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A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines. 职业足球运动员外侧踝关节扭伤后的康复算法:基于临床实践指南的方法。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120205
Zacharias Flore, Karen Hambly, Kyra De Coninck, Götz Welsch

Lateral ankle sprain (LAS) is one of the most common types of injury in professional football (soccer) players with high risk of recurrence. The rehabilitation after LAS in professional football players is often still time-based and relies on anecdotal experience of clinicans. There is still a lack of utilization of criteria-based rehabilitation concepts after LAS in professional football. The aims of this clinical commentary are (1) to critically discuss the need for criteria-based rehabilitation concepts after LAS in professional football players, (2) to highlight the current lack of these approaches and (3) to present a novel clinical guideline-based rehabilitation algorithm. Short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS in professional football. Despite consequences for many stakeholders involved (players, teams, clubs, insurers), there is still a lack of of criteria-based, step-by-step approaches. The use of a criteria-based rehabilitation approach might reduce the high recurrence rate after LAS in professional football players and will lead, in turn, to increased long-term player availability. Practical experiences of he authors demonstrate the feasibility of such an approach. The effectiveness of this novel rehabilitation algorithm remains to be evaluated in future studies. Level of Evidence: 5.

外侧踝关节扭伤(LAS)是职业足球运动员最常见的损伤类型之一,复发风险很高。职业足球运动员在外侧踝关节扭伤后的康复治疗通常仍以时间为基础,并依赖于临床医生的轶事经验。在职业足球运动员接受 LAS 治疗后,仍然缺乏基于标准的康复理念。这篇临床评论的目的是:(1)批判性地讨论职业足球运动员LAS术后基于标准的康复理念的必要性;(2)强调目前缺乏这些方法的现状;(3)提出一种新颖的基于临床指南的康复算法。短时间损失(15 天)和高复发率(17%)提出了职业足球运动员 LAS 无足轻重的问题。尽管这对许多利益相关者(球员、球队、俱乐部、保险公司)都有影响,但目前仍缺乏基于标准、循序渐进的方法。使用基于标准的康复方法可能会降低职业足球运动员 LAS 后的高复发率,进而提高球员的长期可用性。作者的实践经验证明了这种方法的可行性。这种新型康复算法的有效性仍有待今后的研究进行评估。证据等级:5.
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引用次数: 0
Enhancing Return to Alpine Skiing: Integrating Perceptual-Motor-Cognitive Considerations in Testing and Progressions: A Clinical Commentary. 提高高山滑雪的恢复能力:将感知-运动-认知因素纳入测试和练习:临床评论。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120285
Conor Smith, Dustin R Grooms, Helen Bradley

Alpine skiing poses significant risks for anterior cruciate ligament (ACL) injury at both recreational and professional levels, which is compounded by high rates of re-injury. Despite the existence of return to sport (RTS) and return to snow protocols, the frequency of ACL re-injury has not been mitigated, raising doubts about protocol effectiveness. Current RTS protocols primarily focus on biomechanical and neuromuscular factors in isolation, neglecting the important perceptual-motor-cognitive changes associated with ACL injuries and the high cognitive demands of skiing. The purpose of this clinical commentary is to address the perceptual-motor-cognitive demands specific to alpine skiing, evaluate RTS testing for skiers, and propose updated standards for testing and return to snow progressions that incorporate these considerations.

Level of evidence: 5.

高山滑雪对休闲和专业水平的前十字韧带(ACL)损伤造成了极大的风险,而再次损伤的高发率又加剧了这一风险。尽管已经制定了重返运动场(RTS)和重返雪场方案,但前十字韧带再次损伤的频率并未降低,这让人对方案的有效性产生了怀疑。目前的恢复训练方案主要关注生物力学和神经肌肉因素,而忽视了与前交叉韧带损伤相关的重要感知-运动-认知变化,以及滑雪运动对认知的高要求。本临床评论旨在探讨高山滑雪运动特有的感知-运动-认知需求,评估滑雪者的 RTS 测试,并结合这些考虑因素提出测试和重返雪场进展的最新标准:5.
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引用次数: 0
Return to Play Assessment After Lateral Ankle Sprains - German Male Elite Youth Football (Soccer) Academy Baseline Data. 外侧踝关节扭伤后重返赛场评估 - 德国男子青年精英足球(足球)学院基线数据。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120201
Zacharias Flore, Götz Welsch, Hendrik Bloch

Background: Lateral ankle sprain (LAS) is one of the most common types of injury in football (soccer). Normative baseline data of performance tests for Return to Play (RTP) decision are still lacking.

Purpose: The primary aim of this study was to generate baseline values for uninjured elite youth football players for a multifactorial RTP assessment and compare with previously published data. A secondary aim was to investigate the use of the Limb Symmetry Index (LSI) as a method to determine whether an athlete passes a performance test or not.

Study design: Observational Cohort study.

Methods: Baseline data of performance tests (Y-Balance [YBT-LQ], Heel Rise [HRT]; Singe Leg Squat [SLST]; Single Leg Drop Jump [SLDJ]; Side Hop [SHT]; Figure of 8 Hop [F-8]; Modified Agility T-Test [MAT]) were assessed in 20 elite youth football players, aged 16-21 years. Additionally, the traditional LSI (dividing the result of the non-dominant leg by the result of the dominant leg and multiplying by 100) and directionally corrected LSI (the worst value is divided by the better value and multiplied by 100) were calculated. The test values were compared to previously reported study results. LSI and side-to-side comparisons between dominant and non-dominant leg sides were analyzed using the Wilcoxon test.

Results: Male elite youth football players achieved better results in the dynamic performance tests (SHT, F-8, and MAT) compared to reference values of the cohorts previously described in the literature: YBT-LQ total score (cm) dominant (dom) 99.3±8.3, non-dominant (ND) 99.5±10.4; HRT (average number) dom. 27.1±5.4, ND 25.2±5.1); SLDJ height (cm) dom 15±5, ND 15±5 and contact time (sec) dom 0.29±0.08, ND 0.29±0.07, Reactive Strength Index (RSI) dom 0.52±0.12, ND 0.50±0.13); SHT (sec) dom 7.12±0.73, ND 7.39±0.93; F-8 (sec) dom 10.52±1.02, ND 10.37±1.04; and MAT (sec) 5.82±0.22. Directionally corrected LSI differed significantly from the traditional calculated LSI (p<0.05).

Conclusion: The findings of this study highlight the need to determine specific baseline data for RTP testing in male elite youth football players after LAS. The traditional LSI should not be used as a "stand alone method" for determining RTP. LSI calculations should consider the direction of asymmetry to determine passing a performance test or not.

Level of evidence: 3b.

背景:外侧踝关节扭伤(LAS)是足球运动中最常见的损伤类型之一。目的:本研究的主要目的是为未受伤的青少年精英足球运动员生成多因素 RTP 评估的基线值,并与之前公布的数据进行比较。研究设计:观察性队列研究:观察性队列研究:方法:对 20 名 16-21 岁的青少年精英足球运动员的成绩测试(Y-平衡 [YBT-LQ]、脚跟抬高 [HRT]、单腿深蹲 [SLST]、单腿下蹲跳 [SLDJ]、侧跳 [SHT]、8 字形跳 [F-8]、修正敏捷性 T 测试 [MAT])基线数据进行评估。此外,还计算了传统 LSI(用非优势腿的结果除以优势腿的结果再乘以 100)和方向校正 LSI(最差值除以较好值再乘以 100)。测试值与之前报告的研究结果进行了比较。使用 Wilcoxon 检验对优势腿侧和非优势腿侧的 LSI 和侧对侧比较进行分析:结果:与之前文献中描述的参考值相比,男性青少年精英足球运动员在动态表现测试(SHT、F-8 和 MAT)中取得了更好的成绩:YBT-LQ总分(厘米)优势(dom)99.3±8.3,非优势(ND)99.5±10.4;HRT(平均数)优势(dom)27.1±5.4,非优势(ND)27.1±5.4。27.1±5.4,ND 25.2±5.1);SLDJ 高度(厘米)dom 15±5,ND 15±5;接触时间(秒)dom 0.29±0.08,ND 0.29±0.07;反应强度指数(RSI)dom 0.52±0.12,ND 0.50±0.13);SHT(秒)dom 7.12±0.73,ND 7.39±0.93;F-8(秒)dom 10.52±1.02,ND 10.37±1.04;MAT(秒)5.82±0.22。经方向校正的 LSI 与传统计算的 LSI 有显著差异(p 结论:本研究的结果突出表明,有必要在 LAS 后确定男性精英青少年足球运动员 RTP 测试的具体基线数据。传统的 LSI 不应作为确定 RTP 的 "独立方法"。LSI 计算应考虑不对称的方向,以确定是否通过性能测试:3b.
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引用次数: 0
Pain Neuroscience Education for Acute Pain 急性疼痛的疼痛神经科学教育
IF 1.7 Q3 Medicine Pub Date : 2024-06-02 DOI: 10.26603/001c.118179
A. Louw, Teresa Schuemann, K. Zimney, E. Puentedura
In musculoskeletal and sports medicine, pain has traditionally been linked to tissue injury, often assuming a linear correlation between tissue damage and pain intensity. However, modern pain science has illuminated the complexity of the human pain experience, incorporating psychosocial elements, nervous system sensitization, immune responses, and structural changes in the brain as factors. This contemporary understanding of pain has proven highly beneficial for both clinicians treating individuals in pain and those experiencing pain. Pain neuroscience education (PNE) provides individuals in pain with an understanding of the underlying neurobiology and neurophysiology of their pain experience, which has been shown to result in decreased self-reported pain, reduced disability, the alleviation of fear and fear-avoidance behaviors, diminished pain catastrophizing, and improved movement. Currently, research on PNE predominantly focuses on interventions with individuals with persistent or chronic pain conditions. However, those who experience acute, sub-acute, and perioperative pain also have the potential for elevated levels of fear, fear-avoidance, and pain catastrophizing, indicating potential benefits from PNE. This invited commentary seeks to inform readers about the latest advancements in pain science and propose a conceptual model for delivering PNE in acute pain experiences. 5
在肌肉骨骼和运动医学中,疼痛历来与组织损伤有关,通常假定组织损伤与疼痛强度之间存在线性关系。然而,现代疼痛科学揭示了人类疼痛体验的复杂性,将社会心理因素、神经系统敏感性、免疫反应和大脑结构变化等因素纳入其中。事实证明,这种对疼痛的现代理解对治疗疼痛患者的临床医生和疼痛患者都非常有益。疼痛神经科学教育(PNE)让疼痛患者了解其疼痛体验的潜在神经生物学和神经生理学,这已被证明可减少自我报告的疼痛、减少残疾、减轻恐惧和恐惧回避行为、减少疼痛灾难化和改善运动。目前,有关 PNE 的研究主要集中在对持续或慢性疼痛患者的干预上。然而,那些经历过急性、亚急性和围手术期疼痛的人也有可能出现恐惧、恐惧回避和疼痛灾难化水平升高的情况,这表明 PNE 有潜在的益处。本特约评论旨在向读者介绍疼痛科学的最新进展,并提出在急性疼痛经历中提供 PNE 的概念模型。5
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引用次数: 0
Fifth World Congress of Sports Physical Therapy Scientific Abstracts 第五届世界运动理疗大会科学摘要
IF 1.7 Q3 Medicine Pub Date : 2024-06-02 DOI: 10.26603/001c.117952
The International Journal of Sports Physical Therapy is pleased to publish abstracts from the 5th World Congress of Sports Physical Therapy, which will take place in Oslo, Norway, June 14-15, 2024. The theme of the Congress is “From Science To Clinical Practice.” The variety of presentations during this congress are examples of the contemporary sports physical therapy research activities taking place around the world. The abstracts presented in the following pages were selected by the Scientific Committee, which included members from the International Federation of Sports Physical Therapy. It should be noted that abstracts have not been reviewed by the Editorial Board, Associate Editors or Editor-in-Chief of the International Journal of Sports Physical Therapy. After careful review by an international team of reviewers, research abstracts will be presented by authors at the World Congress. Each abstract presents only a brief summary of a research project / presentation and does not permit full assessment of the scientific rigor with which the work was conducted. While the abstracts offer only preliminary results that may require further refinement and future validation, they do serve an important role of sharing new research ideas from around the world. This sharing of ideas helps to encourage worldwide dialogue among researchers, clinicians, and educators that will ultimately contribute to the sports physical therapy body of knowledge. Notice: The abstracts below are presented as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors.
国际运动理疗杂志》很高兴刊登将于 2024 年 6 月 14-15 日在挪威奥斯陆举行的第五届世界运动理疗大会的论文摘要。大会的主题是 "从科学到临床实践"。大会期间的各种演讲是世界各地当代运动理疗研究活动的典范。以下介绍的摘要由科学委员会筛选,其中包括国际运动理疗联合会的成员。请注意,摘要未经《国际运动理疗学杂志》编辑委员会、副主编或主编审核。经过国际审稿小组的认真审查,研究摘要将由作者在世界大会上发表。每份摘要仅对研究项目/演讲进行简要概述,无法对工作的科学严谨性进行全面评估。虽然摘要提供的只是初步结果,可能还需要进一步完善和未来验证,但它们在分享世界各地的新研究理念方面确实发挥了重要作用。这种观点共享有助于鼓励研究人员、临床医生和教育工作者之间开展全球性对话,最终为运动理疗知识体系做出贡献。注意事项以下摘要由作者撰写。每篇摘要的准确性和内容均由作者负责。
{"title":"Fifth World Congress of Sports Physical Therapy Scientific Abstracts","authors":"","doi":"10.26603/001c.117952","DOIUrl":"https://doi.org/10.26603/001c.117952","url":null,"abstract":"The International Journal of Sports Physical Therapy is pleased to publish abstracts from the 5th World Congress of Sports Physical Therapy, which will take place in Oslo, Norway, June 14-15, 2024. The theme of the Congress is “From Science To Clinical Practice.” The variety of presentations during this congress are examples of the contemporary sports physical therapy research activities taking place around the world. The abstracts presented in the following pages were selected by the Scientific Committee, which included members from the International Federation of Sports Physical Therapy. It should be noted that abstracts have not been reviewed by the Editorial Board, Associate Editors or Editor-in-Chief of the International Journal of Sports Physical Therapy. After careful review by an international team of reviewers, research abstracts will be presented by authors at the World Congress. Each abstract presents only a brief summary of a research project / presentation and does not permit full assessment of the scientific rigor with which the work was conducted. While the abstracts offer only preliminary results that may require further refinement and future validation, they do serve an important role of sharing new research ideas from around the world. This sharing of ideas helps to encourage worldwide dialogue among researchers, clinicians, and educators that will ultimately contribute to the sports physical therapy body of knowledge. Notice: The abstracts below are presented as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors.","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141273207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Data-Driven Prognosis and Improved Outcomes Part 3: Clinical Intelligence vs. Clinical Wisdom 数据驱动的预后和改善疗效 第 3 部分:临床智能与临床智慧
IF 1.7 Q3 Medicine Pub Date : 2024-06-02 DOI: 10.26603/001c.117949
Gray Cook
{"title":"Data-Driven Prognosis and Improved Outcomes Part 3: Clinical Intelligence vs. Clinical Wisdom","authors":"Gray Cook","doi":"10.26603/001c.117949","DOIUrl":"https://doi.org/10.26603/001c.117949","url":null,"abstract":"","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141228996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Sex and Lateral Ankle Sprain History on Dorsiflexion Range Of Motion Asymmetry During the Weight Bearing Lunge Test. 性别和外侧踝关节扭伤史对负重跳跃测试中背屈运动范围不对称的影响
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117775
Kathrine P Cady, Mark De Ste Croix, Martine Deighan

Background: Reduced dorsiflexion range of motion (DFROM) which is commonly seen following lateral ankle sprain (LAS) has the potential to influence lower extremity biomechanics which have been linked to increased injury risk in the female athlete. Current research on the effect of sex and LAS history on DFROM is limited.

Hypothesis/purpose: This study had three aims 1) to determine the effect of sex, leg dominance and LAS history on DFROM, 2) to determine the effect of sex and LAS history on magnitude of DFROM symmetry and 3) to examine the association of sex on direction (whether dominant or non-dominant limb had the higher DFROM) of symmetry.

Study design: Cross-Sectional Study.

Methods: DFROM was measured bilaterally in 105 recreational athletes all participating in multidirectional sports using the tape measurement method during the weight bearing lunge test (WBLT). A mean of three measurements was used for analysis. A 3-way mixed ANOVA was carried out to determine the interaction between sex, LAS history and leg dominance on DFROM and a 2-way ANOVA for the effect of sex and LAS history on asymmetry. A chi-square test was used to determine the association of sex and direction of asymmetry.

Results: The results indicate no significant effect of sex, LAS history, and leg dominance on DFROM (p=0.65). Main effects were significant for sex and LAS on DFROM. The mean asymmetry for all participants was reported as 12.25±14.76cm. No significant effect of sex and LAS history on magnitude of asymmetry was reported. There was a significant association of sex and direction of asymmetry (χ2(1) = 11.26, p = 0.00). Sixty-five-point two percent of males were shown to have higher DFROM of their non-dominant limb compared to 75% of females who were higher in their dominant limb.

Conclusion: Findings from this study suggest that DFROM is affected by sex and LAS history. While females have increased DFROM compared to males, those with LAS history are more likely to have a decreased DFROM on the involved side. The results also indicate that interlimb asymmetries in DFROM are present in athletes, therefore practitioners should exercise caution when using bilateral comparisons in injury and return to play assessments.

Level of evidence: 2b.

背景:外侧踝关节扭伤(LAS)后常见的背屈活动范围(DFROM)减小可能会影响下肢生物力学,这与女性运动员受伤风险增加有关。假设/目的:本研究有三个目的:1)确定性别、腿部优势和外侧踝关节扭伤史对外侧踝关节扭伤的影响;2)确定性别和外侧踝关节扭伤史对外侧踝关节扭伤对称性大小的影响;3)研究性别对对称性方向(优势肢体或非优势肢体的外侧踝关节扭伤对称性更高)的相关性:研究设计:横断面研究:方法:对 105 名参加多方向运动的休闲运动员进行双侧 DFROM 测量,测量方法是在负重腾跃试验(WBLT)中使用卷尺测量法。采用三次测量的平均值进行分析。进行了三方混合方差分析,以确定性别、LAS历史和腿部优势对DFROM的交互作用,以及性别和LAS历史对不对称的影响的双向方差分析。采用卡方检验来确定性别与不对称方向的相关性:结果表明,性别、LAS历史和腿部优势对DFROM无明显影响(P=0.65)。性别和 LAS 对 DFROM 的主效应显着。所有参与者的平均不对称度为(12.25±14.76)厘米。性别和 LAS 历史对不对称程度无明显影响。性别与不对称方向有明显相关性(χ2(1) = 11.26, p = 0.00)。结果显示,65.2%的男性非优势肢体的DFROM较高,而75%的女性优势肢体的DFROM较高:本研究结果表明,DFROM受性别和LAS病史的影响。与男性相比,女性的 DFROM 增加,而那些有 LAS 病史的人更有可能患侧的 DFROM 减少。研究结果还表明,运动员肢体间的DFROM存在不对称现象,因此从业人员在进行伤病和重返赛场评估时,应谨慎使用双侧比较法。
{"title":"Effect of Sex and Lateral Ankle Sprain History on Dorsiflexion Range Of Motion Asymmetry During the Weight Bearing Lunge Test.","authors":"Kathrine P Cady, Mark De Ste Croix, Martine Deighan","doi":"10.26603/001c.117775","DOIUrl":"10.26603/001c.117775","url":null,"abstract":"<p><strong>Background: </strong>Reduced dorsiflexion range of motion (DFROM) which is commonly seen following lateral ankle sprain (LAS) has the potential to influence lower extremity biomechanics which have been linked to increased injury risk in the female athlete. Current research on the effect of sex and LAS history on DFROM is limited.</p><p><strong>Hypothesis/purpose: </strong>This study had three aims 1) to determine the effect of sex, leg dominance and LAS history on DFROM, 2) to determine the effect of sex and LAS history on magnitude of DFROM symmetry and 3) to examine the association of sex on direction (whether dominant or non-dominant limb had the higher DFROM) of symmetry.</p><p><strong>Study design: </strong>Cross-Sectional Study.</p><p><strong>Methods: </strong>DFROM was measured bilaterally in 105 recreational athletes all participating in multidirectional sports using the tape measurement method during the weight bearing lunge test (WBLT). A mean of three measurements was used for analysis. A 3-way mixed ANOVA was carried out to determine the interaction between sex, LAS history and leg dominance on DFROM and a 2-way ANOVA for the effect of sex and LAS history on asymmetry. A chi-square test was used to determine the association of sex and direction of asymmetry.</p><p><strong>Results: </strong>The results indicate no significant effect of sex, LAS history, and leg dominance on DFROM (p=0.65). Main effects were significant for sex and LAS on DFROM. The mean asymmetry for all participants was reported as 12.25±14.76cm. No significant effect of sex and LAS history on magnitude of asymmetry was reported. There was a significant association of sex and direction of asymmetry (χ2(1) = 11.26, p = 0.00). Sixty-five-point two percent of males were shown to have higher DFROM of their non-dominant limb compared to 75% of females who were higher in their dominant limb.</p><p><strong>Conclusion: </strong>Findings from this study suggest that DFROM is affected by sex and LAS history. While females have increased DFROM compared to males, those with LAS history are more likely to have a decreased DFROM on the involved side. The results also indicate that interlimb asymmetries in DFROM are present in athletes, therefore practitioners should exercise caution when using bilateral comparisons in injury and return to play assessments.</p><p><strong>Level of evidence: </strong>2b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248955","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
Use of Diagnostic Musculoskeletal Ultrasound in the Evaluation of Piriformis Syndrome: A Review for Rehabilitation Providers. 使用诊断性肌肉骨骼超声波评估梨状肌综合症:康复治疗师综述》。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.118145
Robert C Manske, Chris Wolfe, Phil Page, Michael Voight, Beth Bardowski

Piriformis Syndrome (PS) is a neuromuscular condition caused by the entrapment of the sciatic nerve at the level of the piriformis muscle (PM) and can cause significant discomfort and disability. PS is often misdiagnosed due to its overlapping symptoms with other lumbar and sciatic issues and as such, diagnosing PS remains challenging despite recent invasive and non-invasive diagnostic methods. Diagnostic musculoskeletal ultrasound (MSK US) offers a non-invasive, cost-effective alternative for the identification and evaluation of PS, providing dynamic, real-time imaging of the PM and adjacent structures. This article reviews the applications, advantages, and procedural insights of MSK US in the diagnosis of PS, emphasizing its relevance in rehabilitation settings. We discuss the technical aspects of ultrasound use, interpretation of findings, and integration into clinical practice, aiming to enhance the diagnostic accuracy and therapeutic outcomes for patients with suspected PS.

梨状肌综合症(Piriformis Syndrome,PS)是一种神经肌肉疾病,由坐骨神经在梨状肌(Piriformis muscle,PM)处受压引起,可导致严重不适和残疾。由于坐骨神经痛的症状与其他腰部和坐骨神经问题重叠,因此经常被误诊,尽管最近出现了侵入性和非侵入性诊断方法,但诊断坐骨神经痛仍然具有挑战性。诊断性肌肉骨骼超声(MSK US)可为腰椎间盘突出症的鉴别和评估提供一种无创、经济有效的替代方法,它能对腰椎间盘突出症和邻近结构进行动态、实时成像。本文回顾了 MSK US 在 PS 诊断中的应用、优势和程序见解,并强调了其在康复环境中的相关性。我们讨论了超声使用的技术方面、研究结果的解释以及与临床实践的结合,旨在提高疑似 PS 患者的诊断准确性和治疗效果。
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引用次数: 0
Pre- and Post-Operative Pain Intensity and Physical Activity Levels in Individuals with Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Prospective Cohort Study. 接受髋臼周围截骨术的髋臼发育不良患者术前和术后疼痛强度及体力活动水平:一项前瞻性队列研究
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117403
Naif Alrashdi, Robert Motl, Elroy Aguiar, Donald Lein, Suzanne Perumean-Chaney, Michael Ryan, Matthew Ithurburn

Background: Acetabular dysplasia (AD) causes pain, limited function, and development of early hip osteoarthritis. Periacetabular osteotomy (PAO) is a surgical treatment for AD that aims to reposition the acetabulum to reduce pain and improve function.

Purpose: To examine pain recovery and physical activity (PA) before and during the six months after PAO.

Study design: Case series, prospective.

Methods: Individuals with AD scheduled for PAO were enrolled. Pain intensity was evaluated before PAO and at one week and one, three, and six months following PAO. PA levels was evaluated before and six months following PAO using accelerometers (time spent in sedentary behavior, light PA, moderate-to-vigorous PA [MVPA], and daily steps) and the International Physical Activity Questionnaire (IPAQ; time spent in walking and in MVPA). Pain improvements was examined over time following PAO using a repeated-measures one-way ANOVA as well as improvements in PA levels before and six months after PAO using paired-sample t tests. In addition, time spent in MVPA was qualitatively summarized at each time point (before and six months after PAO) measured by both the accelerometers and IPAQ.

Results: Out of 49 screened participants, 28 were enrolled, and 23 individuals (22 females; age=23.1±7.9 years) completed both study visits. Compared to pre-PAO pain, participants reported significant improvements in pain at one month and onward following PAO (p<0.011). However, PA levels at six months following PAO did not differ from pre-PAO PA levels (p>0.05). Qualitatively, participants reported spending more time in MVPA recorded by the IPAQ (pre-PAO=73.3±150.2 mins/day; six-months after PAO=121.2±192.2 mins/day), compared with MVPA recorded by accelerometers (pre-PAO=22.6±25.2 mins/day; six-months after PAO=25.0±21.4 mins/day).

Conclusions: Individuals with AD reported significant pain reduction at one month and up to six months after PAO, but PA levels did not change six months after PAO compared to baseline testing. Future studies should consider examining longitudinal pain recovery and PA improvements over longer periods of time with larger samples of individuals with AD undergoing PAO and identifying modifiable factors to minimize pain and increase PA participation.

Level of evidence: III.

背景:髋臼发育不良(AD)会导致疼痛、功能受限和早期髋关节炎。髋臼周围截骨术(PAO)是一种针对髋臼发育不良的手术治疗方法,旨在重新定位髋臼以减轻疼痛并改善功能:研究设计:病例系列,前瞻性:研究设计:病例系列,前瞻性。在 PAO 前、PAO 后一周及 1、3 和 6 个月时对疼痛强度进行评估。使用加速度计(久坐时间、轻度活动时间、中强度活动时间 [MVPA] 和每日步数)和国际体力活动问卷(IPAQ;步行时间和 MVPA)对 PAO 前和 PAO 后六个月的活动水平进行评估。采用重复测量单因素方差分析研究了 PAO 后疼痛随时间的改善情况,并采用配对样本 t 检验研究了 PAO 前和 PAO 后 6 个月的 PA 水平改善情况。此外,在每个时间点(PAO 前和 PAO 后 6 个月),通过加速度计和 IPAQ 测量的 MVPA 所花费的时间也进行了定性总结:在 49 名经过筛选的参与者中,有 28 人参加了研究,其中 23 人(22 名女性;年龄=23.1±7.9 岁)完成了两次研究访问。与PAO前的疼痛相比,参与者报告PAO后一个月及以后的疼痛明显改善(p/p>0.05)。定性分析显示,与加速度计记录的MVPA(PAO前=22.6±25.2分钟/天;PAO后6个月=25.0±21.4分钟/天)相比,参与者在IPAQ记录的MVPA(PAO前=73.3±150.2分钟/天;PAO后6个月=121.2±192.2分钟/天)上花费了更多时间:结论:注意力缺失症患者在 PAO 后一个月和六个月内疼痛明显减轻,但 PAO 后六个月的水平与基线测试相比没有变化。未来的研究应考虑对接受PAO治疗的更多AD患者样本进行更长时间的纵向疼痛恢复和PA改善情况检查,并确定可改变的因素,以最大限度地减少疼痛和增加PA参与:证据等级:III。
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引用次数: 0
Functional Performance and Tendon Morphology After Operative or Nonoperative Treatment of Achilles Tendon Ruptures. 跟腱断裂手术或非手术治疗后的功能表现和肌腱形态。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117549
Sophie Zhu, Josh Garofalo, Monther Abuhantash, Sheila McRae, Peter MacDonald, Rob Longstaffe, Dan Ogborn

Background: While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon (AT) ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping.

Hypothesis/purpose: The purpose of this study was to determine if functional performance including strength, jumping, and hopping outcomes differed between OM and NOM of acute ATR. The secondary objective was to assess the degree of association between AT morphology and performance outcomes.

Study design: Retrospective cohort with a single prospective evaluation.

Methods: All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance.

Results: Affected limb AT was elongated and thickened (p<0.01), gastrocnemius was atrophied (p< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance.

Conclusions: Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. AT length holds limited explanatory power in plantar flexor strength, although this relationship should be evaluated further.

Level of evidence: Level III.

背景:虽然关于跟腱(AT)断裂(ATR)的手术治疗(OM)与非手术治疗(NOM)的相对益处仍存在争议,但很少有研究对跳跃和跳跃等高冲击力动作的影响进行研究。次要目标是评估AT形态与表现结果之间的关联程度:研究设计:具有单一前瞻性评估的回顾性队列:所有患者均在一家机构的二级医疗中心接受治疗。符合条件的参与者(n=12 OM;12 NOM)在受伤后三周内接受了ATR的OM或NOM治疗,并在ATR后至少20个月接受了评估。通过 B 型超声波对 AT 长度、厚度和腓肠肌厚度进行评估。完成了等速跖屈肌力量、跳跃测试、反向运动和落跳。对所有测试的单侧值进行了双向方差分析,对双侧结果进行了独立t检验,并进行了线性回归以评估归一化AT长度与成绩之间的关系:结果:受累肢体AT变长变粗(p/Conclusions:尽管存在跖屈无力、腓肠肌萎缩和助行肌伸长,但跳跃测试的成绩仍能保持。这可能是代偿运动模式的结果。跖屈肌长度对跖屈肌力量的解释力有限,但这种关系应进一步评估:证据等级:III 级。
{"title":"Functional Performance and Tendon Morphology After Operative or Nonoperative Treatment of Achilles Tendon Ruptures.","authors":"Sophie Zhu, Josh Garofalo, Monther Abuhantash, Sheila McRae, Peter MacDonald, Rob Longstaffe, Dan Ogborn","doi":"10.26603/001c.117549","DOIUrl":"10.26603/001c.117549","url":null,"abstract":"<p><strong>Background: </strong>While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon (AT) ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to determine if functional performance including strength, jumping, and hopping outcomes differed between OM and NOM of acute ATR. The secondary objective was to assess the degree of association between AT morphology and performance outcomes.</p><p><strong>Study design: </strong>Retrospective cohort with a single prospective evaluation.</p><p><strong>Methods: </strong>All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance.</p><p><strong>Results: </strong>Affected limb AT was elongated and thickened (p<0.01), gastrocnemius was atrophied (p< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance.</p><p><strong>Conclusions: </strong>Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. AT length holds limited explanatory power in plantar flexor strength, although this relationship should be evaluated further.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248966","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}
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International Journal of Sports Physical Therapy
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