个可行选择,因为与传统的力量训练相比,它能以最小的关节负荷提高力量。本病例报告旨在通过疼痛测量、定量感觉测试、患者报告结果测量、体能测试以及肌力和力量测试,描述血流限制对 TKA 术后患者的影响,以探讨潜在的治疗效果,并为今后的研究确定潜在的反应预测因素:一名 49 岁的前铁人三项女运动员,曾有膝关节损伤和关节镜手术史,接受了右侧 TKA 手术,由于疼痛、活动范围(ROM)受限以及负重活动时膝关节不稳定,她寻求物理治疗(PT)。物理治疗干预包括徒手治疗、步态训练和家庭计划。尽管参加了有指导的 PT,但她在 TKA 术后 16 周仍有持续疼痛、活动范围受限和肌肉无力的症状。术后16周,她将BFR纳入了家庭计划。简表麦吉尔疼痛问卷-2(SF-MPQ-2)和数字疼痛评定量表(NPRS)用于测量疼痛。定量感觉测试包括压痛阈值(PPT)和两点辨别率(TPD),用于测量感觉知觉的变化。评估患者身体功能感知的患者报告结果指标包括膝关节损伤和骨关节炎结果评分(KOOS)和KOOS-关节置换(KOOS-JR)。体能通过 30 秒快速行走测试 (30SFW)、定时爬楼梯测试 (SCT)、30 秒椅子站立测试 (CST) 和定时起立行走测试 (TUG) 进行测量。膝关节活动度通过标准动态关节角度计进行评估。膝关节伸肌和屈肌的肌力和力量通过仪器测力计进行等动和等长测试,并生成肢体对称性指数(LSI):结果:疼痛和定量感觉测试取得了有临床意义的改善,表明在使用 BFR 期间和之后敏感性降低。患者的身体功能和症状明显改善,尤其是在体育和娱乐活动中,KOOS 而非 KOOS-JR 最能反映出这一点。使用 BFR 后,步行速度、椅子站立重复次数和定时爬楼梯测试中的体能表现都有了有临床意义的改善。根据 LSI 测定,与未受累腿相比,BFR 后膝关节伸肌和屈肌的等动和等长力量显著增加:在本病例中,BFR 似乎是一种安全且耐受性良好的干预措施。讨论:在这个病例中,BFR 似乎是一种安全且耐受性良好的干预措施,其结果表明,在增加功能、力量、功率和减少疼痛方面,该特定患者在接受 TKA 后可能会受益。全面的疼痛和感觉评估以及临床测量可帮助确定适合在 TKA 术后进行 BFR 的患者。与KOOS-JR相比,KOOS-Sport & Recreation子量表在监测功能恢复方面的反应可能更灵敏,这可能与受试者的运动背景有关:4.
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引用次数: 0
Hip Strength, Change of Direction, and Falls in Recreational Pickleball Players. 休闲皮球运动员的髋部力量、方向变化和跌倒。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122490
Betsy Myers, June Hanks

Background: While a high incidence of pickleball-related falls is reported, little is known regarding factors differentiating persons with and without a fall history during play.

Purpose: This study aimed to determine differences between recreational pickleball players who fell while playing and those who did not. Additional aims were to determine reasons for falling and to investigate associations among assessed factors.

Study design: Cross-sectional study.

Methods: Participants completed a survey reporting age, fall history, and reasons for falling during play. Hip abduction strength, single leg squat form, ankle dorsiflexion, and change of direction time using a modified T-test on a pickleball court (i.e. pickleball T-test) were assessed.

Results: Among the 92 individuals participating in the study, 42% reported a fall while playing and 30% reported falling more than once. Leading reasons for reported falls were lunging and moving backward. Participants who reported falling were significantly older (z = -2.60, p = 0.009) and slower on the pickleball T-test (z = -2.10, p = 0.036) than those who did not report falling. Hip abduction strength was not associated with fall history but was associated with faster time on the pickleball T-test (left rs = -.41, p < 0.001, right rs = -.48, p < 0.001). Single leg squat form and dorsiflexion were not related to fall history.

Conclusion: Falls are common among recreational pickleball players, particularly older players. Fall prevention programs for pickleball players should be considered including multi-directional lunging, lower extremity strength and power development, and change of direction training that includes moving backward.

Level of evidence: 2.

背景:目的:本研究旨在确定在打球时摔倒和没有摔倒的休闲皮球运动员之间的差异。研究设计:横断面研究:研究设计:横断面研究:参与者填写一份调查问卷,报告年龄、跌倒史和在打球时跌倒的原因。评估内容包括髋关节外展力量、单腿下蹲姿势、踝关节外展以及在皮球场上使用改良 T 测试(即皮球 T 测试)改变方向的时间:在参与研究的 92 人中,42% 的人报告在打球时摔倒过,30% 的人报告摔倒过不止一次。摔倒的主要原因是猛冲和向后移动。与未报告摔倒的参与者相比,报告摔倒的参与者年龄明显偏大(z = -2.60,p = 0.009),在皮球 T 测试中速度明显偏慢(z = -2.10,p = 0.036)。髋关节外展力量与跌倒史无关,但与皮球 T 测试时间的快慢有关(左侧 rs = -.41, p < 0.001,右侧 rs = -.48, p < 0.001)。单腿下蹲姿势和背屈与跌倒史无关:结论:摔倒在休闲皮球运动员中很常见,尤其是老年运动员。应考虑为挑球运动员制定跌倒预防计划,包括多方向的肺活量、下肢力量和力量发展,以及包括向后移动在内的改变方向训练。
{"title":"Hip Strength, Change of Direction, and Falls in Recreational Pickleball Players.","authors":"Betsy Myers, June Hanks","doi":"10.26603/001c.122490","DOIUrl":"10.26603/001c.122490","url":null,"abstract":"<p><strong>Background: </strong>While a high incidence of pickleball-related falls is reported, little is known regarding factors differentiating persons with and without a fall history during play.</p><p><strong>Purpose: </strong>This study aimed to determine differences between recreational pickleball players who fell while playing and those who did not. Additional aims were to determine reasons for falling and to investigate associations among assessed factors.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Participants completed a survey reporting age, fall history, and reasons for falling during play. Hip abduction strength, single leg squat form, ankle dorsiflexion, and change of direction time using a modified T-test on a pickleball court (i.e. pickleball T-test) were assessed.</p><p><strong>Results: </strong>Among the 92 individuals participating in the study, 42% reported a fall while playing and 30% reported falling more than once. Leading reasons for reported falls were lunging and moving backward. Participants who reported falling were significantly older (z = -2.60, p = 0.009) and slower on the pickleball T-test (z = -2.10, p = 0.036) than those who did not report falling. Hip abduction strength was not associated with fall history but was associated with faster time on the pickleball T-test (left <i>r<sub>s</sub></i> = -.41, p < 0.001, right <i>r<sub>s</sub></i> = -.48, p < 0.001). Single leg squat form and dorsiflexion were not related to fall history.</p><p><strong>Conclusion: </strong>Falls are common among recreational pickleball players, particularly older players. Fall prevention programs for pickleball players should be considered including multi-directional lunging, lower extremity strength and power development, and change of direction training that includes moving backward.</p><p><strong>Level of evidence: </strong>2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 9","pages":"1116-1125"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126999","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
The Impact of Blood Flow Restriction Training on Tibial Bone Stress Injury Rehabilitation: An Exploratory Case Series. 血流限制训练对胫骨骨应力损伤康复的影响:探索性病例系列。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122641
Andrew P Golden, Kathleen K Hogan, Jamie B Morris, Bryan B Pickens

Background: Lower extremity bone stress injuries (BSI) are common injuries among athletes and military members. Typical management involves a period of restricted weightbearing which can have rapid detrimental effects upon both muscle and bone physiology. Few studies have investigated the effect of blood flow restriction (BFR) training on bone in the rehabilitative setting.

Purpose: The purpose of this study was to investigate the effects of lower extremity exercise with the addition of BFR upon bone mineral density, bone mineral content, and lean body mass in military members with tibial BSIs.

Study design: Case series.

Methods: Twenty military members with MRI-confirmed tibial BSI were recruited to complete lower extremity exercise with the addition of BFR twice per week for four weeks. The BFR cuff was applied proximally to the participant's involved limb while they performed gluteal, thigh, and leg resistance exercises. Outcomes were assessed at baseline and four weeks. The primary outcomes were whole leg bone mineral density (BMD), bone mineral content (BMC), and lean body mass (LM) as measured by dual-energy x-ray absorptiometry. Secondary outcomes included thigh and leg circumference measures and patient-reported outcomes, including the Lower Extremity Functional Scale (LEFS), Patient-Reported Outcomes Measurement Information System 57 (PROMIS-57), and Global Rating of Change (GROC).

Results: No significant differences were found in BMD (p=0.720) or BMC (p=0.749) between limbs or within limbs over time. LM was generally less in the involved limb (p=0.019), however there were no significant differences between or within limbs over time (p=0.404). For thigh circumference, significant main effects were found for time (p=0.012) and limb (p=0.015), however there was no significant interaction effect (p=0.510). No significant differences were found for leg circumference (p=0.738). Participants showed significant mean changes in LEFS (15.15 points), PROMIS physical function (8.98 points), PROMIS social participation (7.60 points), PROMIS anxiety (3.26 points), and PROMIS pain interference (8.39 points) at four weeks.

Conclusion: The utilization of BFR in the early rehabilitative management of tibial BSI may help mitigate decrements in both bone and muscle tissue during periods of decreased physical loading.

Level of evidence: 4.

背景:下肢骨应力损伤(BSI)是运动员和军人中常见的损伤。典型的处理方法包括在一段时间内限制负重,这可能会对肌肉和骨骼生理产生快速的不利影响。目的:本研究旨在调查在下肢运动中加入血流限制(BFR)训练对胫骨骨损伤军人的骨矿物质密度、骨矿物质含量和瘦体重的影响:研究设计:病例系列:研究设计:病例系列。方法:招募 20 名经核磁共振成像证实患有胫骨 BSI 的军人进行下肢锻炼,每周两次,每次增加 BFR,持续四周。在进行臀部、大腿和腿部阻力练习时,将 BFR 袖带套在受试者受累肢体的近端。结果在基线和四周时进行评估。主要结果是通过双能 X 射线吸收测量法测得的整条腿骨矿物质密度 (BMD)、骨矿物质含量 (BMC) 和瘦体重 (LM)。次要结果包括大腿和小腿周长测量以及患者报告结果,包括下肢功能量表(LEFS)、患者报告结果测量信息系统 57(PROMIS-57)和全球变化评分(GROC):肢体间或肢体内的 BMD(p=0.720)或 BMC(p=0.749)随时间变化无明显差异。受累肢体的 LM 通常较少(p=0.019),但随着时间的推移,肢体之间或肢体内部无明显差异(p=0.404)。在大腿围度方面,时间(p=0.012)和肢体(p=0.015)具有显著的主效应,但没有显著的交互效应(p=0.510)。腿围没有发现明显差异(p=0.738)。四周后,参与者的 LEFS(15.15 分)、PROMIS 身体功能(8.98 分)、PROMIS 社会参与(7.60 分)、PROMIS 焦虑(3.26 分)和 PROMIS 疼痛干扰(8.39 分)的平均值均有明显变化:结论:在胫骨 BSI 的早期康复治疗中使用 BFR 可能有助于在身体负荷减少期间减轻骨骼和肌肉组织的损伤:4.
{"title":"The Impact of Blood Flow Restriction Training on Tibial Bone Stress Injury Rehabilitation: An Exploratory Case Series.","authors":"Andrew P Golden, Kathleen K Hogan, Jamie B Morris, Bryan B Pickens","doi":"10.26603/001c.122641","DOIUrl":"10.26603/001c.122641","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity bone stress injuries (BSI) are common injuries among athletes and military members. Typical management involves a period of restricted weightbearing which can have rapid detrimental effects upon both muscle and bone physiology. Few studies have investigated the effect of blood flow restriction (BFR) training on bone in the rehabilitative setting.</p><p><strong>Purpose: </strong>The purpose of this study was to investigate the effects of lower extremity exercise with the addition of BFR upon bone mineral density, bone mineral content, and lean body mass in military members with tibial BSIs.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Methods: </strong>Twenty military members with MRI-confirmed tibial BSI were recruited to complete lower extremity exercise with the addition of BFR twice per week for four weeks. The BFR cuff was applied proximally to the participant's involved limb while they performed gluteal, thigh, and leg resistance exercises. Outcomes were assessed at baseline and four weeks. The primary outcomes were whole leg bone mineral density (BMD), bone mineral content (BMC), and lean body mass (LM) as measured by dual-energy x-ray absorptiometry. Secondary outcomes included thigh and leg circumference measures and patient-reported outcomes, including the Lower Extremity Functional Scale (LEFS), Patient-Reported Outcomes Measurement Information System 57 (PROMIS-57), and Global Rating of Change (GROC).</p><p><strong>Results: </strong>No significant differences were found in BMD (p=0.720) or BMC (p=0.749) between limbs or within limbs over time. LM was generally less in the involved limb (p=0.019), however there were no significant differences between or within limbs over time (p=0.404). For thigh circumference, significant main effects were found for time (p=0.012) and limb (p=0.015), however there was no significant interaction effect (p=0.510). No significant differences were found for leg circumference (p=0.738). Participants showed significant mean changes in LEFS (15.15 points), PROMIS physical function (8.98 points), PROMIS social participation (7.60 points), PROMIS anxiety (3.26 points), and PROMIS pain interference (8.39 points) at four weeks.</p><p><strong>Conclusion: </strong>The utilization of BFR in the early rehabilitative management of tibial BSI may help mitigate decrements in both bone and muscle tissue during periods of decreased physical loading.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 9","pages":"1126-1137"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127003","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
Limitations of Separating Athletes into High or Low-Risk Groups based on a Cut-Off. A Clinical Commentary. 根据临界值将运动员分为高风险组和低风险组的局限性。临床评论。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122644
Justin M Losciale, Linda K Truong, Patrick Ward, Gary S Collins, Garrett S Bullock

Background: Athlete injury risk assessment and management is an important, yet challenging task for sport and exercise medicine professionals. A common approach to injury risk screening is to stratify athletes into risk groups based on their performance on a test relative to a cut-off threshold. However, one potential reason for ineffective injury prevention efforts is the over-reliance on identifying these 'at-risk' groups using arbitrary cut-offs for these tests and measures. The purpose of this commentary is to discuss the conceptual and technical issues related to the use of a cut-off in both research and clinical practice.

Clinical question: How can we better assess and interpret clinical tests or measures to enable a more effective injury risk assessment in athletes?

Key results: Cut-offs typically lack strong biologic plausibility to support them; and are typically derived in a data-driven manner and thus not generalizable to other samples. When a cut-off is used in analyses, information is lost, leading to potentially misleading results and less accurate injury risk prediction. Dichotomizing a continuous variable using a cut-off should be avoided. Using continuous variables on its original scale is advantageous because information is not discarded, outcome prediction accuracy is not lost, and personalized medicine can be facilitated.

Clinical application: Researchers and clinicians are encouraged to analyze and interpret the results of tests and measures using continuous variables and avoid relying on singular cut-offs to guide decisions. Injury risk can be predicted more accurately when using continuous variables in their natural form. A more accurate risk prediction will facilitate personalized approaches to injury risk mitigation and may lead to a decline in injury rates.

Level of evidence: 5.

背景:运动员损伤风险评估和管理是体育运动医学专业人员的一项重要而又具有挑战性的任务。损伤风险筛查的一种常见方法是根据运动员在某项测试中的表现与临界值的比较,将运动员划分为不同的风险组别。然而,伤害预防工作效果不佳的一个潜在原因是过度依赖于使用这些测试和测量方法的任意临界值来确定这些 "高危 "群体。本评论旨在讨论在研究和临床实践中使用临界值的相关概念和技术问题:临床问题:我们如何才能更好地评估和解释临床测试或测量方法,从而对运动员进行更有效的损伤风险评估?临界值通常缺乏强有力的生物合理性支持,而且通常是以数据驱动的方式得出的,因此无法推广到其他样本。当在分析中使用临界值时,信息就会丢失,从而导致潜在的误导性结果和不太准确的损伤风险预测。应避免使用临界值对连续变量进行二分。在原始尺度上使用连续变量是有优势的,因为信息不会被丢弃,结果预测的准确性也不会降低,还能促进个性化医疗的发展:临床应用:鼓励研究人员和临床医生分析和解释使用连续变量的测试和测量结果,避免依赖单一的临界值来指导决策。使用自然形式的连续变量可以更准确地预测受伤风险。更准确的风险预测将有助于采取个性化方法来降低受伤风险,并可能导致受伤率下降:5.
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引用次数: 0
Validity, Agreement and Reliability of the ForceFrame Dynamometer in Patients with Anterior Cruciate Ligament Injury. 前十字韧带损伤患者使用 ForceFrame 测力计的有效性、一致性和可靠性。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122486
Kamilla Arp, Thomas Frydendal, Troels Kjeldsen, Ulrik Dalgas, Signe Timm, Bjarke Viberg, Kim Ingwersen, Claus Varnum
<p><strong>Background: </strong>Restoring maximal muscle strength of the knee extensors (KE) and knee flexors (KF) following anterior cruciate ligament (ACL) injury and ACL reconstruction is of great importance to reduce the re-injury rate after ACL reconstruction and to reduce the risk of knee osteoarthritis. Therefore, it is essential that clinicians and healthcare providers use valid and reliable measures to assess knee muscle strength to ensure a safe return to sport.</p><p><strong>Purpose: </strong>To evaluate the reliability (test-retest reliability, inter-tester reliability and test-retest agreement) and validity (concurrent validity, convergent validity and ForceFrame (FF) vs. isokinetic dynamometer (ID) agreement) of the ForceFrame (FF) dynamometer during isometric testing of the knee extensors and flexors.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Material and methods: </strong>Twenty-seven participants with ACL injury or reconstruction were recruited for participation in this study. maximal voluntary isometric contration (MVIC) of the knee extensors and flexors was tested on two separate days. Day one included validity assessments with FF, a gold-standard ID and a handheld dynamometer (HHD). Day two included reliability assessments with FF performed by two assessors. Main outcome measures were day-to-day test-retest reliability and agreement and inter-tester reliability of FF, and concurrent validity (FF vs. an ID and a HHD). Reliability was tested as test-retest and inter-tester reliability using interclass correlation coefficient (ICC), while agreement was tested using Bland & Altman plots with limits of agreement (LOA), standard error of measurement (SEM) and smallest detectable change (SDC). Concurrent validity between FF, ID, and HHD was assessed using Pearson's correlations and mean difference was evaluated by Bland & Altman plots.</p><p><strong>Results: </strong>Twenty-seven participants (10 females, 17 males) with a median age of 25 years (range 19-60) were included in this study. There was a good day-to-day test-retest reliability for MVIC of KE (ICC=0.77, CI95:0.48-0.90) and KF (ICC=0.83, CI95:0.61-0.92) and excellent inter-tester reliability for MVIC of KE (ICC=0.97, CI95:0.94-0.98) and KF (ICC=0.93, 95CI:0.85-0.97). Standard error of measurement (SEM) was 8% and 9%, while the smallest detectable change (SDC) was 22% and 27% for KE and KF, respectively. FF showed fair concurrent validity compared to ID for KE (r=0.56), poor concurrent validity for knee flexors (KF (r=0.24) and compared to HHD a moderate correlation for KE (r=0.74) and poor correlation for KF (r=0.12). Bland & Altman plots between FF and the ID showed a mean difference of -0.51 Nm/kg for KE and -0.32Nm/kg for KF.</p><p><strong>Conclusions: </strong>FF can be used to obtain reliable and valid results to assess MVIC of the KE, but not the KF. It should be noted that absolute results produced by the FF may be considered an underes
背景:前交叉韧带(ACL)损伤和前交叉韧带重建后,恢复膝关节伸肌(KE)和屈肌(KF)的最大肌力对于降低前交叉韧带重建后的再次损伤率和减少膝关节骨性关节炎的风险非常重要。目的:评估ForceFrame(FF)测力计在膝关节伸肌和屈肌等长测试中的可靠性(重复测试可靠性、测试者间可靠性和重复测试一致性)和有效性(并发有效性、收敛有效性和ForceFrame(FF)与等动测力计(ID)的一致性):研究设计:横断面研究:本研究招募了 27 名前交叉韧带损伤或重建的参与者。在两天内分别对膝关节伸肌和屈肌的最大自主等长收缩(MVIC)进行测试。第一天包括使用 FF、黄金标准 ID 和手持式测力计(HHD)进行有效性评估。第二天包括由两名评估员使用 FF 进行可靠性评估。主要结果指标是 FF 的日间重复测试可靠性、一致性和测试者之间的可靠性,以及并发有效性(FF 与 ID 和 HHD 的对比)。信度采用类间相关系数(ICC)测试重测信度和测试者之间的信度,而一致性则采用布兰德和阿尔特曼图(Bland & Altman plots)测试,图中包含一致性限值(LOA)、测量标准误差(SEM)和可检测到的最小变化(SDC)。FF、ID和HHD之间的并发效度采用皮尔逊相关性进行评估,平均差采用布兰德和阿尔特曼图进行评估:本研究共纳入 27 名参与者(10 名女性,17 名男性),中位年龄为 25 岁(19-60 岁不等)。KE的MVIC(ICC=0.77,CI95:0.48-0.90)和KF(ICC=0.83,CI95:0.61-0.92)的日常测试-重复测试可靠性良好,KE的MVIC(ICC=0.97,CI95:0.94-0.98)和KF(ICC=0.93,95CI:0.85-0.97)的测试者间可靠性极佳。KE和KF的测量标准误差(SEM)分别为8%和9%,而可检测到的最小变化(SDC)分别为22%和27%。与 ID 相比,FF 对 KE 的并发有效性较好(r=0.56),对膝关节屈肌(KF)的并发有效性较差(r=0.24),与 HHD 相比,KE 的相关性中等(r=0.74),KF 的相关性较差(r=0.12)。FF和ID之间的Bland & Altman图显示,KE的平均差异为-0.51牛米/公斤,KF的平均差异为-0.32牛米/公斤:FF可用于获得可靠有效的结果,以评估KE的MVIC,但不能用于KF。应该注意的是,FF 得出的绝对结果可能被认为低估了实际 MVIC。在 FF 中评估 KF 的测试位置似乎不是最佳的,可以考虑不同的测试位置:证据等级:3 级。
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引用次数: 0
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International Journal of Sports Physical Therapy
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